This document outlines the infection prevention and control advice for healthcare workers involved in receiving, assessing and caring for patients who are a possible or confirmed case of COVID-19. It is based on the best evidence available from previous pandemic and inter-pandemic periods and focuses on the infection prevention and control aspects of this disease only, recognising that a preparedness plan will consider other counter measures.
The infection prevention and control advice in this document is considered good practice in response to this COVID-19 pandemic.
N.B. The emerging evidence base on COVID-19 is rapidly evolving. Further updates may be made to this guidance as new detail or evidence emerges.
Author(s): Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS), Public Health England
Edition: 1.0
Year: 2020
Language: English
Tags: COVID-19; Coronavirus
Abbreviations ................................................................................................................... 5
Glossary ........................................................................................................................... 5
1. Introduction ............................................................................................................. 6
1.1 Scope and purpose ........................................................................................... 6
2. Transmission characteristics of COVID-19 and principles of infection prevention and control ........................................................................................... 7
2.1 Routes of transmission ..................................................................................... 7
2.2 Incubation and infectious period ....................................................................... 8
2.3 Survival in the environment ............................................................................... 8
3. Organisational preparedness for preventing and controlling COVID-19 ......... 10
4. Infection prevention and control precautions .................................................. 12
4.1 Standard infection control precautions (SICPs) definition ............................... 12
4.2 Transmission Based Precautions (TBPs) definition ........................................ 12
4.3 Routes of transmission: .................................................................................. 12
5. Standard infection control precautions (SICPs) ................................................. 14
5.1 Patient placement/assessment for infection risk ............................................. 14
5.2 Hand hygiene.................................................................................................. 14
5.3 Respiratory and cough hygiene – ‘Catch it, bin it, kill it’ .................................. 15
5.4 Personal Protective Equipment (PPE) ............................................................ 16
5.4.1 Disposable apron/gown ....................................................................... 17
5.4.2 Disposable gloves ............................................................................... 17
5.4.3 Eye protection/Face visor .................................................................... 17
5.5 Safe management of linen (laundry) ............................................................... 18
5.6 Staff uniforms/clothes ..................................................................................... 19
5.7 Management of blood and body fluid spills ..................................................... 19
5.8 Management of healthcare (including clinical) and non-clinical waste ............ 19
6. Transmission based precautions (TBPs) for COVID-19 .................................... 20
6.1 Duration of precautions ................................................................................... 20
6.2 Segregation and cohorting (inpatient settings) ............................................... 21
6.2.1 Negative pressure isolation rooms ...................................................... 21
6.2.2 Single rooms ........................................................................................ 21
6.2.3 Cohort areas ........................................................................................ 21
6.2.4 Staff cohorting ..................................................................................... 22
6.2.5 Visitors to segregated/cohort areas ..................................................... 22
6.3 Patient transfers and transport ........................................................................ 23
6.3.1 Intra-hospital transfers: ........................................................................ 23
6.3.2 Transfer from primary care/community settings: .................................. 23
6.3.3 Inter-hospital transfers: ........................................................................ 23
6.4 Personal protective equipment (PPE) ............................................................. 24
6.4.1 Fluid resistant (Type IIR) surgical face masks (FRSM)........................ 24
6.4.2 Filtering face piece (class 3) (FFP3) respirators .................................. 26
6.5 Aerosol-generating procedures (AGPs) .......................................................... 28
6.6 Management of equipment and the care environment .................................... 29
6.6.1 Equipment ........................................................................................... 29
6.6.2 Environment ........................................................................................ 30
6.7 Care of the deceased ..................................................................................... 31
7. Occupational health and staff deployment ......................................................... 32
8. Specific settings.................................................................................................... 33
8.1 Care home settings ......................................................................................... 33
8.2 Primary care ................................................................................................... 33
8.3 Outpatient settings .......................................................................................... 34
8.4 Dental surgeries .............................................................................................. 34
8.5 Home visits ..................................................................................................... 34
8.6 Ambulances .................................................................................................... 34
8.7 Emergency departments and acute assessment units ................................... 35
8.7.1 Screening and triage ........................................................................... 35
8.7.2 Reception area .................................................................................... 35
Appendix 1 – Best practice how to hand wash ........................................................... 37
Appendix 2 – Best Practice How to hand rub ............................................................. 38
Appendix 3 – Best Practice - Putting on and taking off PPE ..................................... 39
Appendix 4: Routine decontamination of reusable non-invasive patient care equipment .............................................................................................................. 40
Appendix 5 – Best Practice - Management of blood and body fluid spillages ......... 41
Appendix 6: Facial hair and FFP3 respirators ............................................................. 42
References ..................................................................................................................... 49
