The Ministry of Health & Family Welfare has issued a revised advisory for managing Health Care Workers (HCWs) working in Covid and Non-Covid areas of Health Care Facilities.
According to the advisory, the health workforce is a valuable resource for the country. The health care personnel working in hospitals are at increased risk of acquiring the Covid-19 disease, if there is a breach in the personal protection while managing patients. It is important to ensure proper advisory to protect HCWs, particularly in the context of safety from Healthcare Associated Infections (HAIs) while managing Covid-19.
The advisory provided institutional mechanism for preventing and responding to Healthcare Associated Infections (HAIs) among HCWs.
All health facilities shall activate its Hospital Infection Control Committee (HICC). The HICC in the health facility is responsible for implementing the Infection Prevention and Control (IPC) activities and organizing regular training on IPC for HCWs.
A Nodal Officer (Infection Control Officer) shall be identified by each health facility to address all matters related to Healthcare Associated Infections (HAIs). With reference to preventing such infection among healthcare workers, the nodal officer will ensure that:
i. Healthcare workers in different settings of hospitals shall use PPEs appropriate to their risk profile.
ii. All healthcare workers have undergone training on Infection Prevention and Control and they are aware of common signs and symptoms, need for self-health monitoring and need for prompt reporting of such symptoms.
iii. Provisions have been made for regular (thermal) screening of all hospital staff.
iv. All HCWs are vaccinated with 2 doses of the COVID vaccine and also take the precautionary third dose as per prescribed protocol.
v. Provisions have been made for prompt reporting of breach of PPE by the hospital staff and follow-up action.
Action for Healthcare Workers , the Advisory states:-
i. Ensure that all preventive measures like frequent washing of hands/use of alcohol based hand sanitizer, respiratory etiquette (using tissue/handkerchief while coughing or sneezing), etc. are followed at all times.
ii. Appropriate PPE is used at all times while on duty.
iii. A buddy system* to be followed to ensure that there is no breach in infection prevention control practices.
iv. Any breach in PPE and exposure is immediately informed to the nodal officer/HoD of the department
v. HCWs after leaving the patient care units (wards/OPDs/ICUs) at the doctor’s duty rooms/hostels/canteen or outside the HCF must follow physical distancing and masking to prevent transmission to/acquiring infection from other HCWs who may be positive.
vi. Pregnant/lactating mothers and immuno-compromised healthcare workers shall inform their medical condition to the hospital authorities for them to get posted in appropriate areas.
In case HCW reports exposure/breach of PPE , Standard operating procedure (SOP) to be followed according to the advisory is :-All the Healthcare workers must report every unprotected exposure/ breach of PPE while managing COVID-19 patients to the concerned nodal officer and HoD of the concerned department immediately. Such exposed HCWs shall continue to work wearing appropriate PPE and test themselves at day 5 of the exposure or if symptoms develop anytime within 14 days from the day of exposure.
If any healthcare worker who is manifesting signs and symptoms suggestive of COVID-19, he/she will be tested & isolated immediately and if tested positive the following actions shall be taken:
a. In case of mild case, HCW will have an option of home isolation, subject to the conditions stipulated in the “Revised guidelines for Home Isolation of mild /asymptomatic COVID-19 cases” . Such cases would end their home isolation as per timeline provided in the said guidelines.
b. In cases where home isolation is not feasible, such mild cases will be admitted to a COVID Care Center.
c. Moderate cases that require oxygen therapy shall be managed at a Dedicated COVID Health Center.
d. Severe cases will be managed in a Dedicated COVID Hospital.
“HCWs can resume duties while wearing appropriate PPEs if symptoms have resolved (except mild cough), and they are afebrile for 3 successive days. Those HCWs who test negative and continue to be symptomatic, will be treated in non-COVID wards as per their clinical diagnosis. They can resume work based on the clinical diagnosis and the medical certification by the treating doctor,” the revised advisory reads.