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General COVID-19 infection prevention recommendations for clinics and hospital diagnostic imaging services

1. Minimize the chance of exposure:

When scheduling examinations and appointments for routine medical care (preventive, elective) instruct patients to discuss the possibility of rescheduling, especially if they experience symptoms of a respiratory infection (such as coughing, sore throat, fever).
If the patient needs to undergo tests, establish a screening and ask for possible symptoms of respiratory infection to be informed so that appropriate preventive actions can be taken (face mask at the entrance and during the visit).

2. Consider limiting entry and transit points for patients with symptoms of respiratory infection. Identify a separate, well-ventilated space that allows these waiting patients to be isolated and have easy access to respiratory hygiene supplies.

3. Take steps to ensure that patients and professionals have access to hand hygiene supplies at health service entrances, waiting rooms and service areas.

4. Use visual alerts (signs, posters, etc.) at the entrance and at strategic locations (such as waiting areas, elevators, cafeterias, etc.) to provide patients with instructions (in appropriate languages) on hand hygiene, respiratory hygiene and cough etiquette. Instructions should include how to use tissues to cover your nose and mouth when coughing or sneezing, discard contaminated fabrics and items in garbage containers and how and when to perform hand hygiene.

5. Provide specific transmission prevention information and training to all health facility personnel (doctors, nurses, technicians, cleaning service, laundry, maintenance, students, administrative staff and others).

6. Hand hygiene:
Health professionals should perform hand hygiene before and after all contact with the patient, contact with potentially infectious material and before putting on and removing personal protective equipment, including gloves. Wash your hands with soap and water for at least 20 seconds or use specific alcohol-based products with a concentration of 60-95%.

7. Personal Protective Equipment (PPE):
Professionals involved in care and in contact with patients must have access to PPE, receive training and demonstrate an understanding of: when to use PPE, which PPE is needed, how to properly wear, use and remove PPE in order to avoid self contamination, such as disposing or disinfecting and properly maintaining PPE and PPE limitations.

Training of professionals involved in the placement and removal of PPE is recommended. There is evidence that the greatest chance of infection occurs in the process of improper removal of these materials.
PPE recommended when caring for a patient with known or suspected SYMPTOMATIC COVID-19 include:

The. Respirator or Face Mask
The patient must have a simple surgical mask when entering the examination area. The goal is to reduce droplet transmission.
Wear the face mask before contacting patients with respiratory symptoms. It is recommended that these guidelines are updated frequently based on the guidelines of health authorities.
Face masks should be removed and discarded after leaving the patient's room or care area and closing the door. Perform hand hygiene after discarding the face mask.

B. Eye protection
Goggles or a disposable face shield that covers the front and sides of the face when entering the patient's room or care area. Glasses and personal contact lenses are not considered adequate eye protection. Remove eye protection before leaving the service area.
These PPE are only recommended for procedures such as punctures or interventions.

ç. Gloves
Put on clean, non-sterile gloves when entering the service area. Remove and dispose of gloves when leaving the care area and perform hand hygiene immediately.

d. Aprons
Put on clean insulating clothing when entering the patient's area. Remove and discard the apron in a dedicated container before leaving the service area. Non-disposable aprons must be washed after each use. Give preference to the disposable apron.

8. Implement environmental infection control
All non-dedicated, non-disposable medical equipment used for patient care must be cleaned and disinfected in accordance with the manufacturer's instructions and installation policies. Make sure that environmental cleaning and disinfection procedures are followed consistently and correctly.
Management of laundry, food service utensils and medical waste must also be carried out in accordance with protective care.
The disposal of material must follow the rules of health surveillance.

9. Employees and Employees
In hospitals with care for patients with infection confirmed by COVID-19, consider placing part of the health team working remotely to avoid simultaneous contamination of a significant part of the professionals, making it difficult to maintain the service's functioning.
Health care services must implement sick leave policies for professionals who show symptoms of respiratory infection, which are flexible and consistent with public health guidelines.

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Sources:

  1. https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Finfection-control.html
  2. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/infection-prevention-and-control
  3. https://www.jacr.org/article/S1546-1440(20)30150-2/pdf
  4. Coronavirus and Emergency Medicine. http://abramede.com.br/wp-content/uploads/2020/03/POSICIONAMENTO-ABRAMEDE-CORONAVIRUS-03-10032020.pdf
  5. Newsletter of the Brazilian Society of Infectious Diseases. https://drive.google.com/file/d/1X0AxDYIOVPjzBK8qauFkFMDi9a74iq7H/view

 

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Simone Max

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