Infection control in OPD and Hospitals during this pandemic situation
Hospitals should take all the necessary precaution in running its OPD and IPD services with strict safety protocols for infection prevention. With coronavirus numbers increasing regularly, social distancing and good personal and social hygiene is the only way to stop the spread of the infection.
For preventing infection these steps should be taken-OPD Appointment software- to give an appointment to reduce the crowd at any point of time. Triple Screening for everyone at the entrance is done, it includes temperature checks with thermal guns and sanitizing. Hand sanitizer and hand wash facility should be available in hospital/clinic entrance. Ensure every person should wear a mask in the premises. The physical distancing of minimum 3-feet away, sanitizing hands frequently, wiping patient files/cards, etc before and after handing them over to be ensured. Housekeeping staff and nurses should wear personal protective equipment (PPE), frequently touched areas (like chairs, door handles, knobs, tables, etc) are sanitized frequently. Bio-medical waste is collected in defined disposable bags and discarded, and deep cleaning with scrubbing is also done. The number of patient attendants should be restricted to one only. Patients must be educated about what to Do and What Not to Do, cough etiquette, proper use of masks, and personal hygiene. Hospitals should put up posters/ Signage at prominent locations to increase awareness among patients on what could be done and what could not be done regarding COVID 19. Diagnostic testing will be needed prior to undergoing a procedure for the safety of other patients and the hospital staff. Patients suffering from chronic kidney disease, diabetes, hypertension, and chronic obstructive pulmonary disease, etc. are more prone to COVID-19 infection. Such patients should be hospitalized, maintain social distancing, eat healthily, hydrate, and follow basic hygiene protocol. The entire hospital should be sanitized for the safety of the patients.
All doctors, nurses and support staff including pre and para-clinical departments must be trained in infection control practices. Hospitals should ensure that stable patients are discharged as early as possible and further new admissions (of stable patients) are also restricted.
Admission of any such patient must be notified to IDSP immediately. All pneumonia patients must be notified to IDSP so that they could be tested for COVID 19. Hospitals should ensure social distancing in their premises. OPDs should be organized in such a way that patients exhibiting flu-like symptoms are attended separately from other patients and spaced out so as to avoid overcrowding. Separate OPD for COVID like symptoms patients could be planned. The waiting area should be modified for social distancing. Online doctor consultation will also help in the prevention and control of infection.
In IPD there should be strict isolation practices for patients with COVID-19, which needs every person should be ruled out for COVID-19 before entering the patient room. They have to apply the following: gown, mask gloves, and eye protection (can be goggles or a face shield), along with hand-washing.
The type of mask required for patients in the non-ICU units without an aerosol-generating the procedure is simply a regular surgical mask. In the ICU, for ventilator patients, a respirator or N95 mask is needed. These are recommendations from the CDC and WHO.
Protocols for preventing cross-contamination from patients to healthcare providers
The isolation practices mentioned above prevent cross-contamination from patient to patient as well as from patient to HCPs. Because it is known that you can have the virus without symptoms and be able to pass it to others, applying masks to everyone protects the HCP and patients as well. With adequate equipment and isolation practices, there is minimal or no cross-contamination.
The United States and other nations have implemented social distancing strategies (staying 6 feet away from each other, hand washing, and coughing into the elbow) as well as stay-at-home orders to prevent the spread of the disease, which includes closing all nonessential businesses. Because this virus is novel, no one has immunity to it, and it is highly contagious, that is why it can and has spread so rapidly. These mitigation strategies will prevent a rapid rise of new cases that will require hospitalization; its aim is to flatten the curve.
Some hospitals have increased their capacity, especially ICU beds. They have converted non-ICU beds to ICU beds. Adequate testing is also mandatory to understand who has the disease so they can be quarantined to prevent the spread.