9 April 2020

COVID–19 staffing guidelines to consider for multi care level ARC sites

Following outbreaks of COVID-19 in several NZ aged care facilities over recent weeks it’s timely to review and consider staff accessibility to different areas throughout the complex.

There has been criticism from Public Health infection control specialists about ARC staff not working solely within their designated area (laundry, kitchen, cleaning, etc), instead being observed working across the whole facility. The same principles apply to care staff working across the facility rather than in a designated work area (rest home, hospital and dementia wings).

While the threat of COVID -19 transference exists, staff should be assigned to work in specific areas of the facility rather than having the general “run” of the complex. This will necessitate staffing and tasks being reviewed and made more specific to area location and rotation but would reduce the number of staff having to be stood down should an outbreak occur.

Areas to consider and review are:

• Laundry service. Who can access the laundry and which staff distribute clean garments and laundry throughout the facility? Laundry staff dealing with soiled linen then delivering clean linen and residents clothing back into all areas of the facility provides potential for the spread of the virus. As does care staff accessing the laundry to pick up articles of linen and clothing. You may need to rethink how this system can be reviewed to minimise the exposure of staff in all
areas and allocate wing staff to distribute the clean linen from a designated drop off point. Think how staff communicate with the laundry to access additional linen, rather than visiting it.

• Kitchen/meal service. Who has access to the kitchen and which staff are permitted to access this area for meal preparation, collection and distribution, accessing food supplies, crockery and cutlery management/washing, etc.
You may need to review how morning/afternoon tea and suppers are prepared and who is responsible for meal distribution if kitchen staff are currently doing this role. Ensure that when supplies are dropped off, they are left outside of the kitchen area and allocated staff then treat these according to the guidelines before storing them appropriately in the kitchen.

• Cleaning. Cleaning staff should be rostered to specific areas within the facility only and remain there for the duration of the pandemic, ensuring they follow all good infection control processes.

• Care staff. All care staff should be allocated/rostered to specific wings of the facility and remain there, rather than being rostered elsewhere within the complex to fill roster gaps (if this is possible). Should an outbreak occur you then minimise the risk of having a lot of staff stood down, if they have not worked in areas of risk.

• Other staff. Consider staff who work across the facility (rather than specific areas) such as maintenance people, and how infection control practices are managed to keep these staff and all onsite residents safe.

• Management. Management overview of the facility and how senior staff interact with the residents and staff throughout the complex also needs to be considered and minimised if possible. Alternative ways of communication will need to be considered/explored to ensure interaction with others is minimised.

Maintaining “hubs of staff” is essential to minimise interaction between units and lessen the risk of spread throughout the complex.

Rhonda Sherriff, NZACA Clinical Advisor, is available for members to seek clinical advice between 9.00am and 5.00pm Monday to Friday (excluding public holidays) on 0800 445 200 or helpline@nzaca.org.nz


Rhonda Sherriff
NZACA Clinical Advisor