24 April 2020
NZACA Guidance for Rest Homes at Covid-19 Level 3
For aged residential care, Covid-19 Level 3 restrictions are recommended to be the same as Level 4 in most areas. Level 3 increases some of the risks and so there are three additional recommendations to all aged care providers:
1. It is best practice for masks to be worn by all care staff where available and we are working with DHBs on supply. Wearing of masks should be supported by thorough washing of hands.
2. Full PPE to be worn, including N95 masks, for Covid-19 confirmed or probable/suspected cases.
3. Restrict the length of time staff members spend completing tasks with an isolated symptomatic or Covid-19 confirmed/probable/suspected resident.
It is recognised there is increased risk of contamination with visits over 15 minutes.
The following advice remains from Level 4:
• End of life compassionate visits by a designated family member (approved by the facility/clinical manager) as a prior arrangement.
• Continue 14-day isolation for all new admissions.
• Recommend Covid-19 testing for new admissions and re-admissions.
• Zone your facilities as far as practicable and restrict staff movement between zones. Staff should be rostered to one area to work and remain in that area rather than be rostered throughout the complex. Tasks will need to be reviewed as part of this overall strategy. This lessens the risk of transmission throughthe complex.
• PPE to be changed when moving between residents/zones.
• Continue to monitor staff competency with PPE management and processes.
• Staff are not to work if they experience any Covid-19 or respiratory symptoms. They need to be tested for Covid-19, and are not to return to work until they have a negative result and no symptoms for 48-hours.
• Staff should not work in more than one facility.
• Management to keep a register of staff living arrangements i.e. whom and how many people they live or flat with in their bubble and what work they undertake. This will need to be revised again with the changes to Level 3 as some staff may increase their contacts to include siblings, children outside of their home, etc. This will ensure Public Health are able to track and trace staff movements and who may be at risk if further facilities announce Covid-19 cases.
• Staff should be advised of infection control protocols/practices to adhere to when finishing their duty/shift and going home. It’s advisable that staff remove their footwear before entering their place of residence, removing work clothing/uniform and launder them every day, shower immediately on arrival home to mitigate any risk of transmission alongside the usual infection control precautions of good hand washing practices and maintaining social
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 email@example.com