Practice Procedures/Infection Control and PPE – June 2020 

Practice Procedures/Infection Control and PPE – June 2020 
 
Step one: Online/remote consultations 
Step two: Pre-screening of staff 
Step three: Pre-screening of patients 
Step four: Arrival at practice procedures 
Step five: Appointment procedures 
Step six: Leaving the practice procedures 
Step seven: Practice alterations - Cleaning procedure - PPE 
 
Step one: Online/remote consultations 
We are providing online/remote consultations for all non-essential, non-urgent cases. In some instances when a face-to-face initial appointment is required, it may be possible for a follow-up appointment to be carried out remotely. 
 
Step two: Pre-screening of staff 
This step helps to reduce the likelihood of our staff bringing the virus into the practice, risking contaminating the practice and potentially anyone who enters. 
How it works: 
All staff will have their temperatures taken each morning before work and if they have a high temperature or any other symptoms of COVID-19 they shall not be allowed to work and shall have to self-isolate for at least 7 days. 
If they have been in contact with anyone who has had symptoms of the COVID-19 virus whilst they were not wearing PPE, then they shall not be allowed to work and shall have to self-isolate for 14 days. All patients who have recently seen that therapist will be notified as soon as possible. 
If they have been in contact with anyone who has had symptoms of COVID-19 whilst wearing PPE (face mask, gloves and apron as a minimum) then they can carry on working and do not have to self-isolate unless they become symptomatic. 
 
Step three: Pre-screening of patients 
The purpose of this triage step is: 
• Reduces the chances of you bringing the virus into the practice, which could then potentially infect staff and other patients. 
 
• Helps us in deciding if the benefits of a face-to-face appointment outweigh any potential risks. 
How it works: 
When you call to arrange an appointment, you will be questioned on whether you or anyone in your household or that you come into close contact with are in an ’at risk’ category; whether you, or anyone that you have been in contact with, have or have had symptoms indicative of Covid-19 within the last two weeks; and we will also ask you questions about your medical history. We will then decide whether a face-to face-appointment would be appropriate or whether you could be helped remotely. If it is decided that you would benefit from a face to face appointment you will be asked to fill in a Pre-screening triage questionnaire/consent form. 
 
Step four: Arrival at practice procedures. 
 
When you arrive at the practice, you will need to wait in your car until your therapist comes out to you. They can only do this once they have finished cleaning the practice following their previous appointment. 
 
You will then have your temperature taken with a non-contact forehead thermometer. 
If you do not have a temperature you will then enter the clinic waiting room where you will be provided with hand sanitiser gel to clean your hands. You will then be given a fluid resistant surgical mask to wear (which you must wear at all times during your appointment) and then will be taken into the treatment room by your therapist. If you have a high temperature you will not be able to enter the practice and shall have to follow the government guidelines on self-isolation. 
 
Where possible, we will ask that only one person (the patient) enters the practice unless the patient is under 18 or requires a chaperone/translator. There will be an additional charge of £3 to cover costs of PPE for a person other than the patient entering the practice. 
 
Step Five: Appointment procedures 
 
In the treatment room there is tape on the floor to delineate 2 metre distancing from the therapist and yourself for the case history to be taken and then also for the observation part of your examination (if these haven’t already been carried out remotely). 
Your therapist will do their best to minimise the time spent within 2 metres of you when this is not necessary. However, some assessment may require physical contact and by its very nature, manual therapy requires hands on treatment and so you will be in close contact with your therapist for that part of your appointment which is why your therapist will be wearing appropriate PPE. 
There will be a 15-minute gap between appointments to allow for cleaning and for aeration of the clinic and to avoid crossover of patients. To assist in aeration the air- conditioning unit which expels air externally will be on when possible. 
 
 
Step six: Leaving the practice procedures 
After your treatment, you will be taken into the waiting room where you will again, clean your hands with the alcohol gel provided and then remove your mask (touching only the straps) and place it into a bin. 
 
Step seven: Practice alterations - Cleaning procedures - PPE 
Our waiting room is currently not in use except for the hand sanitising mentioned above. 
All relevant surfaces in the practice will be cleaned after each appointment. 
There will be no material cover on the treatment couch to allow cleaning between appointments. 
Pillows will be covered with a waterproof plastic covering to allow cleaning between appointments. 
A medical mixer tap has been installed in the treatment room to allow practitioners to wash their entire forearms and hands before and after every appointment. 
Practitioners will be wearing PPE equipment that will be disposed of after every appointment this includes gloves, fluid resistant surgical masks and disposable aprons. In some cases, therapists may also wear a face visor which will be cleaned after each appointment in which it is used. 
Patients will wear fluid resistant surgical masks (provided) and clean hands on entering/leaving practice with the provided hand sanitiser. 
 
Conclusion: 
So, as you can see, we have done our best to reduce the likelihood of you contracting COVID-19 at our practice. We obviously cannot make our practice 100% safe but then no manual therapy clinic can. 
We hope that the procedures we have in place, show you how serious we take your safety and that this will give you confidence in attending our practice for your treatment. 
Luke Jackman 
Principal Osteopath and owner of Dedham Osteopathy 
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