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What precautions should be taken by health practitioner during post COVID-19?

29 September 2019 | By Shristhi Jain

The outbreak of Covid-19 has inflicted global havoc, and it has become imperative to take significant precautionary measures. Especially the health professionals who are fighting at the forefront against the deadly pandemic without a twinge of fear to save our lives. The health of our medical professionals is equally important as our patients who are waging a tough battle against the Covid-19 Pandemic. To curb the further spread of the virus, the physicians, health professionals, hospitals and health systems must take necessary steps to protect themselves and others.

Below are a few recommendations by CDC (Centers for Disease Controls and Prevention), for physicians and other medical experts to protect themselves when caring for COVID -19 patients.

1- Alleviate the risk for exposure:

It should be ensured that the necessary facilities and policies are implemented and installed to reduce the risk of exposure to infectious agents including 2019-nCoV. Identify the health hazards and protect yourself from the potential risks of respiratory infection throughout the presence of the affected patient in the hospital premises.

2- Safeguarding the interest of family members:

: Healthcare workers should be given special instructions regarding how they can avoid unnecessary contact with their family members. Doctors should vacate themselves in the separate living rooms till the time the situation improves. This will also result in safeguarding the interest of the family members as the chances of vulnerability to infection increases.

3- Adherence to standard precautions:

Complying to standard precautionary measures is the need of the hour. Health workers who are treating the suspected Covid-19 patient should adhere to all the precautions like maintaining hand hygiene before and after treating each patient, using eye protection to mitigate the risks of infection. Proper attention should be paid to all the guidance regarding wearing and disposing of Protective Personal Equipment.

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4- Training of Medical Experts:

Medical personnel and health professionals should be given detailed training and counselling to prevent the spread of the virus. This guidance should equip them with all the measures and brace them mentally about the challenges before taking care of the patient. It should aim to provide all the measures which can be taken to minimise their exposure with the patients. It should also stress the other aspects pertaining to their health like removing PPE when leaving work premises, keeping hands away from face and performing hand hygiene. The guidance regarding the disinfection of the environmental surfaces and cleaning will also assist in protecting the health workers from the potential risks.

5- Protective Personal Equipment:

: As per the recommendations by CDC (Centers for Disease Controls and Prevention), Doctors should wear PPE before coming in contact with any suspected COVID patient. This equipment which includes "gloves, face masks, protective eyewear, face shields, and protective clothing (e.g., reusable or disposable gown, jacket, laboratory coat", will protect the health expert from exposure to an infectious agent or respiratory pathogens. The hospital should provide appropriate PPE kits to their health professionals and educate them on its proper selection and its usage. The doctors are advised not to use the same set of gloves for the care of more than one patient and to avoid washing the gloves as it cannot be reused and also to "use mouth, nose, and eye protection during procedures that are likely to generate splashes or sprays of blood or other body fluids".

6-Self-monitoring by health workers:

Health workers should monitor their health before leaving their home for the hospital. If they report being ill and unwell, they should be given a day off to mitigate the chances of infection among the patients. Getting in contact with the patients would elevate the risks for both the patient and the doctor. With the guidance from Public Health Authorities, the movement of health professionals who are sick or in contact with COVID-19 patients must be monitored and managed. Health professionals who take care of Coid-19 patients must be given sick leave policies that are flexible, nonpunitive and consistent with public health guidance. Hence, to curtail the spread of the virus healthcare centres should restrict the movements of their health professionals who are under the weather.

7-Cleaning and disinfection of dental equipment:

: Critical patient care items such as surgical instruments and periodontal scalers should be effectively sterilized using heat. Such instruments are used to penetrate soft tissue hence there is a greater risk of transmitting infection. Clean and disinfect all the medical equipment for patient care. The guideline of the CDC highlights that "cleaning to remove debris and organic contamination from instruments should always occur before disinfection or sterilization. If blood, saliva, and other contamination are not removed, these materials can shield microorganisms and potentially compromise the disinfection or sterilization process". The cleaning and reprocessing of the reusable dental equipment should be done according to the manufacturer's instructions. If the manufacturer does not provide such instructions, the device may not be suitable for multi-patient use.

8- Maintaining Hand Hygiene:

Performing hand hygiene is the most important measure to battle against the deadly pandemic. This activity is not restricted to the healthcare personnel but all the people out there shackled in the clutches of the global pandemic. Medical personnel should indulge in a rigorous hand washing exercise to avoid the contamination of workplaces. Doctors should wash their hands before and after treating every patient. They are also advised to rinse their hands from the alcohol-based hand rub before putting on gloves and immediately after removing it.

9- Fumigation of surfaces:

There are traces of Covid-19 virus surviving on the surfaces for a longer period of time. This calls for an immediate emphasis on the cleaning and the disinfecting of the surfaces that are likely to become contaminated with pathogens and infectious agents. Hence it is advisable for doctors to sanitize their cell phones, wallets and other personal items. Special attention should also be given to Environmental infection prevention and control. Environmental service workers should indulge in the laborious task of disinfecting escalator railings, switches on dental units, elevator buttons, handles, doorknobs, computer equipment etc. Cleaning and disinfecting environmental surfaces are fundamental in reducing healthcare-associated infections.

10- Regulate visitor access:

Monitor and regulate visitor access to the patient's room. Implement proper procedures to manage and train visitors. Restrict visitors for suspected or infected patients by arranging alternative ways for visitors to interact with patients like video-calling through applications on mobile, tablets or computers. This process will help the organisation to reduce the crowd in the premises and thereby mitigating the resulting risk for both the patients and the doctors

The crucial times have called for substantial precautions. Our health personnel should adhere to the laid guidelines by the CDC (Centers for Disease Controls and Prevention) to mitigate their risk of exposure to the deadly pandemic. The public health authorities should organise time-to-time webinars to update and provide relevant information about the changes in guidelines and policies. Using appropriate precautions at work can help minimize risk and exposure to COVID-19 patients and, in turn, can protect families too. Whether at a hospital, health system or small clinic, it is important to take all preventive measures available. These preventive measures will assist our health personnel in making our country fit and healthy again.

Writer’s desk: Shristhi Jain

A wanderlust and the poetry lover,
Giving voice to her silence,
Through Metaphors and allegory,
Has carved the artistic way to entice our clients with her creative skills.
Like the thick coat of Dalgona coffee,
She comes up with fresh perspectives.
For Shristhi ,writing is indeed the cathartic exercise

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