DR. JOSE P.

RIZAL MEMORIAL
DISTRICT HOSPITAL

COVID 19:
Infection
Prevention and
Control
March 20, 2020
Mode of Transmission
• Droplet and Contact precaution

• Commonly happens during close exposure to COVID-19 infected person

• Spreads via respiratory droplets produced from coughs and sneezes of infected person

• Droplets enter the body through the mouths, noses, eyes and can be inhaled through the
lungs when in close proximity

• Infected droplets can linger on objects for several hours

• Airborne transmission from person to person over long distances is unlikely

CoronavirusS
ymptoms
• Fever Symptoms
may appear
• Cough
2 to 14 days
after
• Shortness of
Breath exposure.
Interim Infection Prevention and
Control Recommendations for
Patients with Suspected or
Confirmed Coronavirus Disease
2019 (COVID-19) in Healthcare
Settings

Source: CDC (Centers for Disease Control and Prevention)

What personal protective equipment (PPE) should be worn by individuals
transporting patients who are confirmed with or under investigation for
COVID-19 within a healthcare facility? For example, what PPE should be
worn when transporting a patient to radiology for imaging that cannot be
performed in the patient room?

▪ Healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient
▪ For transport, the patient should wear a facemask to contain secretions and be covered with a clean sheet.
▪ If transport personnel must prepare the patient for transport (e.g., transfer them to the wheelchair or
gurney), transport personnel should wear all recommended PPE (gloves, a gown, respiratory protection that
is at least as protective as a fit-tested disposable N95 filtering facepiece respirator or facemask—if a
respirator is not available—and eye protection [i.e., goggles or disposable face shield that covers the front and
sides of the face]).
 • Standard Precautions should be followed when caring for any patient,
regardless of suspected or confirmed COVID-19.
2. What PPE should be
worn by HCP providing • Personnel should wear all recommended PPE for the patient encounter.
care to asymptomatic
• This public health response is an important opportunity to reinforce the
patients with a history of
importance of strict adherence to Standard Precautions during all patient
exposure to COVID-19
encounters.
who are being evaluated
for a non-infectious • Standard Precautions are based on the principles that all blood, body
complaint (e.g., fluids, secretions, excretions except sweat, nonintact skin, and mucous
hypertension or membranes may contain transmissible infectious agents.
hyperglycemia)?
• The application of Standard Precautions is determined by the nature of
the HCP-patient interaction and the extent of anticipated blood, body
fluids, and pathogen exposure.
of hospitalized patients with COVID-19?

ould enter the room of patients with COVID-19.

ld consider assigning daily cleaning and disinfection of high-touch surfaces to nursing

y be in the room providing care to the patient.

igned to orderly, they should wear all recommended PPE when in the room. PPE should be
room, immediately followed by performance of hand hygiene.

l cleaning may be performed by orderly. They should delay entry into the room until
sed for enough air changes to remove potentially infectious particles. We do not yet know
mains infectious in the air. Regardless, orderly should refrain from entering the vacated
has elapsed for enough air changes to remove potentially infectious particles . After this
y may enter the room and should wear a gown and gloves when performing terminal
d eye protection should be added if splashes or sprays during cleaning and disinfection
or otherwise required based on the selected cleaning products. Shoe covers are not
for personnel caring for patients with COVID-19.
*Note:

In addition to cough and shortness of breath, nonspecific symptoms such as sore

throat, myalgia, fatigue, nausea, and diarrhea have been noted as initial symptoms in
some cases of COVID-19.

These symptoms can have several alternative explanations; however, failure to identify
and implement proper precautions in a healthcare setting for persons infected with
COVID-19 can contribute to widespread transmission in that facility due to the
presence of susceptible patients and close interactions with healthcare personnel. For
this reason, a lower temperature of 37.78 degrees Celsius and the inclusion of mild and
non-specific symptoms should be used by healthcare settings evaluating these patients
to increase the ability to detect even mild cases of COVID-19.
Donning the PPE
Goggles or face Recommended Gown and shoe
Sshield cover
PPE Components

N95 Respirator Clean

Goves
PERFORM HAND HYGIENE
1 2 3 4

Rub Palms Together Rub the Bback of hHands Interlink Your Ffingers
Wet Hands

5 6 7

Cup Your fFingers Clean the Thumbs Rub Palms With Your
Fingers
Pre Donning Instructions:
• Ensure if  health worker is
hydrated
• tie hair back
• Removed Jewelries
• Check the correct size of the
PPE
• Perform hand hygiene
Step one:
• Put on long, rear fastening fluid resistant and
long sleeved disposable gown
• Fasten the neck tie/Velcro and waist tie
 If glasses are worn:
• Remove glasses before donning the respirator
• Clean them with alcohol wipe
• Replace before donning the
visor
Step two:
• Put on the respirator or N95, must be fit tested
• Position the upper strap at the crown of your
head, above the ears and the lower strap at the
nape.
• Ensure that the respirator is flat against your
cheeks
• Wwith both hands mould the nose piece from
the bridge of the nose firmly pressing down
both side of the nose with your fingers until
you have a good facial fit
Step three:
• Put on eye protection; a disposable full
face visor is preferred
• Goggles may be used if visor is not
available
• If using a visor, ensure it covers all of
your face including your chin
• Adjust the headband if necessary
 Step four:
• Put on a pair of non-sterile gloves

Sstep five:
• When donning PPE has been completed, proceed
to enter the patients room
• After entering the patients room, remain vigilant
of PPE integrity for yourself and any other staff
members
Doffing the PPE
To safely remove the gloves, the healthcare worker will:
• Grasp the outside of the glove with the opposite gloved hand; peel off
• Hold the removed glove in the gloved hand
• The healthcare worker will slide their finger under the remaining ungloved
hand at the wrist
• Peel the remaining glove off over the first glove
• Dispose of the gloves into the waste bin
• Clean hands with alcohol hand gel/rub
Step two
The gown should be removed slowly and carefully:

• Undo the necktie

• Undo the waist tie
• Pull gown away from neck and shoulders, touching the inside of the gown
only using a peeling motion, as the outside of the gown will be contaminated
• Turn the gown inside out, fold/roll into a bundle and discard into waste bin
Step three
• To remove the visor, stand straight, do not bend forwards, as this bring the
bottom of the visor into contact with the (clean) upper body
• Reach for the elastic strap at the back of the head, close eyes and lift the
strap upwards then over the head using both hands
• Place the visor into the clinical waste bin
• Leave the patient room wearing respirator
• Clean hands with alcohol hand gel/ rub
If glasses are worn:
• Remove glasses before doffing respirator
• Clean them with alcohol wipe
• Do not put them back on until you have completed doffing and washed your hands
Step four
After leaving patient room, carefully and slowly remove the N95 respirator
without touching the front of the respirator, which is CONTAMINATED

• Reach behind back of the head with both hands to find the bottom strap and
bring it up to the top strap
• Lift both straps over the top of the head
• Let the respirator fall away from your face and drop into the clinical waste
bin
Step five

• Now that all PPE has been removed safely and placed in the clinical waste
bin, you can step out of the designated doffing area
• IMMEDIATELY wash your hands with soap and water
Thank You