Precautions for COVID-19 cases

[Sue Greig]

Dear brains trust,
I am interested in the how ICPs and educators are explaining to HCWs the
application of standard plus contact plus droplet plus airborne precautions
as required by CDNA latest SoNG, resources provided by the ACSQHC, and NSW
Health COVID-19 Policy,
The areas I am interested in particularly are:

1. The practical application of droplet and airborne precautions
simultaneously.
2. The PPE you are using fo this level of precautions and why
3. The environmental and patient placement considerations applied when
droplet and airborne precautions are applied simultaneously.

Thanks in advance,

Kind regards,
Sue

Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

—

I try to maintain a sensible work-life balance. Please note this is a
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[Anonymous]

Hi Sue

Technically, airborne precautions do not include eye protection whereas droplet do
And so the need to require all three contact+droplet+airborne for COVID as we believe that eye exposure is a significant risk (recent Lancet review by Chu et al)
Obviously a p2/n95 respirator or equivalent is required rather than a surgical mask when airborne required
A risk managed approach is recommended to decide on whether a gown or apron is required

Kind regards
John

Dr John Ferguson MBBS DTM&H FRACP FRCPA
Director, Infection Prevention Service | Hunter New England Local Health District
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49223725 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkf
https://aimed.net.au/2020/03/28/why-are-standard-infection-control-precautions-the-best-bulwark-against-spread-of-covid-19-in-healthcare/
[cid:image010.jpg@01D6051B.57135930]

From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of sue greig
Sent: Wednesday, 8 July 2020 8:49 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Precautions for COVID-19 cases

Dear brains trust,
I am interested in the how ICPs and educators are explaining to HCWs the application of standard plus contact plus droplet plus airborne precautions as required by CDNA latest SoNG, resources provided by the ACSQHC, and NSW Health COVID-19 Policy,
The areas I am interested in particularly are:

1. The practical application of droplet and airborne precautions simultaneously.
2. The PPE you are using fo this level of precautions and why
3. The environmental and patient placement considerations applied when droplet and airborne precautions are applied simultaneously.
Thanks in advance,

Kind regards,
Sue

Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

—

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately delete it. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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[Anonymous]

Morning Sue
Hope you are keeping well.

I came across this article that you may have seen, that I found insightful relating to the topic.

https://first10em.com/aerosols-droplets-and-airborne-spread/amp

Fefe Lawson
Nursing Consultant

Sent from my Samsung Galaxy smartphone.

——– Original message ——–

Thank you to all who replied to my query.
The responses received tell me that some of you are as confused about the application of droplet and airborne precautions simultaneously and how to educate HCWs to be consistent and stay safe whilst using appropriate PPE. Some have addressed the potential confusion by creating new terms for precautions e.g. ‘respiratory precautions’ to try to clarify requirements for HCWs where it does not fit with conventional transmission-based precautions.
I also note there appears to be little consistency across the country at a facility or jurisdiction level. This must make it difficult for those HCWs who work in multiple facilities.
The lack of consistent advice between the Australian Guidelines for the Prevention and Control of Infection in Health care on how to apply standard plus droplet and airborne precautions and the CDNA SoNG and then how this is applied by clinicians. Only tonight on the news, I noted several HCWs at NSW COVID screening/testing centres wearing multiple masks simultaneously. Where does it say that in the evidence!!
Many of the research evidence including the Lancet review by Chu et al discusses the benefit of protective eyewear in conjunction with the use of masks and respirators to protect the eyes, this is not new, it is part of standard precautions but hasn’t been well applied by HCWs prior to COVID-19. The research does not seem to clarify why droplet and airborne precautions are applied together or to what benefit. It makes me wonder if it is a ‘more must be better’ recommendation.
I guess we continue to problem solve the confusion and go back to first principles for providing consistent evidence-based advice to health care workers and try to minimise confusion.
On that note, stay safe and thank you again for your feedback.

Kind regards,
Sue
.
Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

On Thu, 9 Jul 2020 at 16:39, John Ferguson (Hunter New England LHD) <John.Ferguson@health.nsw.gov.au> wrote:
Hi Sue

Technically, airborne precautions do not include eye protection whereas droplet do
And so the need to require all three contact+droplet+airborne for COVID as we believe that eye exposure is a significant risk (recent Lancet review by Chu et al)
Obviously a p2/n95 respirator or equivalent is required rather than a surgical mask when airborne required
A risk managed approach is recommended to decide on whether a gown or apron is required

Kind regards
John

Dr John Ferguson MBBS DTM&H FRACP FRCPA
Director, Infection Prevention Service | Hunter New England Local Health District
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49223725 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkf
https://aimed.net.au/2020/03/28/why-are-standard-infection-control-precautions-the-best-bulwark-against-spread-of-covid-19-in-healthcare/
[cid:image010.jpg@01D6051B.57135930]

Dear brains trust,
I am interested in the how ICPs and educators are explaining to HCWs the application of standard plus contact plus droplet plus airborne precautions as required by CDNA latest SoNG, resources provided by the ACSQHC, and NSW Health COVID-19 Policy,
The areas I am interested in particularly are:

1. The practical application of droplet and airborne precautions simultaneously.
2. The PPE you are using fo this level of precautions and why
3. The environmental and patient placement considerations applied when droplet and airborne precautions are applied simultaneously.
Thanks in advance,

Kind regards,
Sue

Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

—

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately delete it. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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This message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender.

Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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—
Sue Greig

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately delete it. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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[Anonymous]

Hi everyone,

Just to weigh in on this discussion, the transmission-based precautions posters that have been available for use from the ACSQHC site since 2012 did not show wearing eye protection as part of the routine PPE for droplet or airborne precautions. In addition, the only difference shown in these posters between droplet and airborne precautions was the type of mask worn.

This meant that protective eye wear would only be selected for use if there was an anticipated splash or spray of blood or body substances.

Perhaps a simple solution is to include protective eyewear as routine PPE for droplet and airborne precautions from now on?

Then as John indicates, the need to add contact precautions, i.e. cover gown and glove use can be risk assessed, or where the science indicates that exposure of the HCW skin or clothing could be a risk for transmission of the infectious agent to the HCW or others outside the initial patient being cared for.

Or perhaps we need to rethink our models for transmission based precautions entirely?
Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination

PO BOX 2249, Greenvale, VIC Australia 3059
Mobile: +61 (0)438 109 692
Email: terry@steamconsulting.com.au
Website: http://www.steamconsulting.com.au

[cid:image001.png@01D65B4E.6F9D3A00]

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From: ACIPC Infexion Connexion On Behalf Of sue greig
Sent: Wednesday, July 15, 2020 8:41 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Precautions for COVID-19 cases

Thank you to all who replied to my query.
The responses received tell me that some of you are as confused about the application of droplet and airborne precautions simultaneously and how to educate HCWs to be consistent and stay safe whilst using appropriate PPE. Some have addressed the potential confusion by creating new terms for precautions e.g. ‘respiratory precautions’ to try to clarify requirements for HCWs where it does not fit with conventional transmission-based precautions.
I also note there appears to be little consistency across the country at a facility or jurisdiction level. This must make it difficult for those HCWs who work in multiple facilities.
The lack of consistent advice between the Australian Guidelines for the Prevention and Control of Infection in Health care on how to apply standard plus droplet and airborne precautions and the CDNA SoNG and then how this is applied by clinicians. Only tonight on the news, I noted several HCWs at NSW COVID screening/testing centres wearing multiple masks simultaneously. Where does it say that in the evidence!!
Many of the research evidence including the Lancet review by Chu et al discusses the benefit of protective eyewear in conjunction with the use of masks and respirators to protect the eyes, this is not new, it is part of standard precautions but hasn’t been well applied by HCWs prior to COVID-19. The research does not seem to clarify why droplet and airborne precautions are applied together or to what benefit. It makes me wonder if it is a ‘more must be better’ recommendation.
I guess we continue to problem solve the confusion and go back to first principles for providing consistent evidence-based advice to health care workers and try to minimise confusion.
On that note, stay safe and thank you again for your feedback.

Kind regards,
Sue
.
Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

On Thu, 9 Jul 2020 at 16:39, John Ferguson (Hunter New England LHD) <John.Ferguson@health.nsw.gov.au> wrote:
Hi Sue

Technically, airborne precautions do not include eye protection whereas droplet do
And so the need to require all three contact+droplet+airborne for COVID as we believe that eye exposure is a significant risk (recent Lancet review by Chu et al)
Obviously a p2/n95 respirator or equivalent is required rather than a surgical mask when airborne required
A risk managed approach is recommended to decide on whether a gown or apron is required

Kind regards
John

Dr John Ferguson MBBS DTM&H FRACP FRCPA
Director, Infection Prevention Service | Hunter New England Local Health District
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49223725 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkf
https://aimed.net.au/2020/03/28/why-are-standard-infection-control-precautions-the-best-bulwark-against-spread-of-covid-19-in-healthcare/

From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of sue greig
Sent: Wednesday, 8 July 2020 8:49 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Precautions for COVID-19 cases

Dear brains trust,
I am interested in the how ICPs and educators are explaining to HCWs the application of standard plus contact plus droplet plus airborne precautions as required by CDNA latest SoNG, resources provided by the ACSQHC, and NSW Health COVID-19 Policy,
The areas I am interested in particularly are:

1. The practical application of droplet and airborne precautions simultaneously.
2. The PPE you are using fo this level of precautions and why
3. The environmental and patient placement considerations applied when droplet and airborne precautions are applied simultaneously.
Thanks in advance,

Kind regards,
Sue

Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

—

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately delete it. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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This message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender.

Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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—
Sue Greig

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately delete it. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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[Lyn Gilbert]

Dear Sue and all,

I appreciate the frustration that HCWs feel about the contradictory advice that is published in the media about the use of PPE which always accelerates in the context of increased community transmission.
I would like to draw you attention to the guidance provided by the Infection Control Expert Group (ICEG) at https://www.health.gov.au/committees-and-groups/infection-control-expert-group-iceg and, in particular to
1. Guidance on the use of personal protective equipment (PPE) in hospitals during the COVID-19 outbreak. https://www.health.gov.au/resources/publications/guidance-on-the-use-of-personal-protective-equipment-ppe-in-hospitals-during-the-covid-19-outbreak
2. Guidance on use of personal protective equipment in non inpatient healthcare settings during the COVID-19 outbreaks. https://www.health.gov.au/sites/default/files/documents/2020/06/coronavirus-covid-19-guidance-on-use-of-personal-protective-equipment-ppe-in-non-inpatient-health-care-settings-during-the-covid-19-outbreak_1.pdf
These documents were published when there was minimal community transmission in Australia, but foreshadowed changes if the transmission rates changed – which will be provided shortly. The CDNA SoNG and ACSQHC advice are based on these ICEG guidance document.

1. The use of face masks and respirators in the context of COVID-19. https://www.health.gov.au/resources/publications/the-use-of-face-masks-and-respirators-in-the-context-of-covid-19

This is a more technical document that aims to provide an evidence base for the guidance documents.

Best wishes

Lyn

Professor Lyn Gilbert AO, MD FRACP FRCPA M. Bioethics,
Marie Bashir Institute for Infectious Diseases & Biosecurity &
Sydney Health Ethics, University of Sydney

Mobile: 0423593385;
email: lyn.gilbert#sydney.edu.au

From: ACIPC Infexion Connexion on behalf of sue greig
Reply to: ACIPC Infexion Connexion
Date: Wednesday, 15 July 2020 at 8:55 pm
To: “ACIPCLIST@ACIPC.ORG.AU”
Subject: Re: [ACIPC_Infexion_Connexion] Precautions for COVID-19 cases

Thank you to all who replied to my query.
The responses received tell me that some of you are as confused about the application of droplet and airborne precautions simultaneously and how to educate HCWs to be consistent and stay safe whilst using appropriate PPE. Some have addressed the potential confusion by creating new terms for precautions e.g. ‘respiratory precautions’ to try to clarify requirements for HCWs where it does not fit with conventional transmission-based precautions.
I also note there appears to be little consistency across the country at a facility or jurisdiction level. This must make it difficult for those HCWs who work in multiple facilities.
The lack of consistent advice between the Australian Guidelines for the Prevention and Control of Infection in Health care on how to apply standard plus droplet and airborne precautions and the CDNA SoNG and then how this is applied by clinicians. Only tonight on the news, I noted several HCWs at NSW COVID screening/testing centres wearing multiple masks simultaneously. Where does it say that in the evidence!!
Many of the research evidence including the Lancet review by Chu et al discusses the benefit of protective eyewear in conjunction with the use of masks and respirators to protect the eyes, this is not new, it is part of standard precautions but hasn’t been well applied by HCWs prior to COVID-19. The research does not seem to clarify why droplet and airborne precautions are applied together or to what benefit. It makes me wonder if it is a ‘more must be better’ recommendation.
I guess we continue to problem solve the confusion and go back to first principles for providing consistent evidence-based advice to health care workers and try to minimise confusion.
On that note, stay safe and thank you again for your feedback.

Kind regards,
Sue
.
Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

On Thu, 9 Jul 2020 at 16:39, John Ferguson (Hunter New England LHD) <John.Ferguson@health.nsw.gov.au> wrote:
Hi Sue

Technically, airborne precautions do not include eye protection whereas droplet do
And so the need to require all three contact+droplet+airborne for COVID as we believe that eye exposure is a significant risk (recent Lancet review by Chu et al)
Obviously a p2/n95 respirator or equivalent is required rather than a surgical mask when airborne required
A risk managed approach is recommended to decide on whether a gown or apron is required

Kind regards
John

Dr John Ferguson MBBS DTM&H FRACP FRCPA
Director, Infection Prevention Service | Hunter New England Local Health District
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49223725 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkf
https://aimed.net.au/2020/03/28/why-are-standard-infection-control-precautions-the-best-bulwark-against-spread-of-covid-19-in-healthcare/
Error! Filename not specified.

From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of sue greig
Sent: Wednesday, 8 July 2020 8:49 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Precautions for COVID-19 cases

Dear brains trust,
I am interested in the how ICPs and educators are explaining to HCWs the application of standard plus contact plus droplet plus airborne precautions as required by CDNA latest SoNG, resources provided by the ACSQHC, and NSW Health COVID-19 Policy,
The areas I am interested in particularly are:

1. The practical application of droplet and airborne precautions simultaneously.
2. The PPE you are using fo this level of precautions and why
3. The environmental and patient placement considerations applied when droplet and airborne precautions are applied simultaneously.
Thanks in advance,

Kind regards,
Sue

Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

—

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

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The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately delete it. No liability is accepted for any unauthorised use of the information contained in this transmission.
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—
Sue Greig

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

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[Angela Carvosso]

Hi Sue,

With regards to staff wearing multiple masks, is there a possibility of allergy? I worked with an AIN when we were dealing with norovirus in a different health district to where I c. She came out in a rash if she wore the N95 mask on its own. Being the dedicated nurse that she was, she didnt complain, she just stuck a surgical mask underneath to protect her skin and put the N95 over the top although I do now wonder if she obtained a correct seal. It is just one possible explanation. Utter confusion I guess would be the other.

Regards Angela Carvosso
RN SCHHS

Sent from Mail for Windows 10

Thank you to all who replied to my query.
The responses received tell me that some of you are as confused about the application of droplet and airborne precautions simultaneously and how to educate HCWs to be consistent and stay safe whilst using appropriate PPE. Some have addressed the potential confusion by creating new terms for precautions e.g. ‘respiratory precautions’ to try to clarify requirements for HCWs where it does not fit with conventional transmission-based precautions.
I also note there appears to be little consistency across the country at a facility or jurisdiction level. This must make it difficult for those HCWs who work in multiple facilities.
The lack of consistent advice between the Australian Guidelines for the Prevention and Control of Infection in Health care on how to apply standard plus droplet and airborne precautions and the CDNA SoNG and then how this is applied by clinicians. Only tonight on the news, I noted several HCWs at NSW COVID screening/testing centres wearing multiple masks simultaneously. Where does it say that in the evidence!!
Many of the research evidence including the Lancet review by Chu et al discusses the benefit of protective eyewear in conjunction with the use of masks and respirators to protect the eyes, this is not new, it is part of standard precautions but hasn’t been well applied by HCWs prior to COVID-19. The research does not seem to clarify why droplet and airborne precautions are applied together or to what benefit. It makes me wonder if it is a ‘more must be better’ recommendation.
I guess we continue to problem solve the confusion and go back to first principles for providing consistent evidence-based advice to health care workers and try to minimise confusion.
On that note, stay safe and thank you again for your feedback.

Kind regards,
Sue
.
Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

On Thu, 9 Jul 2020 at 16:39, John Ferguson (Hunter New England LHD) <John.Ferguson@health.nsw.gov.au> wrote:
Hi Sue

Technically, airborne precautions do not include eye protection whereas droplet do
And so the need to require all three contact+droplet+airborne for COVID as we believe that eye exposure is a significant risk (recent Lancet review by Chu et al)
Obviously a p2/n95 respirator or equivalent is required rather than a surgical mask when airborne required
A risk managed approach is recommended to decide on whether a gown or apron is required

Kind regards
John

Dr John Ferguson MBBS DTM&H FRACP FRCPA
Director, Infection Prevention Service | Hunter New England Local Health District
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49223725 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkf
https://aimed.net.au/2020/03/28/why-are-standard-infection-control-precautions-the-best-bulwark-against-spread-of-covid-19-in-healthcare/

Dear brains trust,
I am interested in the how ICPs and educators are explaining to HCWs the application of standard plus contact plus droplet plus airborne precautions as required by CDNA latest SoNG, resources provided by the ACSQHC, and NSW Health COVID-19 Policy,
The areas I am interested in particularly are:

1. The practical application of droplet and airborne precautions simultaneously.
2. The PPE you are using fo this level of precautions and why
3. The environmental and patient placement considerations applied when droplet and airborne precautions are applied simultaneously.
Thanks in advance,

Kind regards,
Sue

Sue Greig RN CICP-E
National Infection Prevention and Control Coordinator
Ramsay Health Care
0407 312 600

—

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

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—
Sue Greig

I try to maintain a sensible work-life balance. Please note this is a personal email and I check messages and respond accordingly.

CONFIDENTIALITY NOTICE AND DISCLAIMER
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