Don’t drop your guard on PPE

The wearing of surgical face masks in non-clinical and clinical areas plays a significant role in reducing further transmission of COVID-19. All staff, (unless working in a room entirely alone), must wear masks at all times and in all areas. This applies to everyone working at all Trust sites (such as visitors and contractors).

You must ‘put on’ (don) and ‘take off’ (doff) type 2 face masks each time you enter and leave a clinical space. Remember to change your mask after giving direct care to a COVID patient and put a clean mask on after attending the staff rest room or break areas. Avoid touching your mask once in place.

Visors are available for all staff as required following risk assessments of patients.

You must wash or alcogel your hands before and after putting on and removing face masks:

  • After you ‘take off' (doff), dispose of your mask in the appropriate bin
  • Face masks must be removed and disposed of as you leave a clinical area
  • Face masks must be used when entering a patient’s home.

Stay vigilant, stay safe

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All staff in clinical areas must be bare below the elbows to ensure that hands can be washed effectively for 20 seconds. This is more important than ever to try to prevent the spread of COVID-19. It means that you must not wear: stone rings, watches, fit bits, bracelets, nail varnish or false nails whilst in a clinical area. Further detail is available in section 8.2 in the Trust  Infection Prevention and Control Policy

There are short films to remind you of the correct process for donning and doffing – please copy and paste this link into Chrome https://vimeo.com/401585323

eLearning training is available on ESR. If you have any questions contact: InfectionControl@merseycare.nhs.uk or call 0151 295 3036.

 You no longer need to wear a face mask across all sites when you are outside.

This includes outside sports such as football but all staff MUST undertake lateral flow test before participation of close contact sports.

However, if staff and patients are in very close contact, for example when using hand cuffs, staff must continue to wear face masks.

 Wearing personal protective equipment (PPE) in warm or hot environments increases the risk of heat stress. This occurs when the body is unable to cool itself enough to maintain a healthy temperature. Heat stress can cause heat exhaustion and lead to heat stroke if the person is unable to cool down.

Measures to control the temperature of clinical environments and enable staff to make behavioural adaptations to stay cool and well hydrated should be made. Staff may require more frequent breaks and the frequency of PPE changes may increase, with a resulting increase in demand.

Staff working in warm/hot conditions should:

  • Take regular breaks, find somewhere cool if you can
  • Make sure you are hydrated (checking your urine is an easy way of keeping an eye on your hydration levels – dark or strong smelling urine is a sign that you should drink more fluids)
  • Be aware of the signs and symptoms of heat stress and dehydration (thirst, dry mouth, dark or strong smelling urine, urinating infrequently or in small amounts, inability to concentrate, muscle cramps, fainting). Don’t wait until you start to feel unwell before you take a break.
  • Use a buddy system with your team to look out for the signs of heat stress (eg. confusion, looking pale or clammy, fast breathing) in each other
  • Between shifts, try to stay cool as this will give your body a chance to recover.

Once used, face masks must be disposed of correctly in line with official guidance from NHSE and NHSi:

Clinical areas

Clinical staff should dispose of surgical face masks in the infectious waste stream (orange bag) if visibly contaminated with bodily fluids or into the offensive waste stream (black and yellow striped bag) if they are not visibly contaminated with bodily fluids.

Community staff

Community staff should continue to dispose of masks (and PPE) in the patient’s domestic waste, unless it is known to be infectious, then it should be placed in an orange bag for collection.

Offices and food prep areas that are COVID-19 secure

Where areas are COVID-19 secure, for example, offices and food preparation areas, masks can be discarded in the domestic waste stream if no longer required.

Patient facing areas

Masks worn by patients, visitors and non-clinical staff who have entered a clinical area should be discarded in the offensive waste stream (black and yellow striped bag) if no longer required. Bins for these should be located at the entrances and exits, where masks are given to those who do not have them.

FAQs on mask 12 June 2020

The link above includes some questions we’ve received from staff regarding masks.

It’s been suggested that instructions regarding PPE aren’t being followed nationally in communal areas (except when eating or drinking) or when travelling in a car with other members of staff. Our staff have been remarkable in their commitment to wearing PPE and we must continue to do so.

Infection prevention and control continues to be vital to how we are handling the ongoing pandemic. We must take collective accountability to ensure that we take appropriate measures to ensure that we protect the health and wellbeing of ourselves, our patients, our colleagues and our families.

It is imperative that ALL STAFF, clinical and non-clinical, including office based (unless working entirely alone), must wear masks at ALL TIMES and in ALL AREAS.

Face masks must be worn appropriately

Where an individual is not wearing a mask correctly, or within a designated area, they should be appropriately challenged to identify their reason for non-compliance and offered support or assistance, if needed. If a clear disregard is acknowledged, reinforce the safety message regarding the need to protect themselves, their colleagues and patients. If necessary, escalate it to the individual’s line manager. For persistent non-compliance a DATIX report should be completed.

We cannot compromise on legal safety requirements of wearing the correct PPE, and wearing it correctly. Failure to do so puts our staff, patients, loved ones and the public at risk. As an organisation we have a legal responsibility under health and safety legislation to monitor any incidents of non-compliance with PPE.

As a reminder, a mask should:

  • cover your nose and mouth while allowing you to breathe comfortably
  • fit comfortably but securely against the side of the face
  • be secured to the head with ties or ear loops.

When wearing a mask you should:

  • wash your hands thoroughly with soap and water for 20 seconds or use hand sanitiser before putting it on
  • avoid wearing it on your neck or forehead
  • avoid touching the part of the mask in contact with your mouth and nose, as it could be contaminated with the virus
  • change the mask if it becomes damp or if you’ve touched it
  • void taking it off and putting it back on a lot in quick succession.

When removing a mask:

  • wash your hands thoroughly with soap and water for 20 seconds or use hand sanitiser before removing
  • only handle the straps, ties or clips
  • do not give it to someone else to use
  • dispose of it carefully in a residual waste bin and do not recycle
  • wash your hands thoroughly with soap and water for 20 seconds or use hand sanitiser once removed.

You can contact the following fit testers who are providing testing across divisions - test takes about 45 minutes to complete.

Community staff fit testing sessions will be held at Liverpool Innovation Park every Thursday between 9am and 4pm. A test takes around 45 minutes to complete and can be booked here click here​. If you have any questions about booking a test online please ​email Trevor.Duggan@merseycare.nhs.uk 

Tested? staff that have been fit mask tested

Will all team leaders/ward managers make sure that staff who have been tested are tagged in staff lists/off duties with ‘FT’ to enable them to be identified during out of hours and weekends.

 

Laundering of staff uniforms and scrubs (Standard Operating Procedure)

Not all areas will have changing facilities at work. Where this is the case staff can change at home but must not go to shops, pubs, restaurants etc. whilst in uniforms/scrubs.

Wear a clean uniform/set of scrubs each day

Areas with changing facilities

 

Areas with no changing facilities

Take uniform to work in a clean bag.

Put on a clean uniform at home.

Change into uniform at work putting regular clothes into bag.

At end of shift place used uniform into a bag for transport home and change back into clean regular clothes.

If items become visibly contaminated with bodily fluids whilst at work, first place into a soluble alginate bag - spare scrubs or uniforms should be available locally for such scenarios.

 

If soluble alginate bags are used this can be placed directly into the washing machine. A pillow case (from home, not hospital linen) could also be used to transport used items but should be emptied into the washing machine and washed with the uniform.

 

N.B. plastic bags should not be taken into secure sites where restrictions apply.

When home, place the uniform into the washing machine and wash on a 60°c wash.

 

Wash separate from other household laundry items.

 

When home, place the uniform into the washing machine and wash on a 60°c wash.

 

Wash separate from other household laundry items.

Wash and dry hands thoroughly.

Remove clean items from the washing machine and tumble dry if possible. Once dry, place clean items into a clean bag ready for use or transport.

All staff wearing uniform are reminded that they should be ‘bare below the elbow’, no rings (other than one plain band), bracelets, long, painted or false nails at all times. For full details see the Infection Prevention and Control Policy.

If an individual cannot wear a mask, this risk assessment should be completed. You may need to discuss it with your HR team member or the infection prevention and control team. Consideration should be given to the individual home working, where possible.