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COVID-19 Bulletin: Tuesday 11 January

January 11, 2022

1.   Important reminder: Revised PPE Guidance – Change to FFP3 in ward areas

Colleagues are reminded FFP3 masks are required in all ward areas when giving patient care.

We have carried out a further risk assessment in relation to PPE usage in our clinical areas. This has taken into account the following:

  • Current high volume of infection rates in the community.
  • The corresponding high number of COVID-19 admissions.
  • Some cases where patients on amber non-COVID wards have subsequently had a positive COVID PCR swab test after initial negative test.
  • Increasing outbreaks in our ward areas.
  • The ventilation in our ward areas (although new HEPA filters in Sandwell are helping with this).

The outcome of that risk assessment has led to a decision to increase the required level of PPE in these inpatient environments for some staff. This is above and beyond the current national guidelines. This is under constant review and may well change if the regular review of the risk assessment indicates that the risk is lowered.

For all inpatient areas where there is direct patient contact (in both red and amber wards), staff should wear as a minimum:

    • A silicone mask/FFP3 mask – these can be sessional use. Single use gloves and aprons (please ensure you have been fit tested for an FFP3 mask before use). Visors may be necessary in some clinical circumstances as per risk assessment for each individual patient.
    • You should wear a fluid-resistant surgical face mask if you do not have direct patient contact.  Non-direct patient contact includes walking on a ward area, pharmacists, clerical staff, estates and facilities staff. Disposable gloves/aprons should be worn for contact with patients/immediate environment. Porters who are transferring patients should wear FFP3/silicone face mask when transferring patients to red and amber wards.
    • If you are visiting the ward from another area, a minimum requirement when entering the unit will be to wear a fluid resistant surgical face mask.

Please note: staff must follow their individual risk assessment for PPE. Occasionally this will recommend a higher level of protection depending on your individual assessment.

  • For all outpatients and community staff inclusive of health visitors/school nurses/GP practices, for staff visiting care home facilities, patients and families homes, surgical face masks should be worn as a minimum with a disposable apron and gloves for direct patient care. Follow your individual risk assessment to see if you need a higher level of PPE.
  • If clinical intervention is required, a clinical risk assessment should be undertaken prior to the contact to establish whether there is a requirement for a higher level of PPE. For example, if a patient with a known respiratory condition has a persistent cough (not COVID related), an FFP3 and a visor should be worn in the event that the contact is essential and cannot be delayed.
  • Porters and facilities staff on wards can continue to wear a surgical face mask. However, if they are in direct patient contact, they will then need to follow the guidelines outlined above for inpatient staff.
  • Fluid resistant surgical face masks may be worn in rest areas and managers are urged to ensure colleagues have regular hydration breaks. If you have any questions, please speak to your line manager or infection control on ext. 5900 or email  swb-tr.SWBH-Team-InfectionControl@nhs.net.

You should be fit-tested for the current masks we have in stock but if you aren’t please make sure you do so as a priority. FFP3 masks can be obtained through usual arrangements by ordering from Stores. Fit testing continues at City Hospital, details of how to book are on Connect.

  1. New: Staff testing requirements

As you know, it is mandatory for all staff to undertake regular testing. Colleagues attending site more than once a week are expected to sign up to our LAMP testing programme and bring in a LAMP sample once a week. This is our preferred regular testing programme for all staff with no symptoms because of the accuracy of the test. To register for LAMP please call 0121 507 2664 (Monday- Friday, 8am-6pm) and select option 6 to register and book a kit collection slot.

If you are unable to take part in the LAMP testing programme then you must do twice weekly lateral flow tests (LFTs). These are available to order online or to collect from a range of services in the community. LFT results should be reported to the national website whatever the result.

As described in the staff isolation and testing guidance that was issued in the COVID-19 bulletin on Friday 7 January, lateral flow testing is additionally to be used for people who are self-isolating as a result of testing positive for COVID-19, and for people who are a contact of a COVID-19 case.

We recognise that at the present time there are difficulties accessing lateral flow tests through usual routes, although it is expected that these issues will be resolved. We do have access to a limited supply of LFT kits If colleagues are having difficulties accessing these and we would prioritise this supply to people who need LFTs as part of the process to end self-isolation or to continue working safely as a contact of a positive case.

LFT kits required in these circumstances are available from the IPC team or from the swabbing pod in the Little Lane car park, Sandwell Hospital.

If LFT kits are required as part of an  outbreak, the ward or service manager should email sandwell.adminhub@nhs.net putting “LFT – outbreak requirement” in the subject field. Please include your ward or service and the number of staff who need to do daily LFTs. We will then respond to you to arrange collection.

  1. Updated: Swabbing pathway for unplanned admissions

An updated swabbing pathway has been issued for patients who are unplanned admissions. All acute admissions must be swabbed in ED. Previously COVID-19 positive patients do not need re-screening for 90 days from first positive result unless they have new COVID symptoms. If a patient has a history of COVID-19 within the last 14 days and has no clinical symptoms, please follow the medium risk stream.

The main changes in this update relate to patients in PCCT. All patients transferring to PCCT beds must be lateral flow tested by the transferring ward and the result shared during a telephone handover to the receiving ward. A PCR must still be done but you do not have to wait for the result to transfer the patient.

All patients going home with a home care package can be lateral flow tested where there are no additional risk factors, rather than waiting for the results of a PCR test. If they test positive for COVID-19 then additional support/advice will be given prior to discharge.

You can read the full guidance here.