DHHS updates PPE guidance, skincare advice to prevent and manage mask and eyewear facial injuries; updated rules for residential aged care; asymptomatic aged care worker testing starts
ANMF has collated the important links all in one place, so you don’t have to go looking. Please bookmark and check this page regularly – anmfvic.asn.au/covid-19
Members with COVID-19-related employment questions can ask via the Member Assistance online inquiry form anmfvic.asn.au/memberassistance
Please read the information on our website before submitting a question. Member Assistance is not taking phone inquiries as ANMF staff are working remotely. Members whom ANMF deems have complex inquiries will still have phone contact with staff.
The DHHS Coronavirus Guidance Note on Employment-Related Matters (bit.ly/2UhDSU2) was last updated 18 September.
Latest COVID-19 statistics
Healthcare Worker COVID-19 data dashboard (updated on Tuesdays) bit.ly/3jQT5q4
Victorian COVID-19 data dashboard bit.ly/3j5vJwC
Victorian Chief Health Officer daily update bit.ly/34Et8Ug
Victorian Chief Health Officer daily media release bit.ly/2EDiQLb
Victorian high-risk locations, outbreaks, hospital admissions and deaths via bit.ly/33szLKu
National COVID-19 survey closes on 31 October
We still need more Victorian nurses, aged care personal care workers and midwives to complete the national ANMF COVID-19 survey. Take the 20-minute survey now is.gd/covidandwork
COVID-19 stressed? Take the self-care quiz
All nurses, midwives, personal care workers and nursing and midwifery students are encouraged to reflect on their current circumstances and wellbeing and fill out the Nursing and Midwifery Health Program Victoria’s self-care plan questionnaire (via bit.ly/343qHLf ). You will be emailed a self-care plan.
The NMHPV is an independent service providing free and confidential counselling and support to Victorian nurses, midwives, nursing and midwifery students and aged care personal care workers.
Nurses and midwives can be reluctant to seek support, fearing being seen as unprofessional or feeling they should be able to cope. The NMHPV’s ‘I’m only human’ campaign (bit.ly/3dhd0wk) is aimed at encouraging nurses, midwives, and residential aged care personal care workers, to seek support before you hit crisis point from the demands of working within a one-in-100 years pandemic.
The NMHPV can provide anything from a caring and compassionate listening ear to helping you develop a care plan to get your health back on track. They are also a safe space to talk about family violence, and alcohol and substance use, and can refer you to specialist services if necessary.
Protective personal equipment guidance updated
On 21 October the Department of Health and Human Services updated its personal protective equipment guidance for health services following the changes to the COVID-19 restrictions for the community.
The ‘Guide to the conventional use of PPE’ document now recognises the probability of the airborne nature of COVID-19. The guide differentiates between ‘suspected’ and ‘probable’ COVID cases.
A suspected case includes people awaiting results of a test, where there may be symptoms that could be consistent with COVID-19 but no epidemiological risk factors.
A probable case is a person who has a compatible clinical illness and meets one or more of the following epidemiological criteria:
- in the 14 days prior to illness onset:
- was a close contact of a confirmed or probable case
- travelled internationally
- resided in an area where outbreaks are present, including aged care
- lived in or travelled through a geographically localised area with elevated risk of community transmission, as defined by public health authorities.
- Where a patient’s history cannot be obtained, they should be considered as a probable COVID-19 case until further screening information can be obtained.
Tier 2 PPE requirements (no N95 respirator mask) now only apply to healthcare workers providing care to a person suspected of having COVID-19.
Tier 3 (including N95 respirator mask) requirements have been expanded to include all scenarios where care is provided to probable and confirmed patients, regardless of the amount of contact time or duties. Tier 3 also applies if a person suspected of having COVID-19 is undergoing an aerosol generating procedure.
Maternity services guidance updated
The DHHS Maternity and neonatal care guidance was updated on 16 October.
The revised guidance acknowledges the impact of the pandemic on women’s perinatal mental health and recommends regular assessment at every contact.
The guidance also provides the following advice about water immersion for labour and birth if COVID-19 is not suspected:
‘Services should consider their response to local circumstances in relation to use of water immersion for labour and birth.
Use of water immersion may be appropriate for women who screen negative for coronavirus (COVID-19) risk factors.
If there is a local outbreak, or increasing rates of local community transmission, it may be appropriate to suspend the use of water immersion. At these times, showers can still be used for pain relief when required, as women can come out of the bathroom for assessment during labour.’
Read the Maternity and neonatal care during COVID-19 (16 October) via bit.ly/3aWCnmc
Skincare advice to prevent and manage facial injuries when wearing PPE
ANMF has been calling for skincare guidance since July when nurses began reporting facial injuries after prolonged use of P2/N95 respirator masks and eye protection equipment.
DHHS has released evidence-based guidance and workplace posters to prevent and manage facial injuries and skin damage for healthcare workers wearing surgical masks and respirator masks. Advice includes recommending regular breaks, allowing at least 30 minutes for barrier creams to dry, how to use dressings if required, how to protect open wounds, when potential redeployment should be considered and when to consult a dermatologist.
Members are encouraged to display the DHHS posters, if not up already in your workplace. This link bit.ly/3o7rggi (PDF) has three posters:
- Caring for facial skin when wearing a surgical face mask
- Caring for facial skin when wearing a P2/N95 respirator and eye protection
- Caring for facial skin – applying dressings under PPE
The DHHS ‘Fact sheet: Extended P2/N95 respirator and eye protection use – preventing facial injury during coronavirus’ provides detailed guidance for nurses, midwives and personal care workers and their employers to identify and manage facial injuries/ skin damage occurring due to prolonged personal protective equipment. bit.ly/31qHjw4
Update: healthcare infection prevention and wellbeing taskforce
The healthcare worker infection data dashboard (bit.ly/3jQT5q4 ) is updated every Tuesday.
Infections are continuing to come down with five new cases in the previous week as at 20 October. There were six cases in the previous reporting week (ending 13 October). New cases included three aged care and disability workers (this category is not broken down) and two nurses.
The Healthcare Infection Prevention and Wellbeing Taskforce (bit.ly/343WtIe ) continues to meet weekly. ANMF (Vic Branch) Secretary Lisa Fitzpatrick is a member of the taskforce.
The taskforce’s latest update includes the information about:
- The preliminary findings from the fit-testing trial at the Northern Hospital. The trial has found almost all employees have been able to achieve a successful fit. It has also found effectiveness is reduced where healthcare workers tape down masks or use gauze to improve comfort.
- The taskforce is developing advice to manage healthcare buildings and equipment based on the analysis and modelling of aerosol behaviour of particles moving around a room that eventually hit and stick to a surface.
- Regular asymptomatic surveillance testing of staff on COVID-19 wards was introduced on 4 September in public and private health services. Testing includes full-time, part-time and agency staff. Testing between 4 -18 September identified three positive cases. The taskforce is considering expanding surveillance testing.
- Developing a pandemic roadmap for the health sector to provide a risk-based decision-making framework.
- An updated screening tool for residential aged care residents to identify typical and atypical COVID-19 symptoms.
Read the full 13 October taskforce update bit.ly/31tFVc7
Important taskforce documents
- COVID-19 Best practice approaches for safe staff amenities for health services bit.ly/3lhKIEZ
- Victoria’s respiratory protection program bit.ly/2G3yr84
- Victoria’s respiratory protection program guidelines bit.ly/2G35gSs
- Daily attestations: frequently asked questions bit.ly/2RXVjbC
ANMF continues to lobby for consistent single site aged care employment policy
A single site employment policy continues to apply in residential aged care in the metropolitan Melbourne and Mitchell Shire.
ANMF continues to lobby the Federal Government to implement a single-site employment policy in Victoria’s private residential aged care sector that is consistent with the policy in the Victorian public sector residential aged care facilities.
The Victorian Government’s single site employment policy – one worker, one site, in public sector aged care facilities has been extended until February 2021.
The Federal Government’s policy was due to end on 26 October. On 16 October, the Federal Government advised the policy would be extended to 30 November 2020 for all private aged care facilities.
Updated rules for all Victorian residential aged care facilities
The DHHS has issued a guidance document explaining new state and national workplace directions for all Victorian residential aged care facilities. This means it applies to public and private residential aged care. The new rules are based on public health advice and have been issued as Directives to slow the spread of COVID-19.
The updated rules include:
- All residential aged care facilities are required to comply with cleaning and PPE in accordance with DHHS requirements. See DHHS website for more information via bit.ly/2HbcQeF
- A worker from an outbreak site cannot work at another site until they have isolated for 14 days and presented a negative test no more than four days prior to starting at another site.
- Where a worker has worked at a site in a restricted zone (e.g. metropolitan Melbourne), they cannot work at a site outside the restricted zone unless they have no COVID-19 symptoms, a negative test result and have isolated while awaiting the test result.
- One site, one worker – workers are still required to work at only one site. Where this is not possible, they must declare if and where they have worked before the beginning of their shift.
- Staff and visitors must now declare in writing before entering the facility that they are free of COVID-19 related symptoms and have not been directed to self-isolate or quarantine.
- A work or visitor must not enter a facility if they are not wearing a fitted face mask or have the mildest of COVID-19 symptoms
- Residential aged care facilities are required to undertake asymptomatic testing of all workers for COVID-19 and keep records.
- Residential aged care facilities are required to retain records and demonstrate compliance with directions including:
– a COVIDSafe plan
– work rosters
– logs created to monitor the directions
– time and attendance information
– payroll data
– worker and visitor logs, including contact details and declarations
– surveillance testing of employees and contractors.A grace period until 26 October applies for new requirements such as the worker and visitor declarations to be in place.
- In addition to the visitor changes announced on 27 September – visitors aged under 16 years are now able to visit.
- A single household can now visit an aged care resident in regional Victoria – limits of 4m2 per person indoors, and 2m2 outdoors, still apply
- Hairdressers can now visit residential aged care facilities in regional Victoria.
This information is from DHHS ‘Directions update: residential aged care – employers and workers’ (19 October). Read the full document via bit.ly/3kiJ8Tb
Regular surveillance testing of aged care workers – Victorian public aged care
Regular asymptomatic testing of all aged care workers in public sector residential aged care began on 19 October. It will be initially in place until the end of January 2021. The decision for continued asymptomatic testing will be reviewed throughout this period.
The Victorian Department of Health and Human Services has released asymptomatic testing guidance for public sector aged care workers and residents.
As reported in our COVID-19 Newsflash #25 all metropolitan aged care workers will be tested every fortnight. All regional aged care workers will be tested every month. The testing requirement applies to public and private residential aged care as part of the Victorian Government’s high-risk industry surveillance program.
The DHHS says testing is not mandatory but is strongly encouraged to protect the health and wellbeing of aged care workers, their families, co-workers and the residents. Where staff choose not to participate, other measures such as daily screening and attestations processes are in place to minimise the risk of staff working when they are unwell.
All staff regularly working should be offered testing conducted by public health services. This includes all direct employees, contract, sessional, casual and visiting staff members across all shifts. This may include for example:
- medical, nursing and allied health staff
- personal care attendants
- administration and management staff
- maintenance staff
- security staff.
Workers participating in asymptomatic testing are not required to isolate while waiting for test results which should be returned within 12-24 hours.
Employers are encouraged to organise testing when aged care workers are rostered on to avoid staff coming in on their days off.
For more information:
DHHS guidance for public sector residential aged care
- DHHS Protecting the health of public sector residential aged care workers and residents: asymptomatic testing Guidance and frequently asked questions – 19 October 2020
- DHHS Protecting our aged care workers: asymptomatic testing – Frequently asked questions for staff of public sector residential aged care facilities – 19 October 2020
Regular surveillance testing of aged care workers – Victorian aged care
As reported in COVID-19 Newsflash #25 all metropolitan aged care workers will be tested every fortnight. All regional aged care workers will be tested every month. The testing requirement applies to public and private residential aged care as part of the Victorian Government’s high-risk industry surveillance program.
The Department of Health has also published an aged care asymptomatic testing fact sheet. The information is less comprehensive than the DHHS information for public aged care.
ANMF is lobbying for consistent information and consistent messages to ensure a holistic approach to the aged care sector erring on the side of the DHHS’ more cautious approach. For example, DHHS is encouraging public aged care facilities to make regular testing convenient across all shifts so that aged care workers do not need to come in on their day off. The DoH information does not refer to the 100 per cent testing targets set by the Victorian and Federal governments.
The DoH fact sheet says Melbourne Pathology, a subsidiary of Sonic Healthcare, or Aspen Medical will offer in-reach testing for asymptomatic aged care workers in Victoria’s private residential aged care.
All staff at the facility on the day of testing will be offered a test. To be effective at least 25 per cent of staff will need to participate and aged care providers are strongly encouraged to promote testing. Results will be provided to the participants and the facility.
Staff who feel well and participate in asymptomatic testing are not required to self-isolate.
For more information:
- DOH website bit.ly/35ksKLw
- DoH Fact sheet: testing of asymptomatic aged care workers – 15 October bit.ly/34fJrIC
If you work in health and aged care settings and have symptoms
All health care workers, including aged care staff, with symptoms must get tested immediately – don’t wait for your workplace test – and you must isolate while waiting for your results.
If you do not have access to paid leave, a Victorian Government test isolation payment of $450 is available while you wait for test results. More information via bit.ly/3fWygqQ
A $1500 Commonwealth Government disaster leave payment is available if you test positive to COVID-19 and must isolate for 14 days. More information via bit.ly/3iHuEuH)
Important PPE guidance and infection control links
- DHHS infection control guidance page bit.ly/DHHSinfectioncontrol
- DHHS PPE guidance (updated 21 October) bit.ly/DHHSppe
includes definitions of tiers and when N95 respirator masks should be worn
- COVID-19 – PPE and levels of protection (20 July) bit.ly/2G7VCO7
- DHHS COVID-19 – a guide to the conventional use of PPE (updated 21 October) bit.ly/2yBnmaa
- Coronavirus disease 2019 (COVID-19) Infection Prevention and Control guideline (10 September) bit.ly/3deTBLE
- DHHS COVID-19 – Disposing of clinical waste bit.ly/2REJF5b
- Personal Protective Equipment for the provision of mental health care (1 September) bit.ly/2ALJgch
- PPE for community service providers for prevention of COVID-19 (29 September) bit.ly/3hIsWt0
- Maternity and neonatal care during COVID-19 (16 October) bit.ly/3aWCnmc
- Respiratory support for children during the COVID-19 emergency (updated 23 September) bit.ly/3dcA2DL
- Assisting patients with hygiene care during coronavirus (COVID-19) – risk minimisation for staff (PDF) (1 October) (new) bit.ly/2H0hknW
- WorkSafe Victoria Managing coronavirus (COVID-19) risks: Healthcare and social assistance industry – Respiratory Protective Equipment (RPE) bit.ly/3ddwqRT
Do you have a personal protective equipment concern?
ANMF continues to advocate and raise and resolve members’ issues at the PPE taskforce union consultation meetings. Members with concerns about PPE should:
- continue to raise and submit OHS incident reports with your employer as well as speaking directly with your manager
- involve your Health and Safety Rep if you have one
- contact ANMF via anmfvic.asn.au/memberassistance (include your report and response if applicable) for further support and advice if after you have raised your concerns they are not addressed by your employer.
Changes to COVID-19 restrictions
From 11.59pm, Sunday 18 October changes to restrictions in Metro Melbourne included –
- removal of the time limit on leaving home and the five km travel limit expands to 25 kilometres
- outdoor gatherings allowed with up to 10 people from two households
- skate parks, golf and tennis are open
- outdoor real estate auctions with a max of 10 people and commercial real estate inspections can occur
- hairdressers re-open
- outdoor pools can host 30 swimmers
- non-essential outdoor home maintenance/ repairs/ renovations – maximum of five workers
- full return to allied health
- retail to open and further changes expected from 11.59, 1 November.
From 11.59pm, Sunday 18 October in regional Victoria
- visitors to the home: maximum of two people plus dependents
- outdoor gatherings allowed up to 10 people from two households
- hospitality venues increase capacity to 70 people outside and 40 inside
- households can visit care facilities rather than one person at a time
- more changes to indoor sport and recreation from 11.59pm, Sunday 1 November
Further changes to restrictions have been flagged by Premier Daniel Andrews to be announced on Sunday 25 October.
COVID-19 call out: be part of the nursing and midwifery exhibition
Victorian nurses and midwives are being asked to share their ‘caring under COVID-19’ experience and photographs as part of an exhibition to mark the International Year of the Nurse and the Midwife.
The exhibition to be held at Her Place museum in East Melbourne will launch in early 2021. It is also expected to travel to regional Victoria.
Funded by the Victorian Government, the exhibition will be hosted in partnership with the Department of Health and Human Services and Safer Care Victoria and is supported by the Australian Nursing and Midwifery Federation (Victorian Branch). To participate, go to bit.ly/caringundercovid
Don’t bring it home: guide to minimise the risk of infection
A reminder that ANMF (Vic Branch) has developed a guide to assist you in relation to returning home from work after a shift.
Job Reps and HSRs are encouraged to print the poster which is part of this PDF newsflash. You can also download the ‘Protocols for entering your home and minimising the risk of infection’ A4 poster via bit.ly/COVID19-DBIH