COVID 19 - Novel Coronavirus

As the BC COVID-19 curve flattens our community begins to move to the “new normal”. The key to moving forward is to ensure that we take every precaution necessary for the safety of our patients and our drivers.

After consultation with several infectious disease health professionals, the VCDS IPAC Policy was written. It has been developed with an abundance of caution, following Provincial Health Officer Dr. Bonnie Henry’s guidance, while balancing necessity with practicable and reasonable action.

Our future service will look and feel different but will remain consistent with our sole objective - getting cancer patients in need to their appointments, safely, on time, with compassion and understanding.



INFECTION PREVENTION AND CONTROL POLICY (IPAC):
Approved: May 22nd, 2020
Revised: November 16th, 2020


Introduction

The VCDS Policy concerning COVID-19-Novel Coronavirus and infections generally such as MRSA and Shingles is intended to be followed at all times by VCDS members when transporting patients to care.
The policy follows the VC Centre for Disease Control directives applicable to the work of VCDS and is designed to mitigate the risk of infection in order to best protect the safety of patients and VCDS members.

Policy

The VCDS IPAC Policy is designed to ensure all Drivers and Patients are compliant with the safety needs in the transportation of cancer patients. The Policy is subject to review and revision to reflect changes in the infection prevention and control environment to ensure our service meet our goal of minimizing the risk of infection to patients and drivers.

VCDS Dispatchers will:

1. Screen the patient at initial registration and at each subsequent appointment booking using the VCDS Health Screening Questionnaire (attached) to determine if the patient currently has or has been exposed to any contagious illness or been out of the country in the last 14 days.
2. If a Patient is in Assisted Living or a Care Facility and the site is on outbreak, all actions in and out of the facility are governed by the Medical Health Officer (MHO).
An outbreak can only be declared over once there are two incubation periods (28 days) with no new symptomatic cases. Dispatchers will need to ask when the outbreak started. We must refuse driving until the outbreak is declared over. If the patient is symptom free, it is good to know but it will not change our policy in terms of transporting patients when their home/care home/ AL site is on outbreak
3. Inform the patient that they are to arrive at the transport vehicle wearing a mask at which time the driver will supply a non-medical disposable mask for their use (this is a 3-layer mask that meets Public Health directives.
4. Inform the patient that if they must have assistance then only one person may accompany them during transportation and that person must arrive to the transport vehicle with a mask and will be issued a non-medical disposable mask as well. An accompanying person must be pre-qualified by the health facility as an essential person otherwise they will not be admitted to the facility and they cannot wait with the VCDS driver.
5. Ensure patients are not transported in a carpool.
6. Record the driver’s notice of the patients’ PASS or FAIL to the VCDS Health Screening Questionnaire as well as the Driver’s attestation that they too PASS the VCDS Health Screening Questionnaire.


VCDS Drivers will:

1. Receive a 24-hour reminder email to contact the patient the day before the scheduled appointment time to screen the patient using the VCDS Health Screening Questionnaire (attached) to assess their health and wellbeing and inform the Dispatcher of the patient’s PASS or FAIL.
2. Concurrently the driver will self-assess their own health consistent with the VCDS Health Screening Questionnaire and advise the Dispatcher that they PASS
3. The driver will inform the patient that has responded positive to any part of the questionnaire that they have FAILED the screening and that we are unable to provide transportation until the patient is well.
4. Advise the patient that they must arrive for transportation wearing a mask but that they and should an essential person be accompanying them, they will be given a non-medical disposable mask for transportation to the facility.
5. The driver is to wear the VCDS issued mask with filter at all times when with the patient and in the alternative may wear the non-medical disposable mask.
6. Place the patient (and essential assistant) in the rear seat(s) to maximize social distancing. Patients and other individuals are not allowed in the front seat under any circumstances.
7. The driver must maintain rigorous hygiene and appropriate precautions by:
         a. Washing hands as well as providing the hand sanitizer to the patient before and after each contact.
         b. Ensuring their vehicle sanitation is maintained by wiping down vehicle hard surfaces and seats with VCDS provided disinfectant wipes (spray aerosols are not recommended) prior to and following patient transport.


Patient falls ill in the vehicle:

1. In the rare event that the patient is ill in the vehicle the following cleaning steps are necessary:
         a. Wear gloves, a mask and eye protection and clean up as soon as possible with soapy water (e.g. Dish detergent). Rinse and dry with paper towels.
         b. Wash hands when gloves are removed.
         c. Use disposable supplies, like paper towels, to wipe up.
         d. If fluid splashes into one’s eyes rinse gently with water for 15 minutes.
2. The VCDS will pay for professional cleaning of the vehicle's interior if the patient is ill. The driver may claim the expense on their monthly driver expense claim.
3. The VCDS will provide drivers with a ‘travel kit’ that includes a VCDS washable mask and filters and supply of non-medical disposable masks, hand sanitizer, disposable gloves and disinfectant wipes. Drivers will ensure the ‘travel kit; is subsequently maintained from supplies via their dispatcher or by purchasing and claiming reimbursement through the monthly driver expense report.

VCDS Recommendations:

It is highly recommended that drivers:
• Get an annual flu vaccine (flu season is typically October to April)
• Consider getting the pneumonia vaccine (if eligible)
• Consider getting the shingles vaccine (if eligible)


VCDS HEALTH SCREENING QUESTIONNAIRE:


To ensure patient and driver safety, Dispatchers and Drivers will ask each patient if they may have any symptoms of a communicable illness such as a cold, flu, fever or any risk factor for COVID-19 exposure as well as MRSA or Shingles. The questions will be asked by:


• The Dispatcher when the patient makes contact to book appointments(s)
• The Driver the day prior to the scheduled appointment

MRSA or Shingles infections: If the patient knows that they may have MRSA or Shingles and if they have an open wound that would indicate that there is an active infection and they should not be transported if the wound cannot be effectively covered. If the wound is able to be covered, then it is okay to proceed as normal and to clean and disinfect the care as you normally would. This also extends to Shingles. If the wounds are wet and weepy and cannot be covered effectively (this usually means the face) then do not drive the patient.

COVID-19 QUESTIONS:

In the last 14 days have you:

• Been outside Canada and not completed a self-isolation or quarantine program
• Been in contact with someone diagnosed with COVID-19
• Lived or worked in a setting that has a COVID-19 outbreak
• Been advised by Public Health to self-isolate or quarantine at home

In the past 3 days have you:

  • Noticed any symptoms of a cold, flu, fever or other contagious illness
  • If the patient answers yes to any of the questions they must be informed that we cannot drive them until they can show they are negative to COVID