industry & reform
Clinical nurse Janice Geary performs a mock coronavirus examination inside the
fever clinic at the Prince Charles Hospital in Brisbane. Image: Darren England
On the front line
How do healthcare workers
protect against COVID-19?
By Dallas Bastian
G
rey’s Anatomy actress Ellen
Pompeo recently shared an
Instagram video explaining to
her 7.2 million followers that while many
citizens are able to follow government
advice to self-isolate to avoid contracting
COVID-19, nurses and other healthcare
workers don’t have that same privilege.
The video has been viewed more
than three million times. Many of the
13,000 comments posted are messages
of support from across the globe for
those on the healthcare front line of the
coronavirus crisis.
Two Australian academics, writing for
The Conversation, echoed Pompeo’s
points. Matt Mason, lecturer and program
co-ordinator for nursing at the University
of the Sunshine Coast, and Peta-Anne
Zimmerman from Griffith University said:
“Regardless of COVID-19, doctors and
other healthcare staff often feel some
level of expectation to turn up to work
even when ill. They’re often worried about
placing strain on co-workers and affecting
patient care.
“The practice of quarantining healthcare
workers who may have been exposed to
the virus puts additional pressure on health
12 agedcareinsite.com.au
services and is expected to increase as the
outbreak continues.”
The lecturers said as much as possible,
healthcare workers should follow
guidelines issued by their place of work or
health department.
On top of the standard health
precautions used all year round, Mason and
Zimmerman said workers are using two
classes of transmission-based precautions:
droplet and contact precautions.
“Contact precautions involve
putting on gloves and a gown upon
entry to the patient care area, to ensure
clothing and skin do not make contact
with surfaces that have potentially been
contaminated with the infectious droplets,”
they wrote.
“Droplet precautions involve wearing a
surgical mask so infectious droplets don’t
get in the mouth and nose.”
They added that while normally
coronavirus is spread only via droplets,
some medical procedures such as inserting
a breathing tube can aerosolise the virus,
meaning it can stay in the air longer.
“Healthcare workers may take
additional airborne precautions when
they’re undertaking aerosol-generating
procedures, such as intubating a critically
unwell patient. These precautions include
wearing a properly fitting P2/N95 respirator
and caring for the patient in a special
isolation room.”
Researchers from Hong Kong found
that health systems can protect healthcare
workers during the COVID-19 outbreak
when best practices for infection control
are “diligently applied”.
The researchers, from Queen Mary
Hospital in Hong Kong, reported that zero
healthcare workers contracted COVID-19
and no hospital-acquired infections were
identified after the first six weeks of the
outbreak, even as the health system tested
1275 suspected cases and treated 42 active
confirmed cases of COVID-19.
“Appropriate hospital infection control
measures can prevent healthcare-
associated transmission of the
coronavirus,” study authors said. “Vigilance
in hand-hygiene practice, wearing
of surgical masks in the hospital, and
appropriate use of personal protective
equipment in patient care, especially
when performing aerosol-generating
procedures, are the key infection control
measures to prevent hospital transmission
of the virus.”
Enhanced infection control measures
were put in place in each Hong Kong
hospital shortly after the reports of the
disease surfaced, including training on the
use of personal protective equipment, staff
forums on infection control, face-to-face
education sessions, and regular hand-
hygiene compliance assessments.
Mason and Zimmerman said while
international studies have shown
additional measures do protect healthcare
workers from contracting infectious
diseases, there’s often a gap between
the recommended practices and their
application in healthcare settings.
“Studies have indicated reasons for
this, including staff attitudes, insufficient
knowledge of procedures, inadequate
supplies, time pressures and staffing levels,”
they said.
“Education and training around these
procedures must be routine so that in
the face of an outbreak like coronavirus,
healthcare workers are supported and
prepared to implement these critical
protocols.”
The duo added that it’s critical that
healthcare workers can access the
appropriate supplies so they can follow the
proper infection prevention and control
protocols.
“We also need consistent messaging for
the public and healthcare workers on when
to contact a healthcare professional, how
that should be done and what to do to
minimise coronavirus risk.” ■