Health and aged care workers

Information for health and aged care workers and organisations

This information should be read alongside COVID-19 information developed by the Australian Government Department of Health for healthcare workers, and additional information on this website and the Australian Government Department of Health website about home quarantine, physical distancing and border control measures. This information is not intended as clinical guidance for health or aged care workers directly caring for confirmed, probable or suspect cases of COVID-19. Information is also applicable for health and aged care organisations.

Who is a health or aged care worker?

Health or aged care workers are staff providing direct care to patients in health and aged care facilities and in residential and community settings. This includes staff registered through the Australian Health Practitioners Regulation Agency, students within those professions and medical attendants.

You cannot go to work as a healthcare worker if:

  • you have direct patient contact AND you develop a fever (≥37.5°C) or history of fever (eg night sweats, chills) OR an acute respiratory infection (eg shortness of breath, cough, sore throat); you fit the definition of a suspect case of COVID-19 and need to be tested*
  • you meet any criteria for quarantine and have not been given exemption from quarantine to attend work; you need to stay where you have been directed to stay
  • you had unprotected close contact with a confirmed case in the last 14 days^; you need to quarantine for 14 days from your last contact with the confirmed case

*This does not include contact you may have with confirmed cases while using recommended personal protective equipment and infection control measures as part of your work.

^Early detection of COVID-19 in healthcare workers is an important protective mechanism for the higher risk population that we care for. For this reason, healthcare workers that provide direct care have a lower threshold for being a suspect case.

If you need to stay away from work but cannot do this in your own home, you may be eligible for emergency accommodation. However, you will need support from your management to be eligible.

COVID-19 is highly transmissible and can be easily spread via sneezing and coughing or touching contaminated environmental surfaces.

Health workers should be mindful of the following principles to reduce transmission risk:

  • reduce physical contact (eg avoid shaking hands)
  • use good hand and respiratory hygiene
  • keep 1.5 metres away from others when possible (see 'What does physical distancing mean for health and aged care workers?' below)
  • ensure each person has 2m2 space around them where possible (eg increase distance between chairs for patients and staff)
  • reduce face-to-face gatherings by using alternative methods where possible (ie teleconference or providing health care remotely eg through Telehealth)
  • minimise staffing changes for patients who are vulnerable to severe illness from COVID-19
  • enforce visitor restrictions
  • read the advice from Worksafe Tasmania on How to keep your workers safe and limit the spread of COVID-19.

In order to provide further support to all workers during this time, workplaces were required to develop ‘COVID-19 Safety Plans’ to meet requirements of the Public Health Direction under Section 16 (Workplace COVID Plan – No. 1). Employees should contact their employer directly about their workplace requirements. Refer to the Worksafe Tasmania website for a range of other resources.

Infection control precautions

Your organisation will have implemented clear infection prevention and control protocols as part of its COVID Safety Plan.

You may find the following resources useful:

Organisations should:

  • provide alcohol-based hand rub for use by all staff, patients and visitors within your facility;
  • provide soap and paper towels at all hand basins;
  • provide tissues and no-touch rubbish bins;
  • provide staff with appropriate personal protective equipment when it is required; and
  • display posters about hand hygiene and respiratory hygiene.

More infection control guidance is available from the Infection Control Expert Group.

Staff must not attend work if they are unwell and should be tested for COVID-19 if they have any respiratory symptoms.

Cleaning staff should wear disposable gloves, wash hands regularly and if cleaning areas that have been used by people in quarantine or isolation, wear PPE in accordance with their organisation’s infection prevention and control protocols. For more information on cleaning, go to Cleaning or the Australian Government Department of Health's Environmental cleaning and disinfection principles for health and residential care facilities.

What does physical distancing mean for health and aged care workers?

Physical distancing means increasing the physical space between yourself and others as much as possible. Clearly this is not always possible when providing direct care. When it is safe and practicable to increase distance, you must do so.

For example:

  • when conducting clinic appointments, place patients’ chairs at least 1.5 metres from your own and keep your distance when not doing physical examinations;
  • avoid handshakes, hugging and kissing people as greetings;
  • increase distances between chairs in waiting rooms, especially for people who are vulnerable to severe illness;
  • minimise staffing changes for those receiving care who are vulnerable to severe illness from COVID-19;
  • minimise unnecessary visits to those who are vulnerable to severe illness from COVID-19;
  • avoid crowding in lunchrooms and offices, including during shift handovers;
  • maintain distance from colleagues where possible;
  • minimise face-to-face meetings; use teleconference and videoconference for meetings where possible and limit the size and duration of meetings;
  • minimise patient visitors and the number of people accompanying patients.

Healthcare workers at higher risk

There are healthcare workers providing direct patient care who are at higher risk of severe illness from COVID-19.

What should healthcare workers at higher risk of severe illness do?

Having a safe working environment is essential.

There are many roles throughout the health system that may be available for staff at higher risk of severe illness, to reduce their risk of exposure to COVID-19.

If you are a healthcare worker at higher risk of severe illness from COVID-19, talk with your manager about your level of risk and ways to lower the risk. You may be asked to seek advice from your GP or relevant specialist.

What should healthcare workers who are caring for or living with a person who is at higher risk of severe illness do?

If you are worried because you live with or care for someone at increased risk of severe COVID-19 illness, discuss options with your manager.

What should managers do?

Managers have a duty of care to work with healthcare workers identified as being at higher risk of severe COVID-19 illness, to provide safe working environments.

Consider:

  • areas of the health service where there is low risk of exposure to COVID-19
  • roles within the health service that have low risk of exposure to COVID-19, eg staff education
  • other health services where there is low risk of exposure to COVID-19
  • the option of providing health services remotely, for example through telehealth or telephone services, or assisting with calls to the Public Health Hotline.

If necessary, request information from the staff member’s GP or relevant specialist.

If I'm looking after someone who is in quarantine, what precautions do I need to take

Contact and droplet precautions are recommended for routine care of patients in quarantine or with suspected or confirmed COVID-19.

Contact and airborne precautions are recommended when performing aerosol-generating procedures, including intubation and bronchoscopy, and for care of critically ill patients.

Remember to change your facemask if/when it becomes damp.

The Tasmanian Infection Prevention and Control Unit has published instructional videos on the use of personal protective equipment.

For more information about infection control precautions, see your service’s infection prevention and control guidelines or contact your infection prevention and control staff.

Can patients in quarantine still attend appointments?

Patients can leave quarantine to access arranged medical care when this is supported by their healthcare provider and the care cannot safely or feasibly be postponed. Patients should contact their healthcare provider before the appointment and let you know they are in quarantine for COVID-19. You should determine if the appointment can be safely or feasibly deferred and provide advice on safe travel (which should be direct to/from the medical premises, to minimise potential spread of illness and protect others) if the appointment proceeds.

For these purposes, medical care includes:

  • antenatal appointments
  • specialist appointments
  • outpatient clinic appointments
  • urgent primary care appointments that cannot be safely postponed
  • urgent and emergency transport to hospital.

All travellers arriving in Tasmania are required to quarantine for 14 days unless they meet Essential Traveller status or exemption criteria and have received official communication stating that they are exempt.

Healthcare workers (including medical, nursing, midwifery and allied health professionals, paramedics and ambulance officers) may apply for exemption from having to complete 14 days quarantine after arriving in Tasmania. Decisions relating to quarantine exemption will be based on the essential (and time-critical) nature of the work to be provided, and the risk profile of the arriving traveller.

Every health care worker seeking an exemption from quarantine must complete an online application as part of registering to travel to Tasmania using the G2G PASS system.

Exemptions are not available for aged care workers.

Further guidance on Tasmanian border restrictions for public and private health workers on the existing exemption categories and the process for seeking exemption from quarantine requirements is available at Border control information for health workers.

Influenza vaccine requirements for aged care workers

Since 1 May 2020, you must have had the 2020 influenza vaccine to work in or visit a residential aged care facility unless your presence is required for the purposes of emergency management or law enforcement. Find out more about this requirement.

Advice for immunisation providers, including councils and General Practice

The Department of Health has produced these recommendations to help councils, General Practice and other immunisation providers provide immunisation services to their community.

The threat of coronavirus (COVID-19) to public health is unprecedented. We must all take steps to minimise the risk of transmission to staff and clients attending community immunisation services.

Immunisation providers will have to consider these recommended procedures, based on current advice, when developing their operational processes based on staffing levels, venues and client numbers.

Recommendations for venues

Signage

It is recommended signage be displayed at the entrances of all sessions. Such signage should include the following information:

  • Due to the ongoing coronavirus (COVID-19) pandemic, <Immunisation provider> is taking measures to protect the community. It is vital their instructions are followed.
  • Only one parent/guardian should accompany a child into the session.
  • People should not attend the session if they or their child have symptoms of a respiratory infection (such as fever, or a sore throat, or a runny nose, or shortness of breath or a cough) or have returned from overseas or interstate in the past 14 days.
  • Wash hands or use hand sanitiser provided at the entrance to the reception or waiting area.

Consideration should be given to the translation of all signage and messaging into other key community languages.

Physical distancing

  • Immunisation providers may need to consider moving immunisation services to larger spaced community venues.
  • Immunisation providers may need to consider implementing a booking system to manage client flow and to avoid gathering people together at the same time.
  • Arrange client seating and queueing for administration so there is 1.5 metres between clients.
  • If there is a child, limit the vaccine process to one adult with the child being vaccinated (unless there are extenuating circumstances).
  • Consider a separate room for clients to wait after vaccination depending on numbers at each session.
  • If many clients arrive and there is not enough seating, a staff member should be available to monitor queueing and maintain the order and flow of clients into the administration area.
  • Sit clients 1.5 metres from administration staff desk on check in and 1.5 metres from other clients at the nurse’s table.
  • Minimise physical contact with clients and client record documents.
  • Individual providers can consider models that work best for their space and circumstances, but may include:
    • using additional waiting areas, eg in car or an outside space before vaccination, or additional waiting rooms if available;
    • using SMS to inform clients when immunisers are ready for them; and
    • using a staggered immunisation approach across three to four clinic rooms/spaces. Clients are placed in separate rooms for immunisation and observation periods and the immuniser moves from room to room.

Vaccine preparation

Do not needle or prepare large quantities of vaccine in case of low attendance.

Personal Protective Equipment (PPE)

  • PPE additional to that normally used as part of your routine immunisation service is not recommended. PPE is only necessary for healthcare workers seeing patients with symptoms consistent with coronavirus (COVID-19), where there is a much higher risk of transmission.
  • Ensure hand hygiene between each vaccination. Wash hands thoroughly at regular intervals or if visibly soiled and use alcohol-based hand sanitiser in between each client.
  • Encourage cough etiquette and respiratory hygiene at the sessions, eg use signage and if children are coughing or sneezing, ensure this is into their elbow and they wash their hands afterwards.

Environmental cleaning

  • Avoid providing toys children will share.
  • Wipe down surfaces that have come into close contact with the client between each vaccination using alcohol-based disinfectant.
  • Disinfectant product must be available at the administration and clinical area.

Immunisation checklists

Use a single page pre-immunisation checklist for each client rather than a laminated version.

Longer immunisation sessions

Consider longer immunisation sessions to implement procedures to protect staff and the community against the transmission of coronavirus (COVID-19).

Communication

Immunisation providers should ensure immunisation webpages, phone messages and venue signage is update regularly with coronavirus (COVID-19) information to ensure clients are aware of the expectations and changes that providers have made to the service.

Staff absenteeism

  • Staff must not attend an immunisation service if unwell.
  • Staff with risk factors for coronavirus (COVID-19) and/or are unwell must not be come to work until they have been assessed by a medical practitioner as being clear. This will involve having a medical assessment and a swab test for coronavirus (COVID-19), which must be negative.
  • If a member of staff is a healthcare worker and is a confirmed case of coronavirus (COVID-19), they must not return to work until they have been assessed by a medical practitioner as fully recovered and have returned a negative coronavirus (COVID-19) virus test.
  • If there are staff shortages, immunisation providers will need to determine if an immunisation session can be undertaken safely.

Safety

Maintain patient safety as a priority, including observation during the 15-minute waiting time following immunisation.

Cancellation of community immunisation

  • Ensure signage is displayed prominently at the venue if services are cancelled.
  • Provide a website or phone contact for the next available immunisation session.
  • Providers using an appointment-based service may consider using SMS and social media to notify clients of any changes to service provision.

There are a range of useful resources for health and aged care workers.

General information about COVID-19

General resources for health and aged care

Prevention and control of infection

Screening and risk assessment

Outbreak management