Victorian guidance for residential aged care facilities - ASU ...
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Victorian guidance for residential aged care facilities
Commences at 11:59pm on 15 July 2021
OFFICIAL
Guidance on COVID-19 risks for residential aged care facilities
This Guidance has been developed in response to changing risks of COVID-19 transmission in the community.
This document provides specific guidance for residential aged care facilities.
For a list of exposure sites in Victoria and other jurisdictions, visit: www.coronavirus.vic.gov.au/exposure-sites
For testing locations, visit Where to get tested
Guidance Residential aged care facilities (RACFs)
Face mask All visitors are required to wear face masks.
requirements
All workers are required to wear surgical face masks.
PPE Addition of eye protection (face shields are preferred) when treating COVID
negative patient/residents.
PPE
guidance Coronavirus Tier 3 PPE for low risk suspected COVID-19, high-risk suspected COVID-19
(COVID-19) PPE and confirmed COIVD residents (see detail below)
guidance for RACF
Factsheet
Resident Screening Testing residents with COVID-19 compatible clinical and/or epidemiological risk
and Testing factors.
Enhanced screening and testing on admission or return to facility from leave.
Residents found to have visited listed exposure sites to be tested and managed
as at risk COVID-19 until results known.
Screen resident regularly (daily) with Safer Care Victoria’s COVID-19 screening
tool and undertake asymptomatic testing based on risk assessment
(https://www.bettersafercare.vic.gov.au/clinical-guidance/older-people/covid-19-
screening-tool-for-residential-aged-care-services).
Aged Care Worker Testing of workforce based on clinical and epidemiological risk factors, for
asymptomatic testing example, facilities in exposure site suburbs or significant wastewater detection.
RACFs with an outbreak to follow outbreak-based testing program as directed
by Public Health, Department of Health.
Workforce and Visitor All workers and visitors must check in to the facility using the Service
Check-in Victoria check-in app.
OFFICIALResidents do not need to check-in.
Emergency workers attending an emergency do not need to check-in.
Workforce Enhanced focus on screening visitors and staff and continuing daily workforce
Declarations and attestations, including mobility declarations (for staff with 2+ employers).
screening
Restricting visitors and staff found to have visited exposure sites until they have
returned a negative test result.
People who have worked or volunteered in hotel quarantine in the last 14 days
should not work in residential aged care.
Non-essential contractors and workers- such as hairdressers - are not permitted
into aged care.
Visitors Enhanced visitor restrictions
No visitors are permitted into aged care or other sensitive settings, except for
end-of-life reasons or other specified purposes.
End of life care visits
Two visitors at a time (a group may exceed the “two visitors at a time” rule if
dependents of a visitor are in the group and care for the dependents cannot be
arranged).
Do not have to be from the same household.
No time limits.
No specified purpose required.
No daily limit.
Specified purposes
Provide essential care or support for the resident’s immediate physical or
emotional wellbeing.
Is the parent, carer or guardian of a person under the age of 18.
As a nominated person (as defined in the Mental Health Act 2014).
As an interpreter or to provide language support.
To learn to support the resident’s care upon discharge.
Visitor restrictions for specified purposes visits
Two visitors at one time.
Do not have to be from the same household.
No time limits.
Specified purpose required.
No more than two visitors per day, including dependents.
A group may exceed the “two visitors at a time” rule if dependents of a visitor (or
patient in hospital) are in the group and care for the dependents cannot be
arranged.
OFFICIALRecommendation for remote / electronic visits
Providing interpreter services or acting as a nominated person should be
provided remotely unless it is not practicable to do so.
Other care and support should be provided remotely if reasonable and
appropriate in the circumstances (e.g. phone call support for someone with
hearing difficulties would not be appropriate).
Visits from prospective residents are not permitted
Medical Telehealth recommended wherever possible for aged care residents.
appointments for
residents
Workforce Mobility Where practicable, restricting all care facility workers mobility to one
campus/facility.
Declaration requirement for workers with more than one employer.
If there is an outbreak at a RACF, all worker mobility is to strictly cease.
Where there is an outbreak, workers cannot work anywhere else without 14
days quarantine and a negative test 3 days from end of quarantine period.
Student clinical Student clinical placements permitted in all settings but restricted from providing
placements care/being exposed to high-risk SCOVID and confirmed COVID patients.
Students restricted to one campus/site only.
Restrictions for residential aged care facilities are set out in a number of CHO Directions. Directions are updated
regularly and can be found here: https://www.dhhs.vic.gov.au/victorias-restriction-levels-covid-19
OFFICIALPPE required for a resident not in quarantine or isolation
Usual standard precautionary practices apply, including appropriately performing hand hygiene.
Table A: Tier 1 PPE is required when caring for or visiting the room of a resident who is not a
suspected or confirmed case of COVID-19 (not in quarantine or isolation)
Tier 1 PPE
Hand P2/N95 Surgical Eye Disposable
When to use hygiene respirator mask gloves Disposable
protection
fluid-
(goggles/
repellent
faceshield) *
gowns
✓ ✓
Examples:
Activities of daily
If required for
standard
If required for
standard
If required for
standard
precautions** precautions** precautions**
living care
(for example,
showering, or as per
continence department
care) directives
Clinical care (for
example,
wound
dressings,
medication
management)
Touching a
resident’s
belongings or
equipment
Visiting a
resident’s
room
*Services and staff must assess whether it is practical to wear a face shield. If not, the staff member must wear goggles.
**Standard precautions involve effective hand hygiene, use of personal protective equipment to protect against blood and body
fluid exposure, practising respiratory hygiene and cough etiquette, aseptic technique, routine environmental cleaning,
appropriate reprocessing of reusable medical devices, safe handling and use of sharps, and linen and waste management.
PPE required for a resident who is a low-risk suspected case of
COVID-19 when there is no community transmission
Low-risk suspected COVID-19 residents have symptoms that could be consistent with COVID-19 (for
example, cough, sore throat, fever, shortness of breath, runny nose), but are not high-risk for COVID-19,
based on their epidemiological risk factors in the 14 days prior to Illness onset. High-risk epidemiological risk
factors are described further below.
Low-risk suspected COVID-19 cases should be managed as seen in Table B unless residents display
aerosol-generating behaviours (AGB) or aerosol-generating procedures (AGP) are being performed, in
which case increased PPE levels are required (Tier 3 PPE), refer to Table C.
OFFICIALTable B: Tier 2 PPE is required when caring for low-risk suspected COVID-19 cases when there is no
community transmission*
Tier 2 PPE
Hand P2/N95 Surgical Eye Disposable
When to use hygiene respirator mask gloves Disposable
protection
fluid-
(goggles/
repellent
face-shield)
gowns
✓ ✓ ✓ ✓ ✓
Low-risk suspected
Faceshield
COVID-19 with
where
no community
practical*
transmission
*If the risk of community transmission increases, Tier 3 PPE would be introduced for low-risk suspected COVID-19
(see tables C and D).
*Services and staff must assess whether it is practical to wear a face shield. If not, the staff member must wear goggles.
Table C: Tier 3 PPE is required when caring for low-risk suspected COVID-19 cases with aerosol-
generating behaviours (AGB) and when performing aerosol-generating procedures (AGP)
PPE Tier 3
Hand P2/N95 Surgical Eye Disposable
When to use hygiene respirator mask gloves Disposable
protection
fluid-
(goggles/
repellent
face-shield)
gowns
✓ ✓ ✓ ✓
Low-risk suspected
COVID-19 cases
✓
Faceshield
with aerosol-
where
generating
practical*
behaviours
(ABG)** and when
performing
aerosol-
generating
procedures
(AGP)** with no
community
transmission
*Services and staff must assess whether it is practical to wear a face shield. If not, the staff member must wear goggles.
**AGBs are behaviours that are more likely to generate higher concentrations of infectious respiratory aerosols; for
example, persistent and/or severe coughing, screaming or shouting.
**AGPs are procedures performed on patients that are more likely to generate higher concentrations of infectious respiratory
aerosols; for example, non-invasive ventilation (CPAP), high-flow nasal oxygen therapy, suctioning, sputum induction or
nebuliser use. Nebulisers have been associated with a risk of transmission of respiratory viruses, and their use should be
OFFICIALavoided. Use a spacer or puffer instead. Refer to Infection Control Expert Group advice on nebuliser use
.
PPE required for a resident who is in quarantine, is a high-risk
suspected COVID-19 case or a confirmed case of COVID-19 and is
in isolation
All staff who enter the room of (i) a resident who is in quarantine as per advice from the Department of
Health or (ii) a resident who is a high-risk suspected or confirmed case of COVID-19 in isolation, must wear
Tier 3 PPE at all times.
A single case of COVID-19 among staff or residents of a facility is considered an outbreak. If there is an
outbreak of COVID-19 in a facility, then all interactions with residents should occur in Tier 3 PPE.
When there is an outbreak of COVID-19 in a facility:
• All residents except for those with a confirmed case of COVID-19 are considered close contacts and
will be placed into quarantine by the department. They will be advised to stay in their rooms at all
times.
• P2/N95 respirators must be worn for contact with all residents unless they are medically cleared.
High-risk suspected cases of COVID-19 include:
1. A person in quarantine for any reason (including being a close contact of a confirmed case of
COVID-19) or a returned traveller from overseas/a relevant interstate area with an outbreak/s (as
defined by public health in the last 14 days) with or without a compatible clinical illness. This group is
also referred to as ‘at-risk’.
2. A person with a compatible clinical illness who meets one or more of the following epidemiological
risk factors in the 14 days prior to illness onset:
• Contact with a confirmed case or an exposure site as defined by public health
• Employed in an area where there is an increased risk of COVID-19 transmission, for example:
o hotel quarantine workers or any workers at ports of entry
o aged care workers/healthcare workers working in a location where there is an active
outbreak/s
o other high-risk industries (such as abattoirs) where there are known cases or high levels
of community transmission
• Lived in, or visited, a geographically localised area at higher risk as determined by public health.
• Has been released from a quarantine facility
If the risk of community transmission increases, Tier 3 PPE would be introduced for low-risk suspected
COVID-19 cases.
OFFICIALTable D: Tier 3 PPE is required when providing care for a resident in quarantine or with high-risk
suspected or confirmed COVID-19.
Tier 3 PPE
Hand P2/N95 Surgical Eye Disposable
When to use hygiene respirator mask gloves Disposable
protection
fluid-
(goggles/
repellent
face-shield)
gowns
✓ ✓ ✓ ✓ ✓
All
care/exposure/contact Faceshield
for a resident:
where
-in quarantine or practical*
-who is a confirmed
COVID-19 case or
-who is high-risk
suspected COVID-19
regardless of the
amount of time in
contact.
*Services and staff must assess whether it is practical to wear a face shield. If not, the staff member must wear goggles
PPE advice
Is there a special way to put on (don) and remove (doff) PPE?
Staff should receive training on putting on (donning) and removing (doffing) PPE. There is a specific
sequence for donning and doffing PPE. For more information, see How to put on and take off your PPE
(PDF) .
It is important to set up donning and doffing stations. Further information about these can be found in the
guidance and tools available on the department website and on the department’s dedicated PPE webpage:
.
Safely wearing a surgical mask
How to safely wear a surgical mask:
• perform hand hygiene before and after putting on a mask
• do not touch the front of your mask while putting it on, wearing it or taking it off
• the mask must cover the mouth and nose
• masks should not be worn for more than four hours
• masks should be changed before four hours if soiled, contaminated, damaged or damp
• masks must not be worn around the neck
• if masks are removed, they must be disposed of immediately.
Masks can be removed while eating or drinking in a designated staff tearoom.
OFFICIALIn a staff tearoom, all staff must continue to practice physical distancing (by staying at least 1.5 metres away
from others), respiratory hygiene, cough etiquette and hand hygiene.
Further information can be found on the department’s website: https://www.dhhs.vic.gov.au/personal-
protective-equipment-ppe-covid-19
To receive this document in another format, phone 1300 651 160, using the National Relay
Service 13 36 77 if required, or email Project Management Office Communications .
Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne.
© State of Victoria, Australia, Department of Health, July 2021.
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