Point of Care Risk Assessment

• Client/Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Point of Care Risk Assessment (PCRA)

• 1. Evaluate The Likelihood Of Exposure To Infectious Blood, Body Fluids Droplets Or Airborne Particles.

• The type of patient contact

  Select  Performing/assisting with aerosol-generating medical procedures (AGMP)  Other clinical procedures/interaction  Non-clinical interaction  Transporting patients  Direct face-to-face interaction with patients

  •  Performing/assisting with aerosol-generating medical procedures (AGMP)
  •  Other clinical procedures/interaction
  •  Non-clinical interaction
  •  Transporting patients
  •  Direct face-to-face interaction with patients

• The type of patient:

  Select  Infants/young children  Patients not capable of self-care/hand hygiene  Patients who have poor compliance with respiratory hygiene  Patients with copious respiratory secretions, frequent cough/sneeze, early stage of influenza-like illness (ILI)  Patients with uncontrollable vomiting and/or diarrhea  Travel or contact history of patient

  •  Infants/young children
  •  Patients not capable of self-care/hand hygiene
  •  Patients who have poor compliance with respiratory hygiene
  •  Patients with copious respiratory secretions, frequent cough/sneeze, early stage of
  • influenza-like illness (ILI)
  •  Patients with uncontrollable vomiting and/or diarrhea
  •  Travel or contact history of patient

• The type of environment:

  Select  Single room  Shared rooms/washrooms  Emergency departments  Public areas  Therapeutic departments  Diagnostic imaging departments  Housekeeping

  •  Single room
  •  Shared rooms/washrooms
  •  Emergency departments
  •  Public areas
  •  Therapeutic departments
  •  Diagnostic imaging departments
  •  Housekeeping

• 2. Choose The Appropriate Actions And PPE Needed To Minimize The Risk Of Exposure To Infectious Agents

• Select applicable

  Select  Frequent point of care Hand Hygiene  Use PPE according to routine precautions and additional or enhanced precautions as assessed  Placement of patient i.e. regular room vs. negative pressure  Use EPA hospital-rated cleaning/disinfectants and follow protocol for cleanup of blood and body fluid spills  Use point of care sharps containers

  •  Frequent point of care Hand Hygiene
  •  Use PPE according to routine precautions and additional or enhanced precautions as assessed
  •  Placement of patient i.e. regular room vs. negative pressure
  •  Use EPA hospital-rated cleaning/disinfectants and follow protocol for cleanup of blood and body fluid spills
  •  Use point of care sharps containers

Room Placement

• Identify a location within your health care facility or hospital that can be used for a patient with
  suspect/confirmed case of EVD or other serious infectious disease. This space has

• 1. Private room with:

  Select  Hard cleanable doors and walls  Private bathroom and/or dedicated commode  Sink/ABHR point of care hand hygiene site  Remove all but essential equipment  Large biohazard container with wipeable sides and closable lid and lined with double yellow bags for waste  Negative pressure room is preferred if there is a possibility for aerosol generating medical procedures (AGMP)  Point of care sharps container

  •  Hard cleanable doors and walls
  •  Private bathroom and/or dedicated commode
  •  Sink/ABHR point of care hand hygiene site
  •  Remove all but essential equipment
  •  Large biohazard container with wipeable sides and closable lid and lined with double yellow bags for waste
  •  Negative pressure room is preferred if there is a possibility for aerosol generating medical procedures (AGMP)
  •  Point of care sharps container

• 2. Identify a PPE donning and doffing area

  Select  Label or clearly identify a clean and dirty section. A disposable drop cloth can be used for this purpose  Large biohazard container with wipeable sides and closable lid, and lined with double yellow bags for waste  Cart with PPE supplies (see list below)  1-2 washable chairs for HCP to sit on while donning and doffing PPE  Room Entry Log to keep track of everyone who has contact with the patient  Clip board and check list for Trained Observer (Buddy)

  •  Label or clearly identify a clean and dirty section. A disposable drop cloth can be used for this purpose
  •  Large biohazard container with wipeable sides and closable lid, and lined with double yellow bags for waste
  •  Cart with PPE supplies (see list below)
  •  1-2 washable chairs for HCP to sit on while donning and doffing PPE
  •  Room Entry Log to keep track of everyone who has contact with the patient
  •  Clip board and check list for Trained Observer (Buddy)

PPE Donning and Doffing Procedure

• Trained Observer (Buddy):
  When there is risk of being infected with a serious infectious disease, the correct donning and doffing of enhanced PPE is particularly important to minimize the risk of self-contamination. A trained observer or “Buddy” is recommended to support and assist with the PPE donning and doffing procedures. The Buddy is

• Trained in proper PPE donning and doffing and Infection Prevention and Control procedures

  Yes

  No

•  Remain on the clean side/area while observing and assisting the HCP

  Yes

  No

• Buddy wears

•  Hospital/health care facility supplied or disposable scrubs under PPE

  Yes

  No

•  Washable footwear

  Yes

  No

•  Fluid impermeable gown

  Yes

  No

•  Face shield

  Yes

  No

•  Bouffant head cover

  Yes

  No

•  Single set of Nitrile gloves over cuff of gown

  Yes

  No

•  Fluid resistant or impermeable shoe covers

  Yes

  No

•  Don and doff their PPE according to the usual PPE donning and doffing procedures

  Yes

  No

•  Observe, assist and instruct HCP during the donning and doffing procedure

  Yes

  No

•  Document each step using the checklist on clip board.

  Yes

  No

Personal Protective Equipment for the HCP

• The following list of PPE supplies should be available at all times in all available sizes:

•Routine and Additional PPE

• 1. Nitrile gloves

  Yes

  No

• 2. Fluid resistant or impermeable disposable gown

  Yes

  No

• 3. Surgical or procedure mask with eye protection

  Yes

  No

• 4. N95 respirator

  Yes

  No

• 5. Protective eye wear or face shield

  Yes

  No

• 6. Fluid resistant or impermeable shoe covers

  Yes

  No

•Enhanced PPE:

• 1. Hospital/health care facility supplied scrubs to be worn under PPE (could be disposable)

  Yes

  No

• 2. Washable footwear

  Yes

  No

• 3. Fluid impermeable gown

  Yes

  No

• 4. Fluid impermeable foot and leg covers

  Yes

  No

• 5. Long cuffed nitrile or surgical gloves

  Yes

  No

• 6. Fluid impervious apron with long sleeves and thumb loops

  Yes

  No

• 7. Surgical/procedure mask

  Yes

  No

• 8. N95 mask for AGMPs

  Yes

  No

• 9. Fluid impervious surgeons head cover

  Yes

  No

• 10. Bouffant head cover

  Yes

  No

• 11. Face shield

  Yes

  No

• The following supplies should also be available in the patient’s room and in the donning/doffing
  area

• 1. Alcohol based hand rub at least 60% alcohol

  Yes

  No

• 2. Virucidal disinfectant wipes (EPA registered hospital cleaner/disinfectant with a drug

  Yes

  No

• identification number)

  Yes

  No

• 3. Sharps container

  Yes

  No

• 4. Fluid resistant drop cloth

  Yes

  No

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