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Infection prevention and control guidance

Infection prevention and control guidance overview

When at work, protecting yourself prevents you becoming unwell from sick patients, clients or residents and prevents the spread of serious illnesses:

 

 

Infection prevention and control practices in health and disability care settings

Mask use guidance for health and disability care workers

Mask wearing in healthcare settings remains an important measure in preventing transmission of respiratory viruses.

 

Presently in New Zealand there is ongoing but low-level community transmission of COVID-19 and low level of community transmission of other respiratory viruses. The focus for mask recommendations at present is on the patient care environment.

 

Mask use should always be considered in conjunction with other interventions to reduce transmission of COVID-19 and other respiratory infections in healthcare settings. These include using standard and transmission-based precautions for all patient/client and resident care, having clean indoor air through good ventilation, access to testing, having occupational health processes that promote staff vaccination and enable staff to stay home from work when unwell.

 

Read this guidance that informs mask use of all employees, volunteers and contractors of healthcare facilities, and patients/clients and visitors of healthcare settings.

 

Healthcare facilities should consider this advice the minimum recommendations. This guidance may be added to based on current epidemiology and other factors (for example, facility-based outbreak, staff resourcing).

 

Mask recommendations will be reviewed prior to winter 2023, or sooner if required.

PPE guidance for primary and community health and disability care workers

This guide assists primary and community health and disability care workers (HCW) in selecting the appropriate personal protective equipment (PPE) following a risk assessment for acute respiratory infections (ARI), including COVID-19.

 

This advice is for all health care workers in the following settings:

  • Aged residential care
  • Community maternity
  • Community services
  • General practice/primary care
  • Home and community support service
  • Disability support workers
  • Urgent care
  • Home based care

 

PPE is considered as part of Standard Precautions which are a set of IPC measures required for all healthcare interactions. A risk assessment is required BEFORE every interaction, and/or every session, with a patient/client or resident by the HCW.  When a patient/client or resident is suspected or confirmed to have a transmissible infectious disease, then Transmission-based Precautions should be followed.

 

Read more about Standards and Transmission-Based Precautions.

Risk assessment for COVID-19

 

This risk assessment considers the risk of the patient/client or resident having an ARI, including COVID-19, the environment the task is to be undertaken in, and the risk of exposure to blood or body fluids, including secretions and excretions. It assists the HCW to decide the PPE required, including any respiratory protective equipment that may be needed.

 

PPE use for care of a COVID-19 CASE

COVID-19 IPC guidance for acute care hospitals

If you have any questions, email the IPC team at the Ministry ipc@health.govt.nz or contact your local IPC team.

Types of personal protective equipment (PPE)

The use of PPE should be considered as one of a range of infection prevention and control measures that can reduce the risk of infection from COVID-19 when used correctly, and in the appropriate context.  

 

PPE includes a range of items to protect the healthcare worker from exposure to harmful pathogens. Details on each of these are outlined below. 

 

Refer to your facility’s policies and undertake an IPC risk assessment to determine the right type of PPE to wear for the care you need to provide and the best place and time to don, doff and dispose of PPE items.

 

It is important that healthcare workers check all items of PPE before donning to ensure items are not damaged, have not expired and the healthcare worker has received the appropriate education and training for donning, doffing and safely disposing of used PPE. Consideration needs to be given to climate and temperature control, comfort breaks and hydration breaks.

Masks

Mask wearing for healthcare workers

 

For those working in the health sector as a registered or employed healthcare practitioner/worker, assess your risk by referring to the Guide for IPC risk assessment for PPE selection. This risk assessment tool and use of Standard and Transmission-based precautions will continue to guide you on what level of PPE is needed to protect you and your clients/patients/residents from COVID-19 and other transmissible infections. You should also refer to your employer’s policies for further advice.

Mask wearing for visitors to healthcare facilities

 

Advice for the public on where and when a mask or face covering must be worn has changed. Visitors to healthcare settings are required to wear a mask.

 

See use of face masks in the community for further information.

Medical masks

 

Masks help to prevent spread of the virus that causes COVID-19 in two ways:

  • decreasing the amount of virus spread by an infectious person by catching the particles containing virus in the mask (source control).
  • helping to prevent a person from inhaling particles containing virus (wearer protection).

 

A well-fitting medical mask provides protection from droplets produced by the wearer because they are contained within the mask (source control). It also protects the wearer from infectious respiratory droplets produced when a person within 1 – 2 metres of them talks, coughs or sneezes.

 

For non-client facing activities, health organisations are encouraged to recommend that their workforces wear face coverings (eg, a mask) in clinical or shared work environments.

 

The following guide provides information on the types of masks available and the purpose of the mask (ie, what it protects you from).

 

P2/N95 Particulate Respirators 

 

P2/N95 particulate respirators are worn to provide protection against exposure to airborne pathogens and procedures that can produce the generation of small particles. Particulate respirators work by filtering particles out of the air as you breathe. To be effective, a tight seal between the respirator and the wearer’s face covering the nose, mouth and chin is required. 

 

Fit testing and fit checking / user seal check

 

Fit testing is a procedure through either a qualitative or quantitative test to ‘match’ the right P2/N95 particulate respirator with the wearers face shape to ensure maximum protection.

 

Fit checking /user seal check is a ‘quick check’ method used by the wearer to ensure the respirator is properly positioned on their face and there is a tight seal between the respirator and face. A fit check/user seal check must be done every time a P2/N95 is put on.

 

In situations where fit testing has not yet been carried out, and a P2/N95 respirator is recommended for use, refer to the interim guidance below.

 

 

Types of P2/N95 particulate respirators

 

There are different types of P2/N95 particulate respirators. Below are some useful links to manufacturer’s information to help don and fit check a P2/N95 particulate respirator correctly. Always refer to the manufacturer’s guidelines.   

 

Note not all brands, make or model below may be available. This is not an endorsement of any brand, make or model, but provides guidance on how to don and fit check the different styles of respirators.   

 

Manufacturers guidance on donning and fit checking:

 

Face mask exemptions for healthcare workers in healthcare settings

 

Healthcare workers will need to discuss on an individual basis with their employer the individual policy on mask exemption at their place of work.

 

It is currently best practice for healthcare workers to wear medical masks when providing healthcare to prevent transmission of acute respiratory infections (ARIs) to patients/clients/residents. When there is a high prevalence of ARIs (including COVID-19) in the community, mask wearing by healthcare workers protects the people they provide care for.

Gloves

 

Gloves protect your hands when exposure to blood or other body fluids is anticipated. They should be changed between each patient or if they become punctured or torn. Hand hygiene should be performed every time you put on or take off a pair of gloves. 

 

Use gloves of appropriate size and type for the nature of care to be provided. For example, single use non-sterile gloves for general patient care or single use sterile gloves for aseptic non-touch technique procedures. 

 

The following guides provide information on the types of gloves available 

 

Gowns and aprons

 

A fluid-resistant, long-sleeve gown should be worn to protect skin and prevent soiling of clothing during activities that are likely to generate excessive splashing of blood or other body fluids, for example when a patient is vomiting. There are different types and grades of fluid resistant gowns. 

 

You can wear a plastic apron whenever contamination of your clothing is anticipated during patient care, where this is unlikely to involve excessive blood or body fluid exposure. 

Eye protection 

 

Eye protection is worn to prevent exposure of the mucous membranes of the eye (conjunctiva) when there is likely exposure to blood body fluid splashes, respiratory droplets or from touching eyes with contaminated fingers.  

 

Eye protection includes goggles, safety glasses (that have side visors and fit closely to your forehead) or a face shield that covers your eyes, nose and mouth. 

 

When selecting protective eyewear consider the task and fit. Reusable eye protection should be cleaned safely prior to reuse, following local Infection Prevention and Control protocols or manufacturer’s instructions.  
 

Prescription glasses do not provide adequate eye protection due to gaps around the frames. Eye protection for wearers of prescription glasses include goggles which are designed to be worn over prescription glasses, safety goggles with prescription lenses or a face shield. 

Safe use of PPE

Correctly donning, doffing and disposing of PPE is important for your safety to help you reduce your risk of contaminating yourself, your clothing or the environment you are working in.

 

Follow your facility’s policies and undertake an IPC risk assessment to determine the right type of PPE to wear for the care you need to provide and the best place and time to don, doff and dispose of PPE items. 

 

The most important step is to ensure that you don’t remove your medical mask or particulate respirator and eye protection until after leaving the patients room, home or care area. 

 

It is also important that you perform hand hygiene before putting on any PPE, and after you remove items of PPE. 

 

In a healthcare setting, used PPE should be discarded in accordance with the healthcare settings policies and procedures for waste. 

 

In a community setting, used PPE can be put into household general waste. 

 

The written and video resources below demonstrate the best practice approach to donning, doffing and disposing of PPE in different health care settings. They should be used in combination with the IPC risk assessment for PPE use guidance mentioned above.

 

Video transcript

As a home care worker, I provide health care for New Zealanders every day.

I love connecting with people and learning about their different cultures.

I enjoy helping them and take pride in my work.

To do my job well,  I need to protect myself and the people I care for by wearing the right PPE.

Before I see a client,  I always complete a risk assessment by asking myself some questions  to determine what the risk of infection could be.

This helps me decide on the right PPE to wear before I provide care.

Protecting us all, that’s what really matters.

I sanitise my hands before I hop out of my car.

My car is like my office.

I store everything I might need for the day in my boot.

In my bag, I have  medical masks, gloves, gowns or aprons, eye protection,  P2 / N95 particulate respirators, hand sanitiser, disinfectant wipes  and a waste bag.

Some of these items I’ll need to change throughout the day,  but others I can wear for a whole session.

I decide according to what happens at each of my visits.

While there is COVID in the community,  I ask everyone in the house to put on a mask before I arrive.

I also ask if windows and doors can be opened  so that I know the house is well ventilated before I enter.

The type of PPE I need to wear depends on the type of care I need to provide.

When a medical mask is the best choice  I hook the elastic bands behind my ears and fit the mask to my face  I make sure it fits well along my nose, cheeks and below my chin.

When a respirator is more appropriate  I position it over my nose and chin,  pulling the top strap over my head to rest above my ears  and the bottom strap to rest around my neck.

I place my fingers at the top of the nose band and slide them down both sides,  molding the band to my face.

Checking the seal of a respirator is really important  I cup both hands over the edges of the respirator  and quickly breathe in and out.

If I can feel any air leaking, then I know there’s not a proper seal.

I readjust until I know everything fits well and there’s no leakage.

Once my mask is on, I don’t touch it again to avoid contamination.

I sanitise my hands and then I’m safe to enter the house.

Most of the time all I need to wear is my mask,  but there are times where I will need more protection.

If I need to put on more PPE, I do this when I am inside the home.

If I need to wear a gown or apron  I fasten it behind my neck and at my waist.

Eye protection can be goggles or a face shield.

I adjust properly to my face and around the back of my head.

When putting on gloves  I pull them up high enough to cover the wrist bands of my gown.

If they ever get damaged or contaminated,  I change them straight away.

Finally, I check everything fits well before I start providing care.

When it’s time to take off my PPE,  I remove my gloves.

I peel them off one at a time  and try not to touch the outside of them with my bare skin.

I then dispose of them in the rubbish.

When removing my gown  I take care not to touch the front of it.

I break the ties at the back,  roll the gown down my arms and fold the gown into itself.

I then dispose of it in the rubbish.

Now is a good time to sanitise my hands.

Next I take off my eye protection  I pull the strap over my head,  taking care not to touch the front of my goggles.

If I know I can reuse them,  I wipe them with a disinfectant wipe,   dispose of the wipe in the rubbish and take the goggles with me.

I sanitise my hands on my way back to my car.

A lot of the time it’s ok for me to wear a respirator or a mask  so I don’t need to remove it between visits.

But when it is the right time to take it off  I grab the straps, pull them over my head  and remove the respirator away from my face without touching the front.

I dispose of it in the waste bag that I have stored in my boot.

I sanitise my hands one last time.

To keep myself safe,  I follow this process every time I visit a client  and before I finish work for the day.

Time for me to go!

Te reo Māori

He aratohu mau kiripākai tinana mā ngā Kaimahi Tiaki ā-Kāinga, ā-Hapori i Aotearoa.

Kia ora, nau mai haere mai ki tēnei ataata a Te Manatū Hauora.

Ko tēnei aratohu āraitanga pokenga me te whakahaere, mā ngā kaimahi tiaki ā-kāinga, ā-hapori e mahi ana i Aotearoa.

E whakaatu ana i te huarahi pai rawa ki te whakamau, ki te tango me te porowhiu hoki i ngā kiripākai tinana i te taiao o te tiaki ā-kāinga.

Hei kaimahi tiaki ā-kāinga, ka tiaki au i te hauora o ngā tāngata o Aotearoa i ia rā.

He rawe ki a au te tūhonohono ki te tangata me te ako i ngā āhuatanga o ō rātou ahurea rerekē.

He pārekareka ki a au te āwhina i a rātou, otirā ka whakahī au ki aku mahi.

E tika ai taku mahi, me ārai ahau i a au anō, ā, me te hunga e tiakina ana e au mā te mau i ngā PPE tika.

I mua o taku kite i tētahi kiritaki, ka whakaoti mārika ahau i tētahi aromatawai mōrearea mā te pātai anō i ētahi pātai ki a au tonu ki te whakatau he aha pea te mōrearea whakapokenga.

Ka āwhina tēnei i a au ki te whakatau he aha te PPE tika hei mautanga māku i mua i taku tiaki i tētahi atu.

Ko te tiaki i a tātou katoa, koinā te mea nui.

Ka patuero au i aku ringa i mua i te putanga i taku waka.

Ko taku waka taku tari.

Kei roto aku mea katoa ka hiahia au mō taua rā, kei taku pūtu.

Kei taku pēke ngā maruhā, ngā karapu, ngā kākahu, ngā ārai kākahu rānei, me ngā ārai kanohi, ngā whakahā P2 / N95, te patuero me ngā muku patu huaketo tae atu ki tētahi pēke para.

Ko ētahi o ēnei mea me panoni i te roanga ake o te rā, engari ko ētahi atu mea, ka taea e au te mau haere tonu.

Ka whakatau ahau i runga i te āhua o ngā tatūtanga i ia o aku toronga.

Ahakoa e kitea tonu ana te KOWHEORI i te hapori, Ka inoi au ki ngā tāngata katoa o taua kāinga kia kuhuna he maruhā i mua o taku taenga atu.

Ka tono hoki au kia huakina ngā matapihi me ngā kūaha kia mōhio au he pai te kōhauhau o te whare i mua o taku kuhunga ake.

Ko te momo PPE hei mau māku kei runga anō i te āhua o te momo tiakanga hei whakarato māku.

Mēnā ko te maruhā hauora te mea tika rawa, ka here au i ngā taura kūtoro ki muri i aku taringa, ā, ka whakamau i te maruhā ki taku kanohi.

Ka tirohia kia tika te mau ki taku ihu, ngā pāpāringa, i raro hoki i taku kauae.

Mēnā he tika ake te mau whakahā, ka whakanoho ki runga ake i taku ihu me taku kauae, ka kūmea te taura o runga ki tua o taku māhunga kia noho ki runga ake o aku taringa me te taura o raro kia noho ki taku kakī.

Ka puritia aku matimati ki runga ake o te waea ihu, ā, ka pēhitia ngā taha e rua, kia piri te waea ki taku kanohi.

He mea nui hoki kia tirohia te herepuru o te whakahā, nā, ka puritia te kapu o ōku ringa ki ngā tapa o te whakahā, kātahi ka whakangā.

Ina rongo au i te hau e pī ana, ka mōhio au kāore i tika te herepuru.

Ka whakatika au i te whakahā kia tika rā anō te mau, ā, kāore te hau i te pī ki waho.

Kia mau i a au taku maruhā, kua kore anō au e raweke, kia kore ai e tāhawahawatia.

Ka patuero au i aku ringa nā, kua haumaru taku kuhu ki te whare.

I te nuinga o te wā ko tāku noa, he mau maruhā, engari he wā anō me mau ahau i ētahi atu āraitanga.

Mēnā ka tika kia mau ahau i ētahi atu PPE, Ka pēnei au i te wā kei roto au i te whare.

Ina hiahia au ki te mau i tētahi kākahu, ārai kākahu rānei, ka whītikina i muri i taku kakī, me ōku tikihope.

Ko te āraitanga ā-kanohi pea he mōhiti, he pākai kanohi rānei.

Ka tika taku whakamau ki taku kanohi ki muri hoki o taku māhunga.

I te wā e whakamau karapu ana,mka kaha tonu taku kukume ki runga kia pai ai te ārai i ngā whatīanga o taku kākahu.

Ina tukinohia, tāhawahawatia rānei ka wawe tonu taku whakakapi.

Hei whakamutunga, ka tirohia mēnā e tika ana te uru i mua o te mahi tiaki.

Kia tae ki te wā kia tangohia e au ngā PPE, ka tango au i ngā karapu.

Ka āta tango i tētahi i te tuatahi, ā, me te kore e pā ā-kiri ki te taha whakawaho.

Kātahi ka porowhiua e au ki te ipu para.

I te wā e tango ana au i taku kākahu me tūpato kei pā ki te wāhanga o mua.

Ka motu i a au ngā here i muri, ka rōra iho te kākahu i aku ringa, ā, ka pōkai haere i te kākahu ki roto anō i a ia.

Kātahi ka makaia atu ki te ipu para.

Nā, he wā pai tēnei ki te muku ki te patuero i ōku ringa.

I muri i tērā ka tangohia e au aku ārai kanohi ka tangohia e au te taura kei taku māhunga, ka āta tango kia kaua e pā ki te wāhanga o mua o aku mōhiti.

Mēnā ka taea e au te whakamahi, ka mukua e au mā te muku patu huaketo, ka porowhiu i te muku ki te ipu para, ā, ka haria e au ngā mōhiti.

Ka patuero au i aku ringa i a au e hoki atu ana ki taku waka.

He nui ngā wā, he pai noa mōku ki te mau i tētahi whakahā, maruhā noa rānei nā, kua kore e mate ki te tango i waenga i ngā toronga.

Engari kia tae ki te wā tika ki te tango, ka kapohia e au ngā taura, ka kūmea ki runga ake o taku māhunga ka tango i te whakahā mai i taku kanohi me te kore anō e pā ki te wāhanga o mua.

Ka whiua e au ki te pēke para kei roto i taku pūtu.

Ka patuero au i aku ringa mō te wā whakamutunga.

Kia noho haumaru ai ahau, ka whāia e au tēnei tukanga i ngā wā katoa ka toro au ki tētahi kiritaki, ā, i mua hoki i te mutunga o taku mahi mō te rā.

Ko te wā tēnei e hoki ai ahau!

Tēnā rawa atu koe mō tō whakawātea i a koe.

Me tiaki i a koe anō, me tiaki tētahi i tētahi.

Ngā mihi maioha ki a Ryman Health mō te whakauru mai ki te hanganga o tēnei ataata.

Video transcript

As an aged care worker, I provide health care for New Zealanders every day.

I’ve been working here for 14 years now  and I love taking care of the residents and working with a great team.

To do my job well,   I need to protect myself and the people I care for by wearing the right PPE.

Before I see a resident,  I always complete a risk assessment  by asking myself some questions to determine what the risk of infection could be.

This helps me decide on the right PPE to wear before I provide care.

There will be many times where all I need to wear is a mask or respirator,  and other situations where I need to wear more.

Before providing care I prepare myself with the items I might need.

Gowns or aprons, eye protection, medical masks,  P2 / N95 particulate respirators, disinfectant wipes, gloves and hand sanitiser.

Some of the PPE I’ll need to change throughout the day,  but other items I can wear for a whole session.

I decide depending on the type of care I need to provide.

Before putting on my PPE I clean my hands thoroughly.

In situations where I need to wear full PPE,  I put on my gown or apron first.

I fasten it behind my neck and at my waist.

During COVID my process can be a little different.

I may already have my respiratory protection on.

This could be a medical mask or a respirator.

If a medical mask is the best choice  I hook the elastic bands behind my ears and fit the mask to my face.

I make sure it fits well along my nose, cheeks and below my chin.

If a respirator is more appropriate  I position it over my nose and chin,   pulling the top strap over my head to rest above my ears  and the bottom strap to rest around my neck.

I place my fingers at the top of the nose band and slide them down both sides,  molding the band to my face.

Checking the seal of a respirator is really important  I cup both hands over the edges of the respirator and breathe in and out.

If I can feel any air leaking, then I know there’s not a proper seal.

I readjust until I know everything fits well and there’s no leakage.

Once my mask is on, I don’t touch it again to avoid contamination.

 Eye protection could be goggles or a face shield.

I adjust the strap around the back of my head to fit.

When putting on gloves,  I pull them up high enough to cover the wrist bands of my gown.

If they ever get damaged or contaminated, I change them straight away.

Now that I have everything fitting correctly, I can start providing care.

When it’s time to take off my PPE,  I remove my gloves first.

I peel them off one at a time  and try not to touch the outside of them with my bare skin.

I then dispose of them in the rubbish.

I sanitise my hands.

When removing my gown  I take care not to touch the front of it.

I break the ties at the back,  roll the gown down my arms and fold the gown into itself.

I then dispose of it in the rubbish.

I sanitise my hands before removing any other items.

There are many occasions where my eye protection can be worn for a session.

 If it’s time to remove it and I know I can reuse it,  I pull the strap over my head, taking care not to touch the front.

I wipe the front with a disinfectant wipe,  dispose of the wipe in the rubbish,  and store the visor safely for the next time I need it.

If I can’t reuse it, I dispose of it in the rubbish.

A lot of the time it’s ok for me to wear my respiratory protection for a session too.

I can keep it on and sanitise my hands before I see my next resident.

But when it is the right time to take it off,  I grab the straps, pull them over my head  and remove the respirator away from my face without touching the front.

I dispose of it in the rubbish.

I clean my hands a final time.

To keep myself safe,  I follow this process every time I care for a resident  and before I finish work for the day.

Time for me to go!

Te Reo Māori

He aratohu mau kiripākai tinana mā ngā Kaimahi Whare Tiaki Kaumātua i Aotearoa.

Kia ora, nau mai haere mai ki tēnei ataata a Te Manatū Hauora.

Ko tēnei aratohu āraitanga pokenga me te whakahaere, mā ngā kaimahi whare tiaki kaumātua e mahi ana i Aotearoa.

E whakaatu ana i te huarahi pai rawa ki te whakamau, ki te tango me te porowhiu hoki i ngā kiripākai tinana i te taiao whare tiaki kaumātua.

Hei kaimahi tiaki kaumātua, ka tiaki au i te hauora o ngā tāngata o Aotearoa i ia rā.

Kua 14 tau ahau e mahi ana i konei ināianei, ā, he rawe ki a au te tiaki i ngā kaumātua me te mahi i roto i tētahi rōpū mīharo.

E tika ai taku mahi, me ārai ahau i a au anō, ā, me te hunga e tiakina ana e au mā te mau i ngā PPE tika.

I mua o taku kite i tētahi kaumātua, ka whakaoti mārika ahau i tētahi aromatawai mōrearea mā te pātai anō i ētahi pātai ki a au tonu ki te whakatau he aha pea te mōrearea whakapokenga.

Ka āwhina tēnei i a au ki te whakatau he aha te PPE tika hei mautanga māku i mua i taku tiaki i tētahi atu.

He nui ngā wā ko te mea noa hei mau māku ko te maruhā, te whakahā rānei, ā, i ētahi atu wā ka nui ake ngā mea hei mautanga māku.

I mua i te tiaki i te tangata, ka whakarite au i a au anō me ngā mea tika e hiahiatia ana.

Ngā kākahu, ngā ārai rānei, ngā ārai kanohi, ngā maruhā hauora, ngā whakahā P2 / N95, ngā muku patu huaketo, ngā karapu me te patuero.

Ko ētahi o ngā PPE me whakarerekē i te roanga ake o te rā, engari ko ētahi atu mea, ka taea e au te mau haere tonu.

Ka whakatau ahau i runga anō i te āhua o te momo tiakanga hei whakarato māku.

I mua o te kuhu i aku PPE, ka āta horoi au i ōku ringa.

Mō ngā wā ka mau ahau i ngā kiritai PPE katoa, Ka kuhu au i taku kākahu, taku kākahu ārai rānei i te tuatahi.

Ka whītikina i muri i taku kakī, me ōku tikihope.

I te wā o te KOWHEORI, ka paku rerekē pea te tukanga.

Tērā pea kua mau kē taku āraitanga whakahā.

Ākene pea he maruhā hauora, he wā anō he whakahā.

Mēnā ko te maruhā hauora te mea tika rawa, ka here au i ngā taura kūtoro ki muri i aku taringa, ā, ka whakamau i te maruhā ki taku kanohi.

Ka tirohia kia tika te mau ki taku ihu, ngā pāpāringa, i raro hoki i taku kauae.

Mēnā he tika ake te whakahā, ka whakanoho ki runga ake i taku ihu me taku kauae, ka kūmea te taura o runga ki tua o taku māhunga kia noho ki runga ake o aku taringa me te taura o raro kia noho ki taku kakī.

Ka puritia aku matimati ki runga ake o te waea ihu, ā, ka pēhitia ngā taha e rua, kia piri te waea ki taku kanohi.

He mea nui hoki kia tirohia te herepuru o te whakahā, nā, ka puritia te kapu o ōku ringa ki ngā tapa o te whakahā, kātahi ka whakangā.

Ina rongo au i te hau e pī ana, ka mōhio au kāore i tika te herepuru.

Ka whakatika au i te whakahā kia tika rā anō te mau, ā, kāore te hau i te pī ki waho.

Kia mau i a au taku maruhā, kua kore anō au e raweke, kia kore ai e tāhawahawatia.

Ko te āraitanga ā-kanohi pea he mōhiti, he pākai kanohi rānei.

Ia whakatika ahau i ngā taura i muri i taku māhunga kia tika te mau.

I te wā e whakamau karapu ana, ka kūmea e au ki runga ake kia ūhia ngā whatīanga o taku kākahu.

Ina tukinohia, tāhawahawatia rānei ka wawe tonu taku whakakapi.

Nā, kia tika katoa te uru o ngā mea katoa, ka taea e au te tiaki i ngā tāngata.

Kia tae ki te wā kia tangohia e au ngā PPE, ka tango au i ngā karapu i te tuatahi.

Ka āta tango i tētahi i te tuatahi, ā, me te kore e pā ā-kiri ki te taha whakawaho.

Kātahi ka porowhiua e au ki te ipu para.

Ka patuero au i aku ringa.

I te wā e tango ana au i taku kākahu me tūpato kei pā ki te wāhanga o mua.

Ka motu i a au ngā here i muri, ka rōra i te kākahu ki raro i ōku ringaringa, ka pōkai i taku kākahu.

Kātahi ka makaia atu ki te ipu para.

Ka patuero au i ōku ringaringa i mua i te tango i ētahi atu mea.

He nui ngā wā ka mau ahau i aku āraitanga ā-kanohi.

Kia tae ki te wā ki te tango, ā, kia mōhio au he pai ki te mau anō, ka tangohia e au te taura kei taku māhunga, ka āta tango kia kaua e pā ki te wāhanga o mua.

Ka muku au i te wāhanga o mua mā te muku patu huaketo, ka porowhiu i te muku ki te ipu para, ā, ka tiaki i te pākai kanohi kia pai ai te mau anō.

Mēnā kāore e taea e au te mau anō, ka porowhiua ki te ipu para.

He nui ngā wā, he pai noa mōku te mau haere tonu i taku āraitanga whakahā i tētahi wā.

Ka mau haere tonu ā, ka patuero i ōku ringa i mua i taku kite i taku kainoho i muri iho.

Engari kia tae ki te wā tika ki te tango, ka kapohia e au ngā taura, ka kūmea ki runga ake o taku māhunga ka tango i te whakahā mai i taku kanohi me te kore anō e pā ki te wāhanga o mua.

Ka makaia atu e au ki te ipu para.

Ka horoi au i ōku ringa mō te wā whakamutunga.

E noho haumaru ai ahau, ka whāia e au tēnei tukanga i ngā wā katoa ka tiaki au i tētahi kainoho, ā, i mua hoki i te mutunga o taku mahi mō te rā.

Ko te wā tēnei e hoki ai ahau! Tēnā rawa atu koe mō tō whakawātea i a koe.

Me tiaki i a koe anō, me tiaki tētahi i tētahi.

Ngā mihi maioha ki a Ryman Health mō te whakauru mai ki te hanganga o tēnei ataata.

Other guidance for keeping safe

Sessional use of PPE

Sessional (or continuous) use of PPE is the ability to wear specific PPE items without needing to remove and replace each and every time you have undertaken and completed a task or activity. 

 

A ‘session’ refers to a period of time where a health care worker is undertaking duties in a specific care setting or exposure environment e.g., on a ward round or providing on-going care for in-patients. The duration of a session will vary depending on the task or activity being undertaken.

 

A medical mask or particulate respirator must be changed every 4 hours or earlier if,  

  • it is soiled/contaminated or becomes damp 
  • it is uncomfortable 
  • it is damaged 

 

PPE items that can be worn sessionally:

  • Medical masks 
  • P2/N95 particulate respirators 
  • Eye protection* 
  • Long sleeve fluid-resistant gowns (unless soiled). 

 

*Eye protection - (does not include prescription glasses), includes face shields and goggles. Re -use of face shields can be considered if a process for decontaminating and storing eye protection has been approved by your infection prevention and control specialist. Goggles that have an elastic strap and face shields that have a foam headband may be difficult to clean. (Single person use is recommended).

 

If you accidently touch the front of your mask or eye protection, stop and perform hand hygiene.

 

PPE Items that cannot be worn sessionally are:

  • Gloves. (Staff must not ‘double’ gloves or sanitise gloves)

 

Change gloves (if task requires use) between activity/task and, wash/dry hands or sanitise using alcohol hand sanitiser between donning new gloves. 

 

Remember to avoid touching your mouth, nose and eyes.

 

PPE should be removed and disposed of safely after each session or earlier if damaged, soiled, or uncomfortable.

Aerosol generating procedures

Aerosol generating procedures are interventions that can promote the generation of small airborne particles. These fine particles remain suspended in the air for longer periods than larger particles and can be inhaled resulting in a risk of airborne transmission.

 

Some aerosol generating procedures may increase the risk of airborne transmission of COVID-19. 
 

Aerosol generating procedures include: 

 

  • intubation, extubation and related procedures, for example manual ventilation and open suctioning of the respiratory tract (including the upper respiratory tract) 
  • tracheotomy or tracheostomy procedures (insertion, open suctioning or removal) 
  • bronchoscopy and upper ENT airway procedures that involve suctioning 
  • upper gastrointestinal endoscopy where there is open suctioning of the upper respiratory tract 
  • surgery and post-mortem procedures involving high-speed devices 
  • some dental procedures (for example, use of any rotary handpieces, triplex syringes or ultrasonic scalers) 
  • Non-Invasive Ventilation, Bi-level Positive Airway Pressure Ventilation, Continuous Positive Airway Pressure Ventilation, High Frequency Oscillatory Ventilation, and High Flow Nasal Oxygen 
  • induction of sputum (cough).  

 

For more information, including how to fit check, refer to PPE guidance: masks, respirators, gloves, aprons and eye protection.

Physical distancing

When caring for patients/clients/residents who have respiratory infections, a recommended physical distance of at least 1 metre should be maintained in healthcare settings between healthcare staff, patients/clients/residents and visitors.