Last update: December 17, 2021
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Infection prevention and control (IPAC) measures protect healthcare providers, staff, and patients from the spread of disease, including COVID-19. A risk assessment of your clinic and exam rooms prior to any interaction with patients will help to determine which IPAC measures are needed, depending on the specific setting and procedures being performed. The resources below may assist as you implement appropriate IPAC measures within your practice.
NEW Webinar: Supporting Community Physicians/ Helping community physicians and nurse practitioners see patients safely in the time of COVID 19.
- Please note: As new information emerges surrounding the Omicron (B.1.1.529) variant of concern, guidance may change. Since the webinar of Dec 7th and the development of the Q&A document, the Interim IPAC Recommendations for use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19 (PDF) has been released from PHO (Dec 15th).
- We encourage physicians to read the guidance to inform their point of care risk assessment. Note that this is interim guidance that is taking a precautionary approach in the absence of studies specific to the use of PPE when providing care to patients with the Omicron (B.1.1.529) variant of COVID-19.
- The notable change in the guidance include:
- “Given the undetermined impact of the Omicron (B.1.1.529) variant, the interim recommended PPE when providing direct care for patients with suspect or confirmed COVID-19 includes a fit-tested, seal-checked N95 respirator (or equivalent or greater protection), eye protection, gown, and gloves. Other appropriate PPE includes a well-fitted surgical/procedure (medical) mask, or non-fit tested respirator, eye protection, gown and gloves for direct care of patients with suspect or confirmed COVID-19.
- Fit tested N95 respirators (or equivalent or greater protection) should be used when aerosol generating medical procedures (AGMPs) are performed or anticipated to be performed on patients with suspect or confirmed COVID‑19.
- These recommendations are interim and will be re-evaluated as more information on the Omicron (B.1.1.529) variant emerges”
- Recorded December 7th, 2021 at 7 pm to 8:15 pm (English only)
- Recorded version.
Preparing your office
The Hierarchy of Controls is an occupational health and safety framework for controlling hazards in the environment. The controls at the top of the hierarchy inverted triangle are the most effective measures, with personal protective equipment (PPE) being the least effective measure of control. All the levels of the framework are important, as they create many layers of protection. This framework can help to structure the approach to COVID-19 IPAC in a clinical setting:
Photo source: National Institute for Occupational Safety and Health National Institute for Occupational Safety and Health
Elimination and substitution |
This layer of IPAC protection prevents people with COVID-19 from coming into the setting without knowledge of the health care provider, through active and passive screening. Pressures that existed early in the pandemic that required prioritizing virtual care have now diminished and, in most instances, in-person care can now be provided safely and appropriately through other control measures. Ontario’s Ministry of Health COVID-19 Guidance: Primary Care Providers in a Community Setting (PDF, Oct. 19, 2021) encourages healthcare workers to take a patient-centered approach in deciding whether to book a visit in-person or virtually.
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Engineering controls |
COVID-19 can be spread by people with asymptomatic infections. Ventilation, physical barriers, and re-designed work areas to facilitate physical distancing can help decrease the risk of COVID-19 spreading from an infectious person.
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Administrative controls |
IPAC policies and procedures; healthy workplace policy; education and training; signage.
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Personal protective equipment (PPE) |
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Additional Resources
Ontario College of Family Physicians
- Printable poster for guiding employees in contact with patients.
Ministry of Health
- Guidance document: Acute Care Settings
- Guidance document: Primary Care Settings.
Public Health Ontario
- Local practices can first consult the Clinical Office Practice IPAC webpage for relevant information including a practical IPAC checklist and video resources. Contact information for the Regional IPAC Support Team is available through that page.
- Further resources from PHO are available on their Healthcare Workers webpage.
- PHO has also developed IPAC fundamental training modules.
The Centre for Effective Practice
- The Centre for Effective Practice has developed its Primary Care Operations webpage as a point of reference for accurate and up to date information on COVID-19, including the latest IPAC recommendations.
For more information on Infection Prevention and Control, please see our page Infection Prevention and Control Resources for Healthcare Professionals.
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