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Table of Contents

Covid-19 management at Western Health

see also:

Introduction

To help navigation of the Microsite:

  • note there are no specific links to each QRG as the QRG links are likely to change every time they get updated which would break the links.
  • see https://coronavirus.wh.org.au/quick-reference-guides/ for:
    • Self-monitoring and home isolation
    • Asymptomatic Staff COVID-19 Testing Clinics
    • Social distancing
    • Clinical handover using social distancing rules
    • Patient infection prevention management
    • Mobile phones guidelines
    • the many PPE guides
    • Covid infection prevention tips for you and your family
    • use of and laundering of scrubs
    • appropriate low risk work clothes
    • vulnerable staff management
    • how to use Zoom for meetings

ED AV presentations and walk in presentations and their triage

ED Short Stay Unit guidelines

ED to ward guidelines

ED discharge or deaths

Sunshine ED's successful Covid-19 Mx in 2020 outbreak

  • Western Health managed over 45% of the total Covid-19 admissions and Aged care infections in Australia in 2020
  • the Sunshine ED through a broad range of measures, leadership and perhaps good fortune managed to avoid any ED doctors acquiring Covid-19 at work
  • the measures that helped achieve this are outlined below

Minimising Covid patients presenting to ED

  • Aged care patients from residential care facilities with positive cases were admitted and managed by Aged care teams direct to wards or to private hospitals and generally bypassing ED
  • Active staff surveillance for infections and contact tracing of staff
  • Strict visitor management

Early recognition of aerosol spread and minimisation of airborne viral loads

  • despite WHO insistence that Covid-19 was not significantly spread by aerosol, the ED leadership believed otherwise based upon early experiences in China
  • Short Stay Unit was re-located to a remote ward away from the ED and only low risk or no risk patients were admitted - this also allowed lower risk “vulnerable” staff to keep working in a clinical environment (high risk vulnerable staff were given non-clinical duties)
  • patients were streamed into “High Risk” suspect Covid and “Low Risk” suspect Covid streams with the high risk patients allocated to cubicles with their own air space which was separate to the low risk cubicle air space and separate to the main staff base which fortunately had floor to ceiling walls to allow this.
  • patients were given surgical masks at an early phase of the pandemic and SH ED was the first to institute this even though at the time there was a shoortage of masks
  • antiviral air cleaners “scrubbers” were imported and placed in high risk zones such as the wait rooms, resuscitation rooms, “High Risk” suspect Covid zone and the staff base
  • air flow levels were increased in high risk zones - especially resuscitation cubicles
  • an outdoor gazebo was installed for staff to not only allow improved social distancing during meal breaks but improved ventilation
  • aerosol generating procedures were either banned or required to be performed in one of the two negative pressure rooms with modifications to the procedures to further reduce local spread of virus
  • early realisation that some patients pose higher risk of aerosol spread through their aerosol generating behaviours such as yelling out
  • where possible, known positive cases were placed in the negative pressure rooms if available
  • early introduction of regular full ED surface cleans

Additional staff protection

  • mandatory face shields (or goggles) along with surgical masks (N95 masks for high risk areas including AGPs) were instituted
  • emphasis on hand hygiene
  • introduction of glove and gowns although it is debatable how effective these were
  • social distancing measures in tea rooms and meetings (most meetings cobverted to Zoom meetings) - each room was measured and a poster clearly indicating maximum occupancy
  • banning of eating or drinking in shared staff areas within the main ED to reduce staff-to-staff transmissions from reduced mask compliance

Protecting families of staff members

  • facilities to allow changing from scrubs at work and placement into washing bags for separate washing at home
  • advice on leaving shoes outside the house in UV light where possible
  • options for hotel quarantine for high exposure risk staff members

Further measures introduced in 2021

  • greater availability of more rapid swab tests arather than the 24-48 hour turnaround times of 2020
  • staff vaccination
  • additional new air cleansers to replace the 2020 models and provide better coverage
  • new negative flow procedure room built
  • resuscitation rooms to be replaced with new rooms - two with negative airflow, one with negative pressure and ante room
  • two additional negative pressure rooms (in addition to the above resuscitation negative pressure room)
  • mandatory staff attestations
  • mandatory Tier 3 PPE use throughout the ED including SSU during Covid Red alert periods of high community prevalence
  • N95 fit testing for all clinical staff
  • streaming of most known positive covid cases to designated Covid streaming hospitals
covid_wh.txt · Last modified: 2026/01/18 08:49 by gary1
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