M E A D O W V A L E P H Y S I O T H E R A P Y & R E H A B I L I T A T I O N C E N T R E
Unit 5, 3080 Windwood Dr, Mississauga, L5N 2K5, Ph: 905 826 5228
COVID-19 Policy and Procedures
0 Staff and Client safety
1.1 Physical distancing of at least 2 metres (6 feet) or more between persons, including clients and co-workers.
1.2 Good hygiene such as; Washing hands often with soap and water when hands are visibly soiled, before and after any breaks, at the beginning and end of shift, and before preparing food or use alcohol-based hand sanitizer (with 70% alcohol content) if hand washing is not possible.
1.3 Sneeze and cough into sleeve.
1.3.1 If a tissue was used, discard immediately and wash your hands afterward.
1.3.2 Avoid touching your eyes, nose or mouth.
1.4 Avoid touching high-touch areas, where possible, or ensure to clean hands after.
1.5 Regular cleaning and disinfecting frequently touched areas (see Environmental Cleaning and Disinfection)
1.6 Minimize contact with people who are sick and ensure controls are in place for the protection of staff and clients.
1.7 Staff and client to stay home if they are sick.
1.8 Where possible, wear gloves when interacting with high-touch areas. Do not touch face with gloved hands. Take care when removing gloves. Ensure to wash hands after removing them.
1.9 Wash clothes as soon as you get home.
1.10 Staff and clients who have symptoms or think they were exposed to COVID-19, to notify clinic immediately, and stay home.
2.0 Environmental Cleaning and Disinfection
2.1 Use soap and water (ways to properly clean hands) or alcohol-based hand sanitizer (70% alcohol) if soap and water are not available.
2.2 Frequent cleaning and disinfecting of washroom facilities preferably after each use.
2.3 Signage on hygiene in English at entrance, reception and washroom, so everyone can understand how to do their part respecting hygiene practices.
2.4 Sanitizing of commonly touched surfaces or areas after every client/ staff use (e.g. medical equipment, door handles, light switches, toilet handles, counters, work surfaces, equipment) and when visibly soiled.
2.5 “Wipe-twice” method to clean and disinfect. Wipe surfaces with a cleaning agent to clean off dirt and wipe again with a disinfectant. Or use a one-step process using a combined cleaner-disinfectant product. OR
2.7 Regular household cleaning and disinfecting products are effective against COVID-19 and to be used according to the directions on the label. OR
2.8 Disinfectant that has a Drug Identification Number (DIN) and a virucidal claim (efficacy against viruses) to be used. OR
2.9 Bleach solution in a well-ventilated area and never be mixed with other chemical products. Diluted bleach solution to disinfect high-touch hard surfaces, do so according to instructions on the label or in a ratio* of:
250 mL (1 cup) of water per 5 mL (1 teaspoon) bleach, or
1 litre of water (4 cups) per 20 mL (4 teaspoons) bleach
2.10 Practitioner should maintain a cleaning log. Cleaning log will be provided by clinic. After cleaning (after every client visit) practitioner should enter and initial in the log.
2.11 Clothing and fabric items should be laundered and dried on the highest temperature setting possible. Ensure items are thoroughly dried.
3.0 Physical Distancing
3.1 Physical distancing may not be possible when providing care, but it can be practiced when not providing care.
3.2 Scheduling appointments to limit 1 client per practitioner and a maximum of 2 caregivers are allowed to practice. A 15 minutes window between appointment is mandated to avoid crowding and disinfecting the areas and equipment touched/ used by staff and client.
3.3 Minors and adults who need assistance are allowed to bring 1 caregiver.
3.3.1 Caregiver should be free from COVID-19 symptoms.
3.3.2 Caregiver will not be allowed into treatment area and should wait at waiting area.
3.3.3 It is mandatory for Caregiver to use mask.
3.4 Spacing seats in waiting areas at least 2 metres apart and non-essential items such as books, magazines, remote controls and toys will not be placed in waiting area.
3.5 When unable to maintain physical distancing during client treatment; staff can use a non-medical mask to protect those around them.
3.7 Limiting to virtual and/or telephone consultations when and where possible.
3.8 Non-essential face-to-face appointments should be postponed or converted to virtual appointments.
4.0 Effective Occupational Health & Safety AND Infection Prevention & Control Plan
4.1Practitioners are encouraged to implement a system for virtual and/or telephone consultations when and where possible. When possible, primary care practitioners should conduct a consultation over the phone, video or secure messaging to determine if a virtual/telephone consultation will suffice or if an in-person appointment is necessary. The purpose of this is to support physical distancing and minimizing contact of persons who may have COVID-19 with health care settings as much as possible.
4.2 Where in person care is required for essential visits, providing some care virtually will be considered even if an in-person visit is needed in order to minimize the in-person time required (i.e., an essential Pelvic Health visit could be divided into a virtual discussion of testing/screening options with a brief in person physical assessment).
4.3 The need for patients to wait in the waiting room will be minimized (e.g. spreading out appointments, or when early arrival of client; having client stay outside the clinic until the examination/ treatment room is ready for them and then call in, by phone preferably).
4.4 Staff including practitioners in the clinic will be minimized.
4.5 Clinic will perform active screening over the phone/ email/ video 2 hrs before appointments are scheduled and upon entry to the facility using the latest case definition. Staff conducting active screening in person should maintain a 2-metre distance or should use appropriate PPE e.g. masks, eye protections, gloves and gowns.
4.6 Clinic will inform clients to not to visit and immediately isolate in case of having symptoms of COVID-19.
4.7 Anyone who screens positive over the phone/ email will be advised to immediately self-isolate and be offered a same day telephone consultation. If the patient/client fits the case definition, they will be referred to the local assessment centre or testing facilitated by the local public health unit.
4.8 A client who screens positive upon entry to the facility should be separated from others so that they are at least 2 metres apart and given a surgical/procedure mask. The client will be instructed to walk out the facility with physical distancing measures. The facility will be sanitized completely by the procedures mentioned in Section 2.
4.9 Clinic to report probable and confirmed cases to local Public Health unit.
4.10 Staff are assigned dedicated work areas. Staff are discouraged from sharing phones, desks, offices and other tools and equipment.
4.11 Limit the exchange of papers (e.g. signing documents). If documents must be exchanged (e.g. Consent, intake forms), leave them on a clean surface while maintaining a two-metre distance, pens and office equipment will be disinfected after each use.
4.12 Scheduled visits to eliminate people gathering in reception areas.
4.13 Administrative controls include restricting the number of personnel entering the room and having proper training about the appropriate use of personal protective equipment (PPE) (gloves, gown, mask or respirator, eye protection, face shield).
4.14 Proper use of personal protective equipment (PPE) for contact/droplet precautions (gown, gloves, mask/respirator, and eye protection) at a minimum.
4.15 Practice at least droplet and contact precautions when physical contact with people who have flu-like symptoms is required
4.16 Posters & other signage posted in high traffic areas: Asking clients to stay home if they have symptoms (fever, cough or difficulty breathing).
5.0 Booking Appointments
5.1 Appointments will be booked only over phone or clients can book online. Clinic will screen the client for symptoms of COVID when booking over the phone and before their arrival to clinic. Clients booked online will be screened over phone as soon as the Clinic notices the appointment and before the arrival of client. Client screening will be done by Client screening questionnaire issued by Ministry of Health and Long-Term Care. A checklist will be completed as a part of client documentation.
5.2 Clients will be informed over the phone or via email of any public health measures you have implemented.
5.3 Appointments will be booked to allow time between patients to help maintain physical distancing and allow for surface and equipment cleaning after each appointment.
5.4 Unless the client requires assistance from another person, encourage them to come alone to their appointment.
6.1Before each appointment, physiotherapists must:
6.1.1 Point-of-care risk assessment conducted to determine the level of precautions required.
6.1.2 Wash your hands or use an alcohol-based sanitizer.
6.2 When encounter a patient who has gone through the screening process and enters the setting yet exhibits signs and symptoms consistent with COVID-19, you must:
6.2.1Separate the patient from others so that they are at least 2 metres apart.
6.2.2 Have the patient complete hand hygiene.
6.2.3 Provide a surgical/procedural mask for the patient to wear.
6.2.4 Provide access to tissue and a hands-free waste receptacle for their used tissues and used masks. Ensure patients do not leave used masks in the waiting area.
6.2.5 Explain the concern to the patient that they are symptomatic, discontinue treatment and reschedule the appointment.
6.2.6 Advise the patient that they should self-isolate, complete the online self-assessment tool before calling their doctor or Telehealth Ontario.
6.2.7 Clean and disinfect the practice area immediately.
6.2.8 Wash hands or use alcohol-based hand sanitizer after contact with the patient and patient environment, and after the removal of PPE.
6.2.9 Practitioner should contact their local public health unit to report any probable and confirmed cases of COVID-19 based on the latest case definition posted on the Ministry of Health COVID-19 website.
6.3 Encourage clients to wash their hands or to use an alcohol-based sanitizer before and after the appointment.
6.4 When practitioners are not interacting with a suspected or confirmed COVID-19 patient or someone with symptoms, if you are not able to maintain physical distancing with others, then:
6.4.1 Practitioner must wear a surgical/procedure mask.
6.4.2 Practitioner should also consider using eye protection (goggles or a face shield).
6.4.3 Practitioner ensure patients wear their own mask & gloves to the clinic if they have one. Ensure that patients do not leave their masks in waiting areas. Wash hands or use alcohol-based hand sanitizer after contact with the patient and patient environment, and after the removal of PPE.
6.4.4 Client entering the clinic should wash hands with hand sanitizer, clinic provides hand sanitizer. Client can also purchase mask and gloves at clinic.
6.4.5 If the appointment involves direct contact with clients who have respiratory symptoms (e.g., coughing and sneezing), a confirmed COVID-19 infection or direct contact with contaminated objects or environments, appropriate PPE must be used.
6.4.6 This may include gloves, a gown, a surgical/procedure mask, and/or a face shield.
6.5 Ensure that you understand the safe use, care and limitations of PPE, including putting on and taking off PPE as well as proper disposal.
7.0 After the Appointment
7.1 After each appointment, wash hands or use an alcohol-based sanitizer.
7.2 Ensure to clean the treatment area and surfaces, and anything used during the appointment by practitioner and the patient.
8.0 Self Monitoring
8.1 Practitioners should monitor themselves for signs of illness.
8.2 If sick, stay home.
8.3 If start experiencing symptoms while you are at work, immediately put on a medical/procedure mask and leave work.
8.4 If having symptoms, think you were exposed to COVID-19, or travelled outside of Canada within the last 14 days, notify clinic immediately, complete the self-assessment available in Ontario.ca and follow the instructions provided.