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COVID-19 Intern & Observer Students

Guidelines for Intern and Observer Students

COVID-19 remains a serious health threat, in particular for older adults, people with underlying heath conditions, and people with compromised immune systems. It is important to note that this virus can lead to serious health outcomes; knowledge about the impacts of the virus continues to evolve. The Chief Medical Officer of Health (CMOH) has issued specific Orders regarding the COVID-19 (CMOH Orders). These CMOH Orders detail the restrictions and precautions necessary to prevent the spread of COVID-19, as well as the actions required to safely resume activities while still protecting Albertans.

This document outlines protocols that the intern and observer students must follow when practicing at CITCM student clinic.

In the lobby and waiting area

  • Patients and their companions will complete the screening questionnaire and get the temperature measured at arrival with the front desk.
  • Intern students need to direct patient to the treatment room immediately upon entering the clinic whenever possible.

In treatment process

  • Each treatment room will allow a maximum two students at each time.
  • Acupuncture Students must wash hands for a minimum 20 seconds with soap and water or hand sanitizer before and after each patient.
  • Massage students must wash hands for a minimum 20 seconds with soap and water before and after each patient.
  • Students must wear mask continuously, at all times and in all areas of their workplace to safely provide in-person services.
  • The mask should be immediately changed and safely disposed of whenever it is soiled or wet, whenever the students feels it may have become contaminated, and at the end of the day.
  • A new mask must be used for each clinical shift.
  • Masks should never be reused.
  • If a patient enters the clinic after they have been screened, but subsequently identified by the students that the patient exhibits signs and symptoms consistent with a respiratory illness, whether COVID-19 is suspected or not, the students must:
    • Provide a new mask for the patient to don.
    • Have the patient complete hand hygiene.
    • Isolate the patient from others in the clinic (Isolation room #6)
    • If patient drives to the clinic, advise patient go back to her/his own vehicle head home, and call Health Link 811.
    • Explain the concern that they are symptomatic, discontinue treatment and reschedule the appointment.
    • Reports to the clinic supervisor and fill out the form of incident, sign by supervisor and submit to the front desk.
    • Advise the patient they should self-isolate and call Health Link 811.
    • Clean and disinfect the practice area immediately.
  • Students must NOT attempt a differential diagnosis of patients who present with signs and symptoms of COVID-19 and discontinue treatment immediately.
  • Massage patients are recommended to wear masks throughout the entirety of the treatment, but especially in the supine position. When lying prone, patients may expose their nose if they have difficulty breathing.
    • ***PLEASE ENSURE THAT YOUR PATIENT IS WEARING THE MASK THE CORRECT WAY (colour side out) SO IT IS EASIER TO BREATHE THROUGHOUT THE TREATMENT***
  • Facial massage is not to be performed unless appropriate PPE has been donned (mask and face shield/safety goggles).
  • Massage Oil/Lotion holsters are not recommended for use at this time due to the difficulty of sanitization protocols in between patients

Clinic Rooms Cleaning and Disinfection

Acupuncture Students

  • must thoroughly clean and disinfect any surface area the patient may have come in contact with using provided by the clinic.
  • Including the treatment bed, chair, floor, countertop, pillows, headrest, door knob, contents in the medical tray, especially the clean and waste container.
  • Lysol wipes, Lysol sprays and Lysol spray cloth are available in clinic rooms.
  • Leave 30 seconds after wipes/sprays to sanitize the surface.
  • Leave 10 minutes after wipes/sprays to disinfect the surface.
  • If after 10 minutes of disinfection, the surface is still wet, use the clean Lysol spray cloth to wipe dry. Wash the Lysol spray cloth with the laundry.
  • When finish the disinfection, put the new linens.
  • When complete the cleaning and disinfection, students need to fill out the check list of the treatment room after each use. Sign and date the form.

Massage students:

  • must wash hands immediately after handling dirty linens.
  • Students must thoroughly clean and disinfect any surface area the patient may have come in contact with using the Lysol wipes or spray provided by the clinic.
  • Including the treatment bed, chair, floor, pillows, headrest, door knobs, window ledges and any tools/equipment used (broom sticks/gua sha tool/hot stones/cupping according to proper cleaning procedures).
    • Pillows with a vinyl cover are recommended to be used and must be wiped down completely after each treatment.
    • Pillows without the vinyl cover (cloth cover) must be sprayed with the Lysol spray and left for 10 minutes to disinfect the surface. If after 10 minutes of disinfection, the surface Is still wet, use the clean Lysol spray cloth to wipe dry, and cover with a fresh pillowcase. Wash the Lysol spray cloth with the laundry.
  • Lysol wipes, Lysol sprays and Lysol spray cloth are available in clinic rooms.
  • Leave 30 seconds after wipes/sprays to sanitize the surface.
  • Leave 10 minutes after wipes/sprays to disinfect the surface.
  • If after 10 minutes of disinfection, the surface is still wet, use the clean Lysol spray cloth to wipe dry. Wash the Lysol spray cloth with the laundry.
  • Gloves may be worn to protect hands while sanitizing and disinfecting the tables and other contact surfaces. If using gloves, wash hands before donning and after doffing.
  • When finished with the disinfection, students must wash their hands, then proceed to put on the new linens
  • At the end of the day, use the Lysol spray to disinfect the high-touch areas of the curtains

Laundry

Acupuncture students need to:

  • Wash the used linens with hot (above 60 ° C) water and soap.
  • When the laundry is finished, student need to place a new patient gown, fold and put the fresh linens into the designated shelves, then take off the patient gown, leave it in the basket to be washed.

Clinic supervisor will assign students to take care of the laundry in turns.

Clinic uniform/ lab coat and clothes

  • Clean clothes and uniform/lab coat must be worn by students each day.
  • If the students drive directly from their home to the clinic, no change of clothes is required. However, if they stop at other locations on their way to the clinic, then donning new clean clothes in the clinic is required.
  • Clothes worn in the clinic must not be worn in public afterwards. Students must change into different clothes at the end of the shift.
  • Students need to write their full name on the back collar of lab coats.
  • Acupuncture students need to leave their uniform/lab coats at student clinic to wash at the end of the shift. Washed with hot (above 60° C) water and soap.
  • Massage students need to leave their uniform/scrub tops at student clinic to wash at the end of the shift – scrub tops are to be washed separate from the other laundry and the bleach may be omitted so as not to not dis-colour the scrub tops, washed with hot (above 60° C) water and soap.

Herbal Pharmacy

  • Herbal Pharmacy is open to student clinic intern and observer students.
  • Only one group at a time, no more than 2 people.
  • Students must clean and disinfect all touched areas after use.

Appendix 1

Hand hygiene

  • Remove jewelry before hand washing procedure.
  • Wet your hands with warm running water.
  • Apply liquid soap and lather thoroughly
  • Rub your hands vigorously for a minimum 20 seconds as you wash them
  • Wash all surfaces of your hands including backs of hands, wrists, between fingers, under fingernails.
  • Rinse your hands well. Leave the water running.
  • Dry your hands with a single use towel (e.g., paper towel)
  • Turn off the water using the same towel, or with a paper towel, not with your bare hands.
  • When using hand rubs, apply the product to dry hands and rub hands together covering all surfaces for a minimum 20 seconds. Hands should be allowed to dry thoroughly. Do NOT use paper towels after using ABHR (Alcohol based hand rub).

Hand Hygiene is the most important infection control measure. Hand washing should be done:

  • Before and after patient contact or acupuncture treatment
  • Before and after preparing, handling, or dispensing herbs or herbal remedies
  • When hands are contaminated during the treatment
  • Immediately after inadvertent exposure to blood or body fluids
  • When hands are visibly soiled
  • After contact with environmental surfaces or equipment
  • After removing gloves
  • Before preparing, handling, and serving or eating food
  • After handling money or other items that may be contaminated
  • After answering the phone or using the computer or other electronic devices and returning to a patient
  • After personal body functions

Appendix 2

Personal protective equipment (PPE)

Personal protective equipment consists of gowns, gloves, masks, facial protection (i.e., masks and eye protection, face shields or masks with visor attachment) or respirators that can be used to provide a barrier to help prevent potential exposure to infectious disease.

Donning mask

  • Perform hand hygiene.
  • Open mask fully to cover from nose to below chin.
  • Put on mask
  • Secure ties to head (top first) or elastic loops behind ears
  • Mould the flexible band to the bridge of nose (if applicable)
  • Ensure snug fit to face and below chin with no gaping or venting

Doffing mask

  • Perform hand hygiene
  • Do not touch the front of the mask
  • Carefully remove mask by bending forward slightly, touching only the ties or elastic loops. Undo the bottom tie first then undo the top tie.
  • Discard the mask in the garbage.
  • If the mask itself is touched during doffing, perform hand hygiene

Resources

Disclaimer: This document will be updated without notice. Please follow the most updated version for the protocol.