Health Care Professionals - Infection Prevention, and Control Guidelines for Primary Care Physicians
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Infection Prevention, and Control Guidelines for Primary Care Physicians
Patient Appointments: Booking, Reception & Triage
Introduction:
The Family Health Team setting provides risk of disease transmission between patients, and between patients and staff. Screening all patients/clients for communicable diseases is the desired practice; this may be difficult to perform due to practicality. Screening can be done using an active, a passive or a combined approach. Active screening involves a receptionist or health care provider that will ask patients/clients about possible symptoms. Passive screening involves signage that asks patients/clients to self-assess and self-identify.
Best Practices:
- Health care settings are encouraged to take an active approach to screening of febrile respiratory illness (FRI)
- Patients/clients who present at a health care setting should be assessed for symptoms of FRI
- It is important to screen for any communicable disease
Booking:
- Consider active screening by triaging patients by phone when they call in to book an appointment. Ask the following questions:
1. Do you have a new/worse cough or shortness of breath?
2. Are you feeling feverish?
3. Do you have diarrhea?
4. Do you have a new rash
5. Have you been exposed to someone with chicken pox or measles in the past three weeks?
- If clinical status allows, book these appointments at the end of the office day
Reception:
- Consider passive screening by posting a sign at office entrance requesting that patients presenting with symptoms of an infectious illness identify themselves to the receptionist.
1. Ask patient to perform hand hygiene
2. Ask patient to put on mask if cough and fever present
3. Have patient wait in a separate area if possible or keep a 2 metre distance from the other patients/staff. Direct these patients into an examination room as soon as possible.
- Respiratory etiquette program is recommended, which includes:
1. Signage that describes respiratory etiquette
2. Provide masks as close to the entry as possible
3. Provide tissues and waste containers
4. Provide instructions to cover the nose and mouth when coughing
5. Provide alcohol-based hand rub
Assessment:
- Initiate appropriate Additional Precautions (e.g. Droplet Precautions for cough and fever, Contact Precautions for diarrhea or rash)
- When screening for FRI follow the procedure listed:
- If a patient presents with new or worse cough and is feeling feverish
(or has fever ≥ 38.0 °C) continue to assess risk of exposure to a significant respiratory illness. Ask the following questions:
1. Have you travelled in the last 14 days? Where?
2. Have you had contact with a sick person who has travelled in the last 14 days? Where did the person travel?
3. Report immediately to the Leeds Grenville and Lanark District Health Unit (613-345-5685) if the patient has a new or worse cough and feeling feverish (or has fever ≥ 38.0 °C) and a travel history to a country with a health alert and/or a possible FRI cluster.
Case Finding Protocol for FRI
*Note: The elderly and immunocompromised patients may not have a febrile response to a respiratory infection.
Adapted from PIDAC (2008) Preventing Febrile Respiratory Illnesses document. |
