Advisory on the Use of the Infection Prevention and Control Checklist for Temporary Treatment and Monitoring Facilities (TTMF)

Standards

YES

NO

The facility provides suspect, probable, and confirmed COVID-19 patients with facemasks during the entire quarantine/isolation period.

Cohorting of patients in a ward is done only to confirmed COVID-19 patients.

Refer to Patient Placement standards for details

Hand hygiene stations or alcohol-based hand rubs are available and visible in designated areas:

• Hallways, waiting or common areas

• Nurses' stations

• At point of care in patient ward and individual isolation rooms

• Buffer zone

Hand hygiene measures are in place:

• Sinks for hand washing are stocked with soap and towels

• Alcohol receptacles for alcohol-based hand rubs are adequately filled

• Proper Hand Hygiene procedure

• Promoted for all healthcare workers, service providers, and patients

Use of appropriate Personal Protective Equipment according to risk assessment

Respiratory hygiene measures are in place:

• Ensure all patients observe proper etiquette such as covering their mouth with tissue or elbow when coughing or sneezing

• Availability of tissue and foot-operated trash bins at common areas and point of care

Movement and transport of patients are prohibited unless medically necessary:

• If transport is warranted, notify the receiving area of necessary precautions as soon as possible before the patient's arrival

Immediate isolation of patients following protocols on patient placement.

Limit the number of people in contact with suspected or confirmed COVID-19 patients to essential personnel only.

Standards

YES

NO

Policies and protocols for the operation of the facility are in place:

• Restricting visitors for suspect, probable or confirmed COVID-19 patients

• Risk-Based Assessment and Management of Exposure, duty schedules, sick leaves, and reporting of symptoms, if there are any

• Laundry of dirty uniforms and/or scrubs worn during duty by healthcare workers

• Accommodation arrangement and transportation for healthcare workers

• Patient transfer/referral

Policies are readily accessible and discussed with staff and key personnel.

Ensuring there is a continuous and adequate supply of PPEs.

Presence of monitoring mechanism for compliance of healthcare workers and service providers to the established infection control measures.

Presence of dedicated Infection Prevention and Control Officer:

• Monitor compliance to IPC Measures

• Conduct training and orientation on IPC policies and protocols

Access to a higher level referral hospital and laboratory centers.

Promotional and/or educational materials on the following are posted within visible range:

• Proper handwashing

• Respiratory etiquette and social distancing

• Appropriate PPE per zone

Ensure that prescribed staff to patient ratio is met:

• Facility Manager (1)

• Sanitation officer (1)

• Facility Physician (either physically present or remote but accessible through telehealth 24/7)

• Nurse or Midwife (2/shift)

• BHW or Community Health Volunteer (1/shift)

• Data Manager

• Security & Maintenance Officer (1/shift)

Maintain a record of all people entering the contaminated area, including all healthcare workers and service providers, and the purpose of their entry.

Orientation and Training for Healthcare workers and other service providers on standard IPC measures.

A clear, unidirectional foot traffic workflow from one zone to the next is established.

Standards

YES

NO

There is a separate entrance and exit for patients and healthcare workers:

• Entrance and exit of HCW should be connected to the clean/sterile area

• Entrance and exit of the patient is connected to the contaminated area

There is adequate ventilation in the facility:

• Diluted ventilation in all areas, with air exhausted to an air space with no people

• Provision of at least fan ventilation in patient rooms or patient observation area

• Unidirectional airflow from sterile/clean zone to contaminated zone

Prescribed zoning for the facility is followed (Sterile/clean zone, Buffer, Contaminated)

Buffer zone follows the prescribed level for donning and doffing. Appropriate equipment and fixtures are available per level

Follows the Patient Placement for each patient population:

• For TTMF catering to Confirmed COVID-19 patients:

o Cohorting (grouping together) may be allowed

o Each patient bed must be separated at least 1 meter on all sides

o Beds are separated with at least a curtain

• For TTMF catering to Suspect/Probable COVID-19 patients and Close Contact:

o Individual enclosed room with own toilet and bath

o If without own toilet and bath, disinfection must follow prescribed cleaning and disinfection protocol

Foot baths available in the following areas:

• Every exit of the facility

• Before entry to the buffer area from the contaminated area

Established methodical or systematic protocol for environmental cleaning

Follows the prescribed cleaning and disinfection schedule per zone or area:

• At least twice (2x) daily for sterile/clean and buffer zone

• At least four times (4x) daily in contaminated area

• At least twice daily for toilets and baths

o Frequently touched surfaces such as faucets, flush lever, doorknobs are disinfected after every use

Use of prescribed disinfectant and cleaning equipment:

• 70% ethyl alcohol to disinfect small surface areas and equipment between uses

• Sodium hypochlorite at 0.1% (1000ppm) for disinfecting surfaces

• Sodium hypochlorite at 0.5% (5000ppm) for disinfecting surfaces with blood or bodily fluids spills (allowing 30 mins for the disinfectant to sit)

• Dedicated cleaning material for each zone

Identified Gaps:

Concrete action points to address gaps: