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101. Coronavirus (COVID-19) guidelines for outbreaks in residential care facilities

to cover a 20-30% staff absentee rate. Developing and maintaining a contact list for casual staff members or external nursing agencies is essential to timely activation of a surge workforce should an outbreak occur. Surge workforce staff should be appropriately educated and orientated to the function of the unit prior to commencing work. Leave planning should also consider the nature of the pandemic and current outbreaks. Staff Education and Training Each RCF is responsible for ensuring their staff (...) are adequately trained and competent in all aspects of outbreak management prior to an outbreak. Staff should know the signs and symptoms of COVID-19 in order to identify and respond quickly to a potential outbreak. Additionally, all staff (including casual, domestic, hospitality and volunteer workers) need to understand the RCF infection control guidelines and be competent in implementing these measures during an outbreak. Topics for staff education and training should include: • Symptoms and signs of COVID

2020 Covid-19 Ad hoc guidelines

102. Covid-19: Information for hospice staff on Alert Level 3 and 4

with a disability and co-existing long-term conditions • people who have medical devices that enter the body (eg, a catheter, tracheostomy, ileostomy, feeding tube) • people with surgical or large open wounds • people older than 70 years of age. Supporting people at home who are more vulnerable to infection but do not have COVID-19 Extra precautions are needed to ensure people at home receiving support are safe, particularly those who are more vulnerable to infection and severe illness. We recommend those staff (...) to feel better. • Reach out to your usual support, like family, whanau and friends and talk about how you feel. • We recommend sticking to a routine such as having regular mealtimes, bedtimes and exercising. • If you feel you are not coping, it is important to talk with someone. For support with grief, anxiety, distress or mental wellbeing, you can call or text 1737 to talk with a trained counsellor. You can also find additional mental health and wellbeing resources at health.govt.nz/covid-19-mental

2020 Covid-19 Ad hoc guidelines

103. COVID-19 and violence against women. What the health sector/system can do

violence by any perpetrator in their lifetime. Most of this is intimate partner violence. • Violence against women tends to increase during every type of emergency, including epidemics. Older women and women with disabilities are likely to have additional risks and needs. Women who are displaced, refugees, and living in conflict-affected areas are particularly vulnerable. • Although data are scarce, reports from China, the United Kingdom, the United States, and other countries suggest an increase (...) on violence against women • Health care for women subjected to intimate partner violence or sexual violence • Strengthening health systems for women subjected to intimate partner violence or sexual violence: A health manager’s manual • Caring for women subjected to violence: A WHO curriculum for training health-care providers • Clinical management of rape and intimate partner violence survivors: Developing protocols for use in humanitarian settings • Violence against women infographic • Violence against

2020 WHO Coronavirus disease (COVID-19) Pandemic

104. COVID-19 - guidance for community settings

). Clinicians working in AP settings should work with management to minimise infection risk to children and young people while ensuring that their needs are met. similarly notes that school, early learning and childcare (ELC) settings may stay open for children of key workers and vulnerable children (defined as those in receipt of free school meals, children with additional support needs and at-risk children). The Northern Ireland Department for Education has , as these children fall within the definition (...) prioritised; safeguarding; continuing care packages; children and end of life care; rapid response service; sexual assault services; antenatal newborn and children screening and immunisation services. Mental health, learning disabilities and autism are the focus of a COVID-19 response cell that is not specific to CYP (see sub-section: ‘Mental health, learning disabilities and autism’). NHS is available. While the entire document is not specific to care for children and young people, it does have a section

2020 Royal College of Paediatrics and Child Health

105. Chronic obstructive pulmonary disease (COPD)

show that PR helps to improve dyspnea, health status and exercise tolerance—especially in patients with moderate to severe COPD—and reduces the risk of re-hospitalization after an exacerbation. Program components include exercise training, disease education, nutritional support, and behavior change strategies that promote long-term adherence to healthy habits. The optimal benefits are obtained from programs lasting for 6-8 weeks with supervised exercise training at least twice per week. Consider PR (...) % of predicted) ? Signs of heart failure ? Signs of polycythemia (Hct > 55%) Assess for hypercapnia (respiratory failure) Cardiopulmonary exercise testing Patients with disproportionate degree of dyspnea for FEV1 Quantify impairment and/or disability and help select patients able to safely undergo lung volume reduction surgery Alpha1-antitrypsin Patients with: ? Early onset COPD ? Little or no history of smoking ? Family history of COPD ? Predominance of basilar emphysema Assess for alpha1-antitrypsin

2020 Kaiser Permanente Clinical Guidelines

106. Addressing Human Rights as Key to the COVID-19 Response

of all ages, however may have greater vulnerabilities to -2- COVID-19 depending on their living arrangements, financial instability and lack of specific safeguards impacting their risk of infection, such as persons with disabilities, people who are homeless, refugees, migrants, and prisoners. 11 COVID-19 has revealed a unique ecology of sickness based on social determinants of health, which requires attention. 12 These groups are among the world’s most marginalized and stigmatized. The Universal (...) discrimination and to ensure access to information, social services, health care, social inclusion, and education for vulnerable groups in national COVID- 19 responses. 14 Quarantine and restrictive measures Many countries have implemented large-scale public health and social measures in an attempt to reduce transmission and minimize the impact of COVID-19, including quarantine and the restriction of movement of individuals. 15 WHO emphasizes that any such measures should be implemented only as part

2020 WHO Coronavirus disease (COVID-19) Pandemic

107. Practical considerations and recommendations for Religious Leaders and Faith-based Communities in the context of COVID-19

their faith community and wider communities. Purpose of this guidance This document is based on guidance and recommendations developed by WHO in response to the COVID-19 pandemic. It acknowledges the special role of religious leaders, faith- based organizations, and faith communities in COVID-19 education, preparedness, and response, through: • Sharing evidence-based information about COVID- 19, preparedness, and response • Avoiding large group gatherings and conducting rituals and faith-related (...) activities remotely/virtually, as required and whenever possible • Ensuring that any decision to convene group gatherings for worship, education, or social meetings is based on a sound risk assessment and in line with guidance from national and local authorities 1 For terminology descriptions please refer to http://data.unaids.org/pub/report/2010/jc1786_fbo_en.pdf 2 These steps are based on Key planning recommendations for Mass Gatherings during COVID-19 • Ensuring safe faith-based gatherings, ceremonies

2020 WHO Coronavirus disease (COVID-19) Pandemic

108. Clinical care of severe acute respiratory infections – Tool kit

and adapted when caring for adult patients.Clinical Care for Severe Acute Respiratory Infection—Toolkit viii Acknowledgements This critical care training is the product of contributions by many individuals under the coordination of the World Health Organization’s Global Influenza Programme and guidance of Nikki Shindo. Major contributions were provided by Janet Diaz (Emergency Programme, WHO), Neill Adhikari (Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Canada) and Paula Lister (...) University School of Medicine, Nashville, TN, United States of America); Sabine Heinrich (Berlin, Germany); Michael Ison (Northwestern University, Chicago, IL, United States of America); Arjun Karki (Patan Academy of Health Sciences, Kathmandu, Nepal); John Luce (San Francisco General Hospital, San Francisco, California, United States of America); Lung Injury Knowledge Network, National Heart, Lung, and Blood Institute (Bethesda, MD, United States of America); Kirsten Lunghi (San Francisco General

2020 WHO Coronavirus disease (COVID-19) Pandemic

109. Covid-19: Clinical guide for the management of stroke patients during the coronavirus pandemic

seek and act on national and local guidelines. We also have a specific responsibility to ensure that essential care continues with the minimum burden on the NHS. We must engage with those planning our local response. We may also need to work outside our specific areas of training and expertise and the General Medical Council has already indicated its support for this in the exceptional circumstances we may face. www.gmc-uk.org/news/news-archive/how-we-will- continue-to-regulate-in-light-of-novel (...) be managed remotely from the hospital or in the community via telephone or video call. • Rehabilitation pathways: These are essential to reduce disability through early intervention and enable rapid assessment and early discharge home if possible. – Consider immediate discharge of ‘walking wounded’ patients from ED, where able, to reduce short-stay admissions using a rapid response MDT team to ED. – Maintaining and ideally increasing early supported discharge and community rehabilitation teams should

2020 Covid-19 Ad hoc guidelines

110. COVID-19 Guidelines for Outbreaks in Residential Care Facilities

and Human Services 6 1.3.3. Australian Aged Care Quality and Safety Commission 6 2. UNDERSTANDING COVID-19 7 2.1. Recognising COVID-19 7 2.2. Incubation Period 8 2.3. Routes of Transmission 8 2.4. People at risk of complications from COVID-19 8 2.5. Complications of COVID-19 8 3. PREPAREDNESS AND PREVENTION 9 3.1. Preparation 9 3.1.1. Prepare an Outbreak Management Plan 9 3.1.2. Education 10 3.1.3. Workforce Management 11 3.1.4. Staff Education and Training 11 3.1.5. Consumable Stocks 11 3.2. Prevention (...) absentee rate. Developing and maintaining a contact list for casual staff members or external nursing agencies is essential to timely activation of a surge workforce should an outbreak occur. Leave planning should also consider the nature of the pandemic and current outbreaks. 3.1.4. Staff Education and Training Each RCF is responsible for ensuring their staff are adequately trained and competent in all aspects of outbreak management prior to an outbreak. Staff should know the signs and symptoms

2020 Covid-19 Ad hoc guidelines

111. What paediatricians can do to support children and youth during the COVID-19

Access to social and community services, including disability supports and cultural continuity. IT HELLPS is a useful mnemonic for taking a complete a social history: I ncome, T ransportation, H ousing, E ducation, L egal status, L iteracy, P ersonal safety, S upport [ ] [ ] . HCPs may want to ask the following questions, which have been adapted from the from Health Providers against Poverty [ ] : Income insecurity [ ] : “Have you had difficulty making ends meet?” Access to food [ ] : “Are you having (...) universal access to technologies and the Internet for educational, health-related, and mental health services, including school-based lending programs for laptops and online connection [ ] . Ensuring that school-based and other programs bringing nutritious meals to children remain ongoing and fully funded [ ] . Collaborating with community services and allied care providers, including teachers and school administrators, social workers, and public health authorities, to support children and youth at risk

2020 Canadian Paediatric Society

112. Subacromial decompression surgery for adults with shoulder pain Full Text available with Trip Pro

decompression surgery should not be offered to patients with SAPS. However, there is substantial uncertainty in what alternative treatment is best. Up to a quarter of adults have experienced shoulder pain over the past year, and it represents the third most common musculoskeletal problem. About half of those affected will recover completely within six months. Pain beyond three months is associated with poorer recovery, disability, and reduced ability to work. Subacromial pain is the most common form (up (...) . The panel was confident that surgery provides no important benefit on pain, function, quality of life, and global perceived effect informed by moderate to high certainty evidence in a one year timeframe. Surgery also comes with burdens and the risk of harm (see main infographic). Clinicians should not offer patients subacromial decompression surgery unprompted, and clinicians, public healthcare providers, and others should make efforts to educate the public regarding the ineffectiveness of surgery

2019 BMJ Rapid Recommendations

113. Infection Prevention and Control guidance for Long-Term Care Facilities in the context of COVID-19

reports for COVID-19. COVID-19 is an acute respiratory illness caused by a novel human coronavirus (SARS-CoV-2, called COVID-19 virus), which causes higher mortality in people aged =60 years and in people with underlying medical conditions such as cardiovascular disease, chronic respiratory disease, diabetes and cancer. Long-term care facilities (LTCFs), such as nursing homes and rehabilitative centers, are facilities that care for people who suffer from physical or mental disability, some of who (...) these recommendations as new information becomes available. All technical guidance for COVID-19 is available online. 1 Training videos on COVID-19, including IPC, can be found here: System and service coordination to provide long-term care • Coordinate with relevant authorities (e.g. Ministry of Health, Ministry of Social Welfare, Ministry of Social Justice, etc.) should be in place to provide continuous care in LTCFs. • Activate the local health and social care network to facilitate continuous care (clinic, acute

2020 WHO Coronavirus disease (COVID-19) Pandemic

114. Guidance for maternal medicine in the evolving coronavirus (COVID-19) pandemic

of depression during the postpartum period. This has the potential to be worse in the pandemic situation, and so should be screened for appropriately. 20 3.7.2 Neurological diseases which are most vulnerable to COVID-19 effects Adults with motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy have been identified as being more vulnerable to the severe effects of COVID-19 and have been advised to stringently follow social distancing measures. 1 The Association of British (...) validated GDM risk model uses routine information collected in the first trimester and predicts the GDM with good discrimination (C-statistic 0.77; 95% CI 0.73-0.81) and calibration (slope 1.1). It also has good predictive accuracy in nulliparous women (C-statistic 0.75; 95% CI 0.68-0.82).39 Appendix 4: Antenatal care of pregnant women with gestational diabetes (GDM) First appointment with diabetes specialist midwife/ nurse, held face-to-face or remotely, to cover: • Training on use of glucose meter

2020 Royal College of Obstetricians and Gynaecologists

115. Mental Health Considerations during COVID-19 Outbreak

an already challenging situation far more difficult. If possible, staying connected with your loved ones including through digital methods is one way to maintain contact. Turn to your colleagues, your manager or other trusted persons for social support- your colleagues may be having similar experiences to you. 10. Use understandable ways to share messages with people with intellectual, cognitive and psychosocial disabilities. Forms of communication that do not rely solely on written information should (...) or depression) within emergency or general health care facilities. Appropriate trained and qualified staff may need to be deployed to these locations when time permits, general health care staff capacity in mental health and psychosocial support should be increased (see mhGAP Humanitarian Intervention Guide) 17. Ensure availability of essential, generic psychotropic medications at all levels of health care. People living with long-term mental health conditions or epileptic seizures will need uninterrupted

2020 WHO Coronavirus disease (COVID-19) Pandemic

116. The Australian and New Zealand Intensive Care Society (ANZICS) COVID-19 Guidelines

Care Society Suite 1.01, Level 1, 277 Camberwell Road, Camberwell VIC 3124 Phone: +613 9340 3400 Email: anzics@anzics.com.au Website: anzics.com.au © Australian and New Zealand Intensive Care Society 2020. This work is copyright. It may be reproduced in whole or in part for study or training purposes, subject to the inclusion of an acknowledgment of the source. Requests and enquiries concerning reproduction and rights for purposes other than those indicated above require the written permission (...) -19 viral pandemic will likely represent an unprecedented challenge to intensive care services throughout Australia and New Zealand. We are fortunate to have world class intensive care services, with a highly trained and professional workforce who are ready and able to serve their communities at this time. This document aims to provide a series of recommendations and suggestions to ensure continued high-quality clinical care in the setting of a pandemic. High-quality evidence to guide medical

2020 Covid-19 Ad hoc guidelines

117. Covid-19: National supporting guidance for Scottish General Practice

pages and community councils may be helpful to support local communications and messaging. Consideration needs to be given as to how to communicate with vulnerable groups such as frail elderly, learning disabilities and other vulnerable groups. 22. Practices should put a COVID-19 message on the practice phone line advising patients of the screening criteria (for those who should not come into the practice without phoning for triage) and directing appropriate patients to the NHS Inform website (...) should introduce processes to triage all appointment requests (on the day or in future). Each practice should identify the most appropriate clinical members of the practice team to carry out this role and ensure that they have appropriate internal training, guidance and support to carry out this role. See Annex A for further guidance on practice telephone triage. 15. The RCGP Action Cards should be reviewed and amended to reflect the agreed practice processes if required and then circulated

2020 Covid-19 Ad hoc guidelines

118. Advice on how to establish a remote ‘total triage’ model in general practice using online consultations

electronically on EMIS and SystmOne • Demand and capacity tool • Remote consulting a survival guide • Online consultations implementation toolkit • Digital Devon Accelerator pack (includes comms examples) • Training video: good and bad consultation • COVID-19 isolation note service via NHS 111, NHS.UK and the NHS App • Remote assessment of COVID-19 • Webinar recordings Dr Minal Bakhai, Deputy Director and Clinical Lead Digital First Primary Care NHS England and NHS Improvement, General Practitioner 4 | How (...) from home. Research shows they also improve access for people with specific information and communication needs, including those with a disability or hearing loss, carers and people who feel apprehensive about accessing health services – eg for a mental health, sensitive or embarrassing problem. 5,6 Telephone functionality helps ensure equity of access for non-digital users. 1 Total digital triage uses an online consultation system to triage all patient contacts. Non-digital users are taken through

2020 Covid-19 Ad hoc guidelines

119. The Geriatricians’ Perspective on Medical Services to Residential Aged Care Facilities (RCFs) in Australia.

in multidisciplinary policy and procedure development. 9. There is a need for the establishment of a medical special interest group, dedicated to promoting high quality research and medical care for the residential care population, in which the Australian and New Zealand Society for Geriatric Medicine should have a major role. This body could progressively establish education and training requirements for recognition of competency in residential care medicine. This recognition could become an entitlement (...) care standards, regular review and reassessment, and participation in audit, education, and staff training. The American Medical Directors Association takes a similar position and oversees certification of competency in these aspects of the medical role in long-term care [35]. Dr Peter Ford, Chairman of the Australian Medical Association (AMA) committee on care of older-aged people, in a 2008 commentary to the AMA, placed some responsibility on the Aged Care Accreditation Agency

2020 Australian and New Zealand Society for Geriatric Medicine

120. COVID-19: Ethical considerations

and Treatment) (Scotland) Act 2003 and the Mental Health (Northern Ireland) Order 1986. For doctors working in mental health, learning disability and autism services, usual ethics principles apply – see and . In addition, see the . However, this pandemic is likely to throw up some dilemmas for which more specific advice is needed. It is strongly recommended that all psychiatrists check that their local clinical ethics committees are in place as they can provide advice and guidance in real-time. The BMA have (...) therapeutic and recreational activities on offer) Blanket restrictions on all patients Greater reliance on physical and procedural security measures to compensate for reduced relational security Less communication with families, relatives, carers In secure services, less ability to support escorted community leave Mental health, learning disability and autism services may need to prioritise the most unwell individuals and those presenting the most severe behavioural challenges. Principles to be borne

2020 Royal College of Psychiatrists

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