Hospital handover – Seasonal respiratory infection guidance

All standard and transmission-based IPC precautions and practices should be followed using a dynamic approach. The below guidance collates some additional points to ensure we consider them, particularly during these times of high infection prevalence and handover delays.

In the event of a delay in handing over the patient at the receiving facility, clinicians must follow the local processes in place with regards to arrival notification and escalation. Where it is necessary for the patient to remain in the ambulance, then the below IPC precautions and the ‘hierarchy of controls’ should be adopted where reasonably practical:

Wear a minimum of a surgical mask during in patient care activities.
Consider providing the patient with a mask, following a dynamic risk assessment, providing it does not compromise their clinical care.
Consider patient positioning and where practical/possible avoid sitting face to face.
Maintain ventilation systems operating (set on extract where possible.)
Periodically open the vehicle doors, when appropriate to do so, to allow fresh air to circulate.
Where more than one clinician is available, the clinician providing care to the patient should be rotated regularly, where possible. This rotation of clinicians will reduce prolonged exposure time and allow individuals the opportunity to safely change PPE and rehydrate, while ensuring safe care for the patient.
Surgical masks worn by staff should be changed regularly, when damp, uncomfortable and when safe to do so.
Decontaminate contact surfaces more frequently, where practical this should be carried out during the delay to reduce the environmental contamination levels.
The decision to upgrade RPE from a surgical mask to a FFP3/Hood may be taken by a clinician, for example, during times where a there is an indication of respiratory infection, and the hierarchy of controls is not able to be applied as effectively as required.

This guidance mainly relates to seasonal respiratory infections, predominantly spread via droplet i.e Covid/Flu etc, and does not supersede the requirement to wear FFP3/Hood or follow the correct precaution for other infections.

Published 9th January 2023