10 April 2020 – Hospitals and retirement homes directed to have adequate PPE and risk management for staff

Type of Intervention: Regulation
Sectors Involved: Health
Level of Jurisdiction: Ontario
Lead People/Agency: Ministry of Health and Long-Term Care; Ontario’s Chief Medical Officer of Health Dr. David Williams

Overview: This directive was issued for public hospitals and long-term care homes (under the Public Hospitals Act and Long-Term Care Homes Act, 2007) under Section 77.7 of the Health Protection and Promotion Act (HPPA). In addition, retirement homes must also take steps to follow the precautions outlined (under O. Reg 68/20 of the Retirement Homes Act). The directive stipulates that public hospitals and long-term care homes must implement the precautions and procedures outlined in this document, including:
(1) Provide staff with information and training on safe utilization of PPE
(2) Conduct ongoing assessment of PPE supplies and how to obtain/maintain sufficient supply
(3) Develop contingency plans for the instance of PPE shortage
(4) Update Organizational Risk Assessment to ensure appropriate health and safety control measures are in place in the institution
(5) Perform point-of-care risk assessments for every patient/resident interaction
(6) Use contact and droplet precautions for all interactions with suspected, presumed, or confirmed COVID-19 cases
(7) For long-term care homes, staff and essential visitors must wear surgical/procedure masks at all times during shifts or visits in the home
(8) All health care workers and staff within 2 metres of a suspected, presumed, or confirmed COVID-19 patient/resident must have access to appropriate PPE
(9) The point-of-care risk assessment must include assessment of frequency/probability of aerosol-generating medical procedures. During such procedures, appropriate PPE must be donned.
Full details here: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/directives/public_hospitals_act.pdf

Other links: 1 2 3 4
Type of Justification: Advice of INTERNAL government advisory committee or group, Advice of EXTERNAL expert advisor or advisory committee
Source of Evidence or Justification: World Health Organisation, Sub-national, governmental agency (Public Health Ontario)
Evidence/Justification: Cites WHO’s declaration of COVID-19 as a pandemic virus (March 11, 2020) and potential severity of the illness. Also cites the spread of COVID-19 to Ontario, technical advice provided by Public Health Ontario on scientific recommendations regarding infection prevention and control measures for COVID-19 by the WHO as justification for the development of this directive and the required steps that must be implemented. As outlined by Directive #1 (revised by Ontario March 30, 2020), these IPAC measures are required to be followed by health care providers and health care entities, including hospitals and long-term care homes.