- COVID-19 Risk Management
- COVIDSafe Plans
- Workers and COVID-19 vaccination guidelines
- Rapid Antigen Tests (RAT) guide
- Personal Protective Equipment (PPE)
- Environmental cleaning and waste guide
- Workforce infection control training
- Information and support for people with disability
NDS's Coronavirus hub is a collection of resources, information and advice from across Australian governments, agencies and our members. We urge all providers to stay abreast of information, noting that advice may change as COVID-19 continues to evolve.
This information should be considered in the context of any formal advice given through the Government Health Authorities. Each organisation will need an individualised response that reflects the risks, size and types of supports they provide.
The NDS COVID-19 2023 risk management information identifies key issues for ongoing consideration by providers and includes links to Commonwealth, state and territory information and resources. The information outlines provider COVID-19 risk mitigation considerations related to policy, procedure, and operational needs in recognition that COVID-19 is predicted to remain a health risk into the future. While the impact of new variants is unknown health authorities advise the current environment of risk related to COVID-19 is that it remains a serious disease for the Australian population and especially for people with disability or who are immune compromised.
Responsibility for reducing the known risks is the obligation of employers as part of work, health and safety legislation. The NDIS Quality and Safeguards Commission, the Australian Commission on Safety and Quality in Health Care, and the Australian Government Department of Health and Aged Care have also communicated risk reduction recommendations associated with services and settings involving the care and support of immune compromised people, those with chronic health conditions and disabilities. The recommendations are based on pandemic evidence identifying these population groups at an increased risk of poorer outcomes from a COVID-19 infection. Health experts promote the importance of maintaining a combination of risk reducing strategies for the settings including people who are more vulnerable or immune compromised, such as disability.
In the absence of government health authority requirements COVID-19 risk mitigation needs to be defined in organisation’s policy and procedures and discussed with workers and individuals with disabilities prior to implementation.
Commonwealth, state, and territory COVID-19 resources have been provided below. The weblinks are intended to assist you with your risk management decisions and planning or review of existing policies and procedures.
- Coronavirus (COVID-19) pandemic
- Control and Public Health Management of Outbreaks of Acute Respiratory Infection (including COVID-19 and Influenza) in Disability Residential Services | Australian Government Department of Health and Aged Care
Australian Capital Territory:
- Home - COVID-19 (act.gov.au)
- Advice for high-risk settings - COVID-19 (act.gov.au)
- Disability - COVID-19 (act.gov.au)
New South Wales:
- COVID-19 | NSW Government
- COVID-19: Advice for disability service providers - COVID-19 (Coronavirus) (nsw.gov.au)
- COVID-19 Infection Prevention and Control Manual - Clinical Excellence Commission (nsw.gov.au)
- COVID-19 in Queensland | Health and wellbeing | Queensland Government (www.qld.gov.au)
- Infection prevention and control guidance (including PPE advice) | COVID-19 | Queensland Health
- COVID-19 health information | SA Health
- COVID-19 information for Residential Aged Care Facilities (RACF) and Disability Residential Services (DRS)
- Coronavirus (COVID-19) | Tasmanian Department of Health
- Best Practice COVID-19 Safety for Disability Services | Tasmanian Department of Health
- COVID-19 (coronavirus) (healthywa.wa.gov.au)
- Advice on how to access Personal Protective Equipment (PPE) (health.wa.gov.au)
- COVID-19 information for aged care and community care providers (health.wa.gov.au)
Current government COVID-19 risk management guidance focus on the residential accommodation setting where potential for infection transmission is highest.
However, the guidance related to case management and exposure to people who are COVID-19 positive, or any other infectious disease can also be used by in home support workers and providers delivering day services to consider what risk management actions can be implemented in their settings to minimise infection transmission.
The Department of Health and Aged Care has provided infection prevention and control guidelines for use by employers to identify and implement COVID-19 risk management policies and procedures. This includes the 2023 Control and Public Health Management of Outbreaks of Acute Respiratory Infection (including COVID-19 and Influenza) in Disability Residential Services | Australian Government Department of Health and Aged Care guidance document. The guidance covers outbreak management and prevention of acute respiratory infections including influenza and respiratory syncytial virus, usually identified as RSV, within residential accommodation settings.
The hierarchy of controls guide in the management of outbreaks document outlines risk-avoidance or mitigation strategies in decreasing order of reliability. Multiple control strategies can support the elimination of, or effective minimization of, any hazards. These can be implemented at the same time or follow one another. The hazard control measures are broadly grouped into six categories with the addition of some COVID-19 disability considerations:
- Reduce workers/residents/visitors’ exposure to a COVID-19 positive individual
- Decrease the number of workers involved with COVID-19 positive person
- Increase infection control protocols to minimise infection transmission at onset of outbreak or when community infection rates are known to be high
- Use online contact options if this can replace face to face interactions. This could apply to interactions with workers, family, and other residents where appropriate to context and needs
- Policy and procedure developed and implemented to require workers who are COVID-19 positive, to isolate from work. Worker roles covered by this requirement defined and communicated
- Development of an agreement with individual residents outlining any actions to be taken when individual is COVID-19 positive, may include:
- isolate from others in shared house in agreed areas of residence
- use of communal areas at agreed times
- not attending external activities during defined timeframe
Engineering controls :
- Increased ventilation, use of air scrubbers
- Worker COVID-19 vaccination policies
- Policy and procedure developed regarding worker/resident reporting of RAT/PCR COVID-19 positive results to support exposure identification
Personal protective equipment (PPE) use and item type communicated and supplies immediately accessible.
The hierarchy of controls should be applied in resident contact settings and other shared facilities such as:
- Shared areas – kitchen, lounge, laundry, bathrooms etc.
- Staff meeting/working areas
- Transport – provider fleet cars and buses, ride share and public transport
COVID-19 risk management policy and procedure development should include consultation with workers, people with disability and their identified supports. A list of key focus areas for policy and procedure needs has been included below:
- COVID-19 testing supplies and who provides these – individual or disability provider
- COVID-19 RAT use, when needed and reporting expectations to employer and other reporting avenues
- COVID-19 positive result expectations including employer notification for exposure identification
- Isolation period from defined work sites if COVID-19 positive and leave arrangements
- Expectations regarding return to work when asymptomatic
- COVID-19 vaccination and evidence requirements including what roles are included
- COVID-19 positive prevention, management and outbreak guidance implementation and monitoring
Focus on people with disability
Individual rights and choices will need to be a key consideration in any discussion and development of risk mitigation agreements to protect the individual, other residents, workers, and broader community regarding infection transmission.
- COVID-19 exposure and testing agreements and notifications to provider relevant to service delivery or accommodation setting
- COVID-19 testing supplies and who provides these – individual or disability provider and any NDIS billing involved
- COVID-19 positive identification and development of agreements regarding:
- reducing the risk of infection between other residents or day settings participants including use of common shared spaces and social distancing etc.
- the individual’s participation in external activities, staying at home while symptomatic etc.
- PPE to be worn by workers when caring for COVID-19 positive individuals and the settings where this will be applied.
Australian workplaces must have a COVID-19 safe plan identifying the actions to prevent infection and responses to a suspected or positive case of COVID-19. Regular reviews of plans with all workers including new employees and casual or agency staff are essential to ensure workplace procedures align with relevant jurisdictions. A comprehensive collection of resources, information, tools, templates, posters, and guidance for workplaces are available from the safe work sites. In some instances, COVID-19 specific details are listed separately or included under the general health and safety obligations of employers. A link to the commonwealth, state, and territory authorities responsible for work health and safety are listed below.
Work health and safety legislation across Australia requires employers to identify known risks as the basis for assessment of relevant requirements to protect the health and safety of workers. This includes visitors and customers. State and territory links have been included for your reference.
- Commonwealth: COVID-19 Information for workplaces | Safe Work Australia (swa.gov.au)
- ACT: COVID-19 - WorkSafe ACT
- NSW: COVID-19 (Coronavirus) | SafeWork NSW
- QLD: Integrating health, safety and wellbeing | WorkSafe.qld.gov.au
- SA: Infectious diseases | SafeWork SA
- TAS: Coronavirus (COVID-19) (worksafe.tas.gov.au)
- VIC: Coronavirus (COVID-19) | WorkSafe Victoria
- WA: COVID 19 - Coronavirus | Department of Mines, Industry Regulation and Safety (commerce.wa.gov.au)
Mandated requirements for disability workers to have or maintain a COVID-19 vaccination ceased in all state and territories by the end of 2022.
It is now the responsibility for individual disability providers to determine if a requirement for a COVID-19 vaccination is an appropriate risk mitigation strategy to adopt.
When considering a decision to require workers to have a vaccination (COVID-19, influenza or any other type) defined in policy and procedure this needs to be developed following a consultation process with all staff. This applies to the introduction of a new vaccination requirement or where a previous mandate has existed and no longer applies. Guidance on how to conduct the consultation appropriately has been identified by the Fair Work Commission and work safe authorities to ensure state and territory considerations can be included to determine how to assess risk in relation to worker positions and vaccination.
ATAGI also provide guidance regarding COVID-19 vaccination as a protective strategy. This is maintained by receiving the current COVID-19 vaccination dose when this is recommended by ATAGI for an update booster.
The current advice from Australian Technical Advisory Group on Immunisation (ATAGI) is for all people to access the dose of COVID-19 vaccination they are eligible to receive according to the most current advice. This ensures protection is maintained as each vaccination dose cover decreases over time. Vaccination reduces the risk of serious illness, hospitalisation, and death. It is possible to be infected by COVID-19 when fully vaccinated however the risks of serious illness are known to be reduced.
ATAGI continually reviews the clinical needs and updated guidance is released when required regarding COVID-19 vaccination recommendations and eligibility.
The ATAGI September 2023 COVID-19 vaccination update recognises that protection available from earlier COVID-19 vaccinations will have decreased. The ATAGI advice is provided in recognition that even when COVID-19 cases may be low it remains a serious disease and future virus transmission will continue to occur.
Adults aged 75 years or older are recommended to receive the additional dose if it has been six months since their last COVID-19 vaccination dose.
The following population groups are identified by ATAGI as eligible due to a higher risk of severe illness and encouraged to consider receiving the additional dose if it has been six months since their last COVID-19 vaccination dose:
- All adults aged 65 to 74 years
- Adults aged 18 to 64 years with severe immunocompromise
- Individuals 18 to 74 years who:
- have no known history of SARS-CoV-2 infection (and therefore are unlikely to have protection from hybrid immunity),
- have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs, or
- reside in a residential aged care facility.
Full details of the September ATAGI advice is available from the Department of Health and Aged Care at ATAGI Update on the COVID-19 Vaccination Program.
ATAGI continues to encourage all adults who were recommended to have a COVID-19 vaccine dose in February 2023, and who have not received one to arrange for a booster dose as soon as possible.
All COVID-19 vaccination information including vaccine options and primary and booster dose eligibility are available at COVID-19 vaccines | Australian Government Department of Health and Aged Care.
Commonwealth, state and territory links have been included for your reference.
- Commonwealth: Approved COVID-19 vaccines | Australian Government Department of Health and Aged Care , Is it true? Get the facts on COVID-19 vaccines | Australian Government Department of Health and Aged Care
- Australian Capital Territory: Vaccination - COVID-19 (act.gov.au)
- New South Wales: COVID-19 vaccination in NSW | NSW Government
- Northern Territory: Vaccine | NT Health - COVID-19
- Queensland: About COVID-19 vaccines | Health and wellbeing | Queensland Government (www.qld.gov.au)
- South Australia: COVID-19 vaccinations
- Tasmania: Vaccination | Tasmanian Department of Health
- Victoria: About COVID-19 vaccines | Coronavirus Victoria
- Western Australia: COVID-19 vaccine (healthywa.wa.gov.au)
The NDIS Commission update from 21 November 2022 on worker vaccination outlines the obligations for providers regarding vaccination and risk management considerations.
Referencing the NDIS Code of Conduct, the Commission highlights need for providers and workers to deliver supports and services to people with disability in a safe and competent manner. This includes assisting participants to access COVID-19 vaccination, planning for an outbreak of COVID-19 and taking precautions to minimise infection risks.
Registered providers have additional obligations under the NDIS Practice Standards in relation to the management of risks, provision of safe supports, and to have emergency and disaster plans in place for the continuity of support to participants including during a COVID-19 outbreak. A link to the Safe work Australia COVID-19 vaccination and work, health and safety obligations is recommended for further guidance and support.
As of January 2024, NDIS providers no longer need to report all COVID infection cases (workers and participants). However, providers must inform the NDIS Commission when the consequences of COVID - or another change or event - have a significant and adverse effect. See the NDIS Commission website for more information.
The Australian Government Health Protection Principal Committee (AHPPC) identified the need for a proportionate approach to COVID-19 risk management in September 2022 this remains applicable for the current context and provider considerations. Recommendations regarding risk management included maintaining continued protection of those most vulnerable to severe illness from COVID-19 especially in settings where there is increased risk of outbreaks occurring.
Risk reduction strategies include:
- Ensure you are up to date with recommended vaccinations
- Stay home if you are unwell and get tested
- Speak to your healthcare professional about eligibility for treatments should you become unwell with COVID-19
- Consider wearing a mask when outside your home and especially when in crowded, indoor environments such as public transport
- Keep indoor spaces well ventilated
- Practice good respiratory and hand hygiene
Fair Work Australia recommends employers undertaking a risk assessment process to determine employee vaccination needs to include consultation with workers. Fair Work Australia provides guidance on worker consultation steps and how to assess levels of risk across worker roles.
Consultation regarding any requirement for employee vaccinations needs to occur with workers regardless of any previously existing government vaccine mandates such as those related to COVID-19. Employers need to communicate with workers about changes with mandates or requirements associated with their position, current risk mitigation needs, and the actions proposed.
Rapid Antigen Tests (RATs) are strongly recommended by health authorities as an important tool in reducing infection transmission. These tests enable providers and workers to identify when COVID-19 infection risk mitigation strategies need to be increased relevant to a positive individual (worker or person with a disability) and setting context.
Worker and resident access to early testing will require immediate access to RATs at each residential site, monitored for expiry dates and stored in a manner that protects product from deterioration. Always follow manufacturers advice regarding correct storage.
Anyone who has been exposed to a COVID-19 positive person or has symptoms of COVID-19, regardless of whether they know an exposure has occurred, is recommended by Australian health authorities to complete a COVID-19 test.
Note: Eligible NDIS participants and providers can purchase rapid antigen tests (RATs) with funding from their NDIS plan.
The time between exposure and a COVID-19 test positive result varies from one individual to another depending on the current COVID-19 variant and the individual's own health or vaccination level of protection. Heath authorities have identified after being exposed to someone with COVID-19, there is a risk of developing it for 14 days. While most people who develop COVID-19 will do so in the first seven days after they are exposed some people will still develop COVID-19 between day eight and 14.
The National COVID-19 Health Management Plan for 2023 includes a table recommending when COVID-19 testing needs to occur and what actions to take when the test result is positive. The recommendations are divided into three levels based on the contact existing between an individual completing the test and the potential risk to COVID-19 illness and poorer health outcomes for the other people around them.
Low risk person
- Person completing test does not have close contact with a high-risk population
Low-risk people are encouraged to stay home when feeling sick. They should complete a RAT if they have respiratory and/or other COVID-19 symptoms. If a positive COVID-19 result is received, stay home where possible and if you must leave, wear a mask, and avoid high-risk settings. Continue to monitor symptoms and engage early with your primary care provider if symptoms worsen.
- This could be interpreted as disability workers who do not have direct care or client facing responsibilities. Providers should consider all work settings related to risks and the potential links with immune compromised individuals, for example workers or those with family members who are immune compromised.
Low-risk person with close contact to high-risk population
- Low-risk people who live or work with other people who are high-risk, particularly for COVID-19, are encouraged to take a RAT if they have respiratory and/or other COVID-19 symptoms and stay home when feeling sick.
- If symptoms persist following a negative RAT, individuals must arrange to have a PCR through a GP or known pathology referral pathway.
Health authorities recommend requesting a telehealth appointment for PCR testing referrals. People who have a disability, are immune compromised or at risk of poor health outcomes from COVID-19 infection and could be eligible for anti-viral treatment to discuss with their GP a plan to arrange referral paperwork for pathology provider PCR test to be available in advance for use when needed.
- People entering high risk settings are recommended to continue to use RATs for screening and diagnosis to prevent further transmission.
- Those at higher risk of severe COVID-19 include older Australians, Aboriginal and Torres Strait Islander people, people with disability, people from culturally and linguistically diverse communities, people living in remote communities, people with complex underlying health conditions, immunocompromised people and people aged 70 years or more.
- People in high-risk populations who are at risk of severe COVID-19 and would benefit from antiviral treatments. People with disability at risk of severe COVID-19, are recommended to consult with their GP about referral paperwork for pathology provider PCR test to be available in advance and eligibility for antiviral treatments to create a plan to ensure fast access to treatment.
Reporting a positive COVID-19 RAT result
Australian health authorities recommend all people who complete a RAT and receive a positive result report this to their state or territory health department. An online portal, or a phone number is provided for anyone unable to use the online form.
Once a person has tested positive to COVID-19 re-testing is not needed for approximately 4 weeks with some minor variation in this time frame between states and territories. Re-testing is recommended after this time has finished if new symptoms are present or an exposure occurs due to the risk of a further COVID-19 infection. All state and territory weblinks related to testing are provided at the end of this section.
This has varied in length from five days as a minimal recommendation to 14 days throughout the COVID-19 pandemic context. While mandated isolation may not be in place the Australian Government Australian Health Protection Principal Committee (AHPPC) recommend the minimum isolation period associated with vulnerable settings, including residential disability services is seven days following a positive COVID-19 test result. This is due to the time frame an individual is infectious regardless of symptoms being present. Symptomatic individuals are recommended to isolate while these persist to reduce interactions with vulnerable people while symptoms persist.
Organisational policy will need to include agreements developed with residents or day settings participants regarding risk reduction plans if they test positive for COVID-19. Where any agreement to isolate has been identified this needs to include a clear description of what this will involve such as:
- Residential settings using common areas of the residence, and minimizing common area interaction
- Agreements with residents will also need to include organizational requirements associated with involvement in external activities (alone or with other people with disability) in relation to protecting others from infection and worker PPE expectations during these activities
- Day settings when a return to activities is agreed as appropriate.
Monitoring worker COVID-19 positive results to reduce infection transmission
NDS has available a simple survey style reporting tool for workers to submit their own data regarding a positive RAT or PCR test to their organisation identified contact. This has been updated (Oct 2023) to reflect increased availability or RAT’s that can also identify influenza and COVID-19.
The summary of results can be download as often as needed by Management for monitoring workers results for rostering and exposure identification. The tool was developed by a disability provider in Victoria and shared with NDS for broader sector use. The current version takes workers approximately two minutes to complete and will enable the manager responsible for oversight to prepopulate a collated excel spreadsheet report as often as needed. Refer to section below for the full details regarding ease of use for Human Resources Managers to download template and establish within your own system. This ensures all data and privacy is retained within your own organisation.
October 2023 revision
NDS has available a Microsoft Forms template that was originally developed and in use by Melba Support Services, a day and accommodation service provider in Victoria. Organisations can modify the template to remove reporting on influenza or add a surveillance testing question and response if needed.
The template can be used with any IT systems that have Microsoft Office 365 Microsoft Forms. Individual organisations can download a duplicate version and modify it to suit specific state/territory and organisation needs. When finalised the tool can be shared from a specific management or HR individual or team email to all workers and the results will remain confidential with the team responsible for COVID tests result follow up.
Instructions to access the template for use:
- Open and download: Template: Disability Worker COVID-19 and Influenza Test Result Record - updated Oct 2023
- Link will open automatically within Microsoft forms and duplicate option is accessed by clicking on the three dots top far right. Duplicate version is your template only
- All worker data is retained in your organisation system when tool is downloaded from NDS this protects the privacy of worker and organisation data
- Rename and save into organisational system for easy identification
- Settings option (available in top righthand corner of page three dots) provides option for you to include:
- Automatically generated email to the worker to indicate the submission is successful
- Automatic email to alert team/individual responsible for oversight of the response that a PCR or RAT result record has been submitted
Worker access to reporting record
The team responsible for distribution of the reporting survey form can elect to use one of the following options when they click on Share tab:
- Send a collection message through the forms system. This is at the top of the page. Drop down arrow allows for the response restrictions within organisation
- Copy link icon (paperclip image) into a relevant internal organisation web page for workers to access
- Copy the QR code link into a relevant internal organisation web page for workers
- Send an email with a copy of the URL to all workers for access.
Workers will be able to open a link to the blank form, available on PC or phone, and simply enter the required data for submission which automatically returns the information to the team/individual responsible.
Downloading worker response data into an excel spreadsheet
The team responsible for distribution of the reporting survey are the only people who can access the data and your organisation’s copy of the survey at any time to check responses and carry out actions as needed.
To access and download an excel spreadsheet of response carry out the steps below:
- Open organisation template form
- Click on responses tab
- Look for excel spreadsheet icon and download for collated responses.
These short Microsoft forms tutorials provide further instruction.
Each tutorial runs for approximately two to three minutes in length.
- Microsoft Forms | Full Tutorial - Bing video
- Microsoft Forms - Share your Survey Link - Bing video
- Microsoft Forms - View your Survey Responses - Bing video
Government supplied RATs and eligibility for access varies across state and territory governments with the responsibility for sourcing a local site supply increasingly the responsibility of providers. While some options for free RATs are available these are commonly small volumes and sourcing when needed may involve delays increasing the risk of transmission if a supply must be sourced at this stage.
Storage and expiry
Most RATs remain effective for six months from development with recommendation to check expiry dates especially with any products offered at discounted rates.
All RATs need to be stored according to manufacturer’s requirements to remain viable for use. Anyone carrying RATs in a vehicle should check the products are not exposed to the elements, especially direct sunlight or excessive heat in vehicles or site storage locations. Insulated containers may be required for outreach workers.
Refer to manufacturer’s guidance for specific details on storage.
RAT supply estimates
The suggested supply for immediate use below is based on the readily available RATs for purchase in the community if needed. Where supply may be less reliable in the local area the stock may need to be doubled.
The table below provides a summary of RAT stock needs to have for immediate use on site when an exposure to COVID-19 has occurred or an individual is showing symptoms of infection.
The summary is a suggestion of stock to have readily available for workers and residents if worker surveillance testing is implemented.
|Reason for volume identified
|Workers and residents
|Two boxes of five RATs on site for each worker delivering support in a residential of a disability accommodation or in-home support setting. Residents are also recommended to have two boxes of five RATs available for personal use.
|Number of tests allows for a positive result to be identified up to day 14, testing as symptoms arise or spread out after day seven. Boxes of five RATs are a common supply volume.
|Worker surveillance testing
|One box of five RATs for each worker.
|This stock only needs to be maintained if organisation implements a policy to include worker surveillance testing during times of increased infection risk in the community.
Rapid Antigen Testing, supplies, management of COVID-19 and reporting weblinks
Reporting a positive COVID-19 RAT is only required in ACT, NT, SA, and TAS. (Nov 2023)
- ACT: Information for people who test positive for COVID-19
- NSW: Testing positive to COVID-19 and managing COVID-19 safely at home
- NT: Managing COVID-19
- QLD: I have COVID-19 | Health and wellbeing
- SA: What to do if I have COVID-19 | SA Health
- TAS: Tested positive to COVID-19
- VIC: I am a COVID case/contact
- WA: COVID-19 Coronavirus: Managing COVID-19 in WA
Personal Protective Equipment (PPE) protects against infection when correctly used applicable to the nature of the infectious agent, is immediately available and donned (put on) and doffed (taken off) in the right sequence.
Residential service providers and in-home supports should consider maintaining a readily accessible supply of PPE to for use when needed on site. In-home support workers should maintain a supply at their home or base site and carried for each individual appointment. This guidance has been informed by the several infection control expert consultants along with the disability sector insights gained during Australian COVID-19 2020-22 outbreaks, isolation, and quarantine needs.
The requirements for COVID-19 risk levels and PPE may vary across states and territories depending on the COVID-19 context and outbreak management recommendations or if emergency health requirements are enacted.
All workers need to be trained in donning and doffing of the PPE supplied and know how to fit check their N95 masks. This is essential for correct use of each item and preventing the spread of infection. It also ensures that the investment in the PPE supply is not wasted through ineffective donning and doffing that can result in an increased risk of workers becoming COVID-19 positive.
NDS and Health Education Collaborative have produced four short videos on the correct use of face masks and what not to do with them. They are clear, informative, at times surprising and essential viewing for anyone working in a healthcare setting.
- Watch the clip: The correct use of face masks - an introduction
- Watch the clip: The application and removal of Cloth Masks
- Watch the clip: The application and removal of Surgical Masks
- Watch the clip: The application and removal of N95 / P2 Masks
All PPE must be removed (doffed) and correctly disposed before going on a break and replaced (donned) before resuming shift and between contact with a COVID-19 positive individual and those at risk of being COVID-19 positive.
- Full cover waterproof gowns: Gowns need to have long sleeves and cover the front and sides of worker, securing at the back.
Waterproof isolation gowns may be used for extended periods in specific cohort environments. They must be replaced if torn or contaminated with body fluids.
- N95 respirator masks: These can only be worn for a maximum of four hours. N95 masks must be TGA-approved for COVID-19 use and supply must allow for different shapes and size of workers’ faces.
- Face shield or goggles: Face shields were identified as the most effective option during COVID-19 outbreak periods in Victoria .Single-use goggles and face shields can be worn for an entire shift. These must be replaced after assisting with an aerosol-generating procedure.
Where single-use face masks, face shields or goggles are used for extended periods, good hand hygiene and sanitising should be maintained. If reusable products are in use they must be cleaned and disinfected before use.
- Disposable gloves: allow for the variations in worker hand size and fit; small, medium, and large and any latex allergies.
Gloves need to be changed between every participant interaction and when contaminated or torn.
The guidance on the use of PPE for health care workers has been sourced from the Australian Department of Health and Aged Care.
PPE stock to have available for worker use sufficient to last seven days follows the Australian Health Protection Principle Committee advice allowing for workers to implement use while organising testing for any individual where immediate testing may not be possible.
- Disability residential service estimate: Rule of thumb estimator is a complete change of PPE every four hours per support worker.
- Calculation formula: [FTE per week] X [hrs. per week normally 38]: [shift length normally eight hours.] X [PPE changes normally four to six for N95] burn rate per week
Shift breaks: All single use PPE must be doffed and disposed of. All reusable items must be cleaned and disinfected before donning can occur again.
The table below identifies the individual PPE stock items required for workers to wear when supporting an individual with personal care who is COVID-19 positive or when a person is displaying COVID-19 symptoms and testing is taking place. The estimated stock needs are based on how often each item must be changed by number of workers to cover a seven-day timeframe. A supply for 14 days is suggested where any difficulty in accessing supplies at short notice may occur such as rural or remote settings.
|Disposable gloves (Small, medium, and large)
|Disposable gown - full cover long sleeve
|Surgical mask - not recommended by health authorities for COVID-19 positive case environments
|P2 / N95 respirator masks
(Goggles or face shield)
|Estimate for stock for access when COVID-19 transmission when increased risk or outbreak occurs.
Gloves need to be replaced after every interaction, remembering you need two per worker per interaction. Estimate is 15 changes each day = 30 gloves x worker x each shift.
Size guide general rule:
|Two for each shift and allow for change every four hours.
Always have spare available for any tears or soiled gowns.
|Two for each shift to allow for changes every four hours.
Two for each shift to allow for changes every four hours.
(Can be used for estimate calculation where organisations require all workers in defined roles to wear a face mask during increased community transmission contexts.)
One each shift with spare available if damaged or soiled.
If reusable can be one per shift with appropriate cleaning supplies.
The Australian Government Department of Health has recommended the following COVID-19 principles for cleaning and disinfection to reduce infection transmission in residential settings:
- ensure all residential sites have an easily accessible supply of appropriate hand sanitizers, detergents, and disinfectant products for implementation when COVID-19 outbreaks are identified
- supply needs on site to allow for increased use during outbreaks to reduce the risk of infection transmission from high contact surfaces and items
Routine cleaning applies to frequently touched surfaces such as door handles, handrails, tabletops, light switches, computers and other shared equipment, shared tools, phones, entertainment devices and controls, kitchen equipment, sinks, bathrooms, and toilets. The process involves the following steps:
- visible grime or dirt should be removed (scrubbed off) by hand first
- use of detergent solution and disinfectant (as per manufacturer’s instructions) or detergent/disinfectant wipes.
Recommendations for minimal touched surfaces, such as floors ceilings, walls, and blinds, include:
- use of detergent solution (as per manufacturer’s instructions) or detergent wipes for cleaning general surfaces
- damp mopping should be used instead of dry mopping to increase effectiveness
- cleaning walls and blinds when visibly dirty or dusty
Waste disposal needs should be identified in advance of any increased infection transmission and checked against state or territory government requirements. The information below is an example identified through the Victorian Department of Health link to EPA waste management COVID-19.
Planning decisions should include:
- Do state or territory waste management regulations allow for PPE to be double-bagged and tied before placing in the external general waste bin?
- Arranging for clinical waste contractors to be set up for use when needed in advance of any outbreaks to ensure required supply.
Infection, prevention and control information and training is critical for the disability workforce, including direct and indirect support workers, casual workers, transport providers, cleaners and volunteers.
Providers must monitor staff training and regularly review relevant Department of Health or NDIA infection prevention and control changes, which may require further training.
Training options include short e-learning refreshers, video demonstrations of infection control practice and longer online training for workers with limited or no infection control training to support workers with the critical foundation knowledge needed for the prevention of infection transmission in day-to-day disability context.
Disability providers are welcome to contact the NDS for further information regarding COVID-19 management, support, resources, and practical disability informed online infection prevention and control training.
Online course: Maintaining safe and effective infection control in disability settings
NDS have partnered with the Health Education Collaborative, experts in infection prevention and outbreak management to develop Maintaining safe and effective infection control in disability settings (nds.org.au) This online training has been developed with input from the NDIS Quality and Safeguards Commission, Australian Services Union and 300 plus sector workers.
Key benefits for this sector specific online program:
- covers essential infection control and prevention knowledge and skills needed for the current disability context
- addresses COVID-19 risk management and other common infectious conditions for broad application
- uses range of learning formats to be accessible for workers with little or no health literacy background.
Organisations investing in the infection control capability of workers need to contact Health Education Collaborative to discuss invoicing and set up for tracking staff completion through an LMS system. Individuals can also request an invoice for access as part of professional development. The sliding scale of user costs reduces from $50 to $30 per worker for non NDS members and $23 to 20 for NDS members depending on access volume required.
To arrange for ‘Maintaining safe and effective infection control in disability settings’ course enrolment access contact Heather McMinn, NDS Disability Sector Consultant at contact Heather McMinn: submit enquiry/feedback or show phone number.
A person-centred approach that includes an ongoing discussion with individuals, families and carers will assist in finding a balance between a social model of health and reverting to a clinical model in response to COVID-19.
The resources listed below can assist providers supporting people with disabilityto manage the risks of COVID-19.
- COVID-19 Planning for People with Disability
- For participants - coronavirus (COVID-19) | NDIS
- COVID-19 vaccination – Easy Read resources | Australian Government Department of Health and Aged Care
- Coronavirus Health Information Line
- COVID-19 | Disability Gateway
- COVID information - Council for Intellectual Disability (cid.org.au)