Union Health Ministry mandates concept of Buddy system for Infection Control in Hospitals, Details

New Delhi: Laying down infection control practices to be followed in hospitals, the Union Health Ministry has fielded a concept of buddy system to be followed to ensure that there is no breach in infection prevention control practices by healthcare practitioners in current COVID-19 era.

Buddy system is when two or more-person team is formed amongst the deployed hospital staff who share responsibilities for his/her partner's safety and well-being in the context of (i) Appropriately donning and doffing of PPEs, (ii) maintaining hand hygiene and (iii) taking requisite steps on observing breach of PPEs.

With the rising number of COVID-19 infection among Health Care Workers (HCWs) professionals, Union Ministry of Health and Family Welfare has recently issued a Revised Advisory for managing Health Care Workers (HCWs) working in COVID and Non- COVID areas of the Health Care Facilities.

The Advisory lays down guidelines for various institutions as well as healthcare workers particularly in the context of safety from Healthcare-Associated Infections (HAIs) while managing COVID

The guideline aims to establish the preventive measures to be observed at the Institution/facility level as well as Testing and isolation measures for health care functionaries.

Regarding the Institutional Mechanism for preventing and responding to Healthcare Associated Infections (HAIs) among HCWs, the guideline states that:

"All health facilities have to activate their Hospital Infection Control Committee (HICC). The HICC in the health facility will be responsible for implementing the Infection Prevention and Control (IPC) activities and organizing regular trainings on IPC for HCWs."

Further the guidelines state that "A Nodal Officer (Infection Control Officer) has be identified by each health facility to address all matters related to Healthcare Associated Infections (HAIs)."

With reference to preventing such infection among healthcare workers, the nodal officer will ensure that:

 The appropriate use PPEs healthcare workers in different settings of hospitals.

 Training on Infection Prevention and Control among all healthcare workers and aware them the common signs and symptoms, need for self-health monitoring and need for prompt reporting of such symptoms.

 Making provision for regular (thermal) screening of all hospital staff

 Make sure all HCWs are vaccinated with 2 doses of the COVID vaccine and also take the precautionary third dose as per prescribed protocol

 To make a provision for prompt reporting of breach of PPE by the hospital staff and follow up action.

The guideline also states the action that the Healthcare workers must follow while prevention of COVID-19 infection. The healthcare workers need to

• Ensure that all preventive measures like frequent washing of hands/use of alcohol based hand sanitizer, respiratory etiquettes (using tissue/handkerchief while coughing or sneezing), etc. are followed at all times.

• Appropriate PPE is used at all times while on duty.

• A buddy system to be followed to ensure that there is no breach in infection prevention control practices.

Buddy system is when two or more-person team is formed amongst the deployed hospital staff who share responsibilities for his/her partner's safety and well-being in the context of (i) Appropriately donning and doffing of PPEs, (ii) maintaining hand hygiene and (iii) taking requisite steps on observing breach of PPEs.

• HCWs after leaving the patient care units (wards/OPDs/ICUs) at the doctor's duty rooms/hostels/canteen or outside the HCF must follow physical distancing and masking to prevent transmission to/acquiring infection from other HCWs who may be positive.

• Pregnant/lactating mothers and immuno-compromised healthcare workers shall inform their medical condition to the hospital authorities for them to get posted in appropriate areas.

The guideline also spells out SOPs for HCWs in

1) conditions of breach of PPE/report of exposure as well as

2) When HCW reports symptoms suggestive of COVID-10

"In case HCW reports exposure/breach of PPE - All the Healthcare workers must report every unprotected exposure/ breach of PPE while managing COVID-19 patients to the concerned nodal officer and HoD of the concerned department immediately. Such exposed HCWs shall continue to work wearing appropriate PPE and test themselves at day 5 of the exposure or if symptoms develop anytime within 14 days from the day of exposure. "

In case HCW reports symptoms suggestive of COVID-19-

• If any healthcare worker who is manifesting signs and symptoms suggestive of COVID-19, he/she will be tested & isolated immediately and if tested positive the following actions shall be taken:

1. In case of mild case, HCW will have an option of home isolation, subject to the conditions stipulated in the "Revised guidelines for Home Isolation of mild /asymptomatic COVID-19 cases" released by the said Ministry.

2. Such cases would end their home isolation as per timeline provided in the said guidelines.

3. In cases where home isolation is not feasible, such mild cases will be admitted to a COVID Care Center.

4. Moderate cases that require oxygen therapy shall be managed at a Dedicated COVID Health Center.

5. Severe cases will be managed in a Dedicated COVID Hospital.

The advisory further adds that

• HCWs can resume duties while wearing appropriate PPEs if symptoms have resolved (except mild cough), and they are afebrile for 3 successive days.

• Those HCWs who test negative and continue to be symptomatic, will be treated in non-COVID ward as per their clinical diagnosis. They can resume work based on the clinical diagnosis and the medical certification by the treating doctor.

• Discharge of COVID-19 positive HCWs will be in accordance with the discharge policy laid down by the Ministry.

Lastly the guideline also add the regular quarantine of healthcare workers after performing duty in COVID-19 areas is not warranted other than stipulated above