COVID-19 Update ACAO Guidelines for Re-Opening - Alberta ...
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COVID-19 Update
ACAO Guidelines for Re-Opening
Notice Contents
1. Public Health Updates and Announcements
2. Patient and Practitioner Considerations
a. Booking and Appointment Process
b. Screening and Working with Patients
i. Adhere to strict screening practices
ii. Adhere to routine practices for patient and practitioner safety
iii. Reduce proximity to patients
3. Infection Control Procedures
a. Cleaning and Disinfection Guidelines
i. What do I need to know?
ii. What do I need to do?
iii. Is there a difference between cleaning and disinfecting?
iv. How do I make disinfecting solution?
4. Personal Protective Equipment (PPE) Guidelines
a. PPE Use in the Healthcare System
b. Surgical/Procedure Mask vs N95 Respirator
c. Non-Medical Cloth Mask Guidelines
d. Ordering PPE from the Government of Alberta
5. Employer/Employee Planning
Last Updated January 25, 2021 1Public Health Updates and Announcements
January 25, 2021: The Notifiable Disease Guidelines for COVID-19 were updated late last
week and can be found at https://open.alberta.ca/publications/coronavirus-covid-19. One
of the key changes that we would like to highlight is a shift in the additional PPE section. The
guidelines have been updated as follows:
“Eye protection is now recommended as an additional layer of protection for all patient
interactions within two metres in areas where there are ongoing high levels of community
transmission.”
December 11, 2020: At a meeting hosted by the Alberta Federation of Regulated Health
Professions, Alberta Health provided the following clarifications to the restrictions
announced on December 8:
• Healthcare professionals may continue to provide urgent/emergent care without an
appointment; appointments are recommended for all other patients.
• If working behind a plexiglass barrier, a mask is not required (per May 4 masking
guidelines); however, continuous masking is strongly recommended.
• For healthcare practices located in shopping malls/retail settings or practices with a
retail space within the practice, the restriction to 15% of fire code occupancy or a
minimum of 5 customers applies to the retail space and not the space in which
healthcare professionals are providing patient care.
December 8, 2020: The Government of Alberta has announced a four-week period of
province-wide restrictions. The following table outlines key information for opticians
Restriction Explanation
Appointment only; Regulated health professions, including opticians, may remain
one-on-one service open for in-person visits but should meet with clients/patients by
appointment only and should be limited to one-on-one service.
Alberta Health Clarification: Appointments are not required if
providing urgent/emergent care to patients; appointments are
recommended for all other patients.
Last Updated January 25, 2021 2Mandatory masking Masks are mandatory in all:
• Indoor public places
See also current ACAO • Indoor workplaces and facilities outside of the home,
guidelines for except when working alone in an office or a safely
additional direction distanced cubicle or a barrier is in place.
related to mask usage.
This workplace requirement:
• Applies to all employees, customers, visitors, delivery
personnel, and contractors
• Includes any location where employees are present in-
person; and
• Includes all workplace locations where masks will not post
a safety risk.
Alberta Health Clarification: If working behind a plexiglass barrier,
a mask is not required (per May 4 masking guidelines); however,
continuous masking is strongly recommended.
Retail restriction: For optical clinics/dispensaries located within shopping malls and
reduction to 15% of optical practices with a retail component or within a retail setting,
fire code occupancy or capacity must be reduced to 15% of fire code occupancy or a
a minimum of 5 minimum of 5 customers (effective December 13, 2020). Curbside
customers pick-up, delivery, and online services are encouraged wherever
possible.
Alberta Health Clarification: For healthcare practices located in
shopping malls/retail settings or practices with a retail space
within the practice, the restriction to 15% of fire code occupancy
or a minimum of 5 customers applies to the retail space and not
the space in which healthcare professionals are providing patient
care.
Opticians who work for Optometrists: Optometrists are subject to
the guidelines issued by the Alberta College of Optometrists.
June 12, 2020: The Chief Medical Officer of Health has rescinded order 16-2020. Despite
order 16-2020 being rescinded, regulated members are still expected to follow all college
guidelines.
May 20, 2020 Update: Alberta Health Services has provided a series of Interim Infection
Prevention and Control (IPC) recommendations for health care workers, including
opticians, to follow in addition to routine practices. The IPC recommendations include
guidelines for continuous masking in health care settings and detailed information on
the use of other PPE.
May 4, 2020 Update: These guidelines require the use of surgical/procedure masks in
the workplace in the following circumstances:
Last Updated January 25, 2021 3• If you are involved in direct client/patient contact,
• If you cannot maintain adequate physical distancing (2 meters) from
clients/patients and co-workers, and
• If you are not protected by a physical barrier (e.g., plexiglass)
May 4, 2020: The ACAO’s guidelines have been updated to include additional detail
regarding usage of surgical/procedure masks (PPE Guidelines).
April 30, 2020: The Government of Alberta has announced that regulated health care
practitioners may re-open on May 4 as part of the Early Actions of Stage 1 of Alberta’s
Relaunch Plan. The guidelines for practitioners, employers, and the public are intended to
provide key information to support the return to full service. Please Note: Lloydminster
opticians should continue to adhere to any guidelines for health care practitioners issued by
Saskatchewan Health.
Last Updated January 25, 2021 4Patient and Practitioner Considerations
Booking and Appointment Process
• At the time of booking or in advance of an appointment, staff should call patients to
perform screening and inform them of the public health measures. Staff should also
ask if patients have been experiencing symptoms of illness consistent with COVID-19.
This screening should be performed for symptomatic patients, asymptomatic
patients required to quarantine due to travel or contact with COVID-19, and
asymptomatic patients.
o Symptomatic patients include those experiencing cough, fever, shortness
of breath, runny nose, and sore throat.
o Patients experiencing symptoms should be encouraged to complete the
AHS online self-assessment tool and be tested for COVID-19.
• Initial patient and client bookings will need to be limited to maintain
necessary public health measures but may need to be prioritized by urgency.
• Patient bookings should be scheduled in a manner that ensures no more
than10 patients are required to gather in waiting areas.
• If patients must attend with children or other family members, those individuals
must be included in the maximum number of people allowed in the area. Should
scheduling errors result in more than 10 people, alternate waiting areas should be
planned.
• Alternative solutions to waiting in the office should be considered, such as asking
people to wait in vehicles and text messaging or calling when appointments are
ready.
• Seats in waiting areas should be spaced to maintain a minimum physical distance of
two meters. Household contacts are not required to separate.
• Visual cues for areas where patients are required to queue should be marked and
a directional flow through the facility established.
• Non-essential items should be removed from client waiting areas,
including magazines, toys, and remote controls.
• Beverages (coffee, tea, water) should not be offered at this time. If necessary,
they can be provided in a disposable cup.
Screening and Working with Patients
Adhere to strict screening practices
• Ample signage should be posted for the public regarding symptoms and
precautions. Alberta Health offers a number of posters and resources on their
COVID-19 webpage, which is updated regularly.
• Patients with symptoms (even mild cold symptoms) or who are asymptomatic
but required to quarantine should be rescheduled if possible after a self-
isolation period.
Last Updated January 25, 2021 5o Alberta Health Services has published additional guidelines for screening.
• Upon patient arrival at the dispensary, notify all patients that as part of your
health and safety procedures, you would like to ask them the following
questions:
o Are they experiencing fever, cough, or shortness ofbreath?
o Have they recently returned from travel outside of Canada?
o Have they interacted with someone who is suspected or confirmed to carry
the virus?
o Depending on patient responses, you may need to reschedule appointments
as needed.
• This additional screening should be performed for symptomatic
patients, asymptomatic patients required to quarantine due to
travel or contact with COVID-19, and asymptomatic patients.
• Daily screening of all staff for symptoms and/or international travel and/or
close contact with persons having COVID-19 should be implemented.
• Staff members with symptoms (even mild cold symptoms) or who report that they
have returned from travelling within the last 14 days should self-isolate and not
come into work.
Adhere to routine practices for patient and practitioner safety
• Use Routine Practices when working with patients. Alberta Health
Services has published guidelines covering Point of Care Risk
Assessment, hand hygiene, accommodation, and personal protective
equipment (PPE).
o For more information about PPE recommendations for practitioners and
patients, please refer to the PPE Guidelines in this notice. Note: Regulated
health professionals may determine if appointments for symptomatic clients
should be cancelled. Patients with possible symptoms may also be asked to
wear appropriate PPE.
• Hand washing stations and/or alcohol-based hand sanitizers (minimum 60%)
should be available, and patients should be encouraged to use them upon entering
and exiting. Ensure hand sanitizers are approved by Health Canada (DIN or NPN
number).
• All regulated health professionals and staff must practice effective hand
hygiene after each patient.
o Perform hand hygiene using alcohol-based hand sanitizer (minimum 60%)
or soap and water as described in Routine Practices from Alberta Health
Services.
o For more information on hand hygiene, refer to Alberta Health Services
Guide to Conduct Hand Hygiene Reviews which includes the 4 Moments for
Hand Hygiene.
• Common areas and other high-touch surfaces and objects should be cleaned
and disinfected after each use, including reception counters, seating areas
Last Updated January 25, 2021 6(including clinic room seats), doors, handrails and objects, tools or machines
used in the provision of health services.
• For more information about cleaning and disinfection, please refer to the
Infection Control Procedures section of this notice.
• During transactions, if possible, limit the exchange of papers such as prescriptions
and receipts. Where possible, payments should be accepted through contactless
methods (e.g., tap or e-transfer) and information should be sent electronically (e.g.
text or email).
Reduce proximity to patients
• With respect to proximity with patients, opticians must use their
professional judgement and may consider the following steps:
o Using previous measurements from the patient’s record if they are an
established patient and are applicable (for example, PD measurements). In this
scenario, it should be well documented in the patient record that a new
measurement wasn’t taken and explained to the patient that this is not usual
or best practice, but that given the circumstances you advise it at this time.
o Measuring PD using an auto refractor or a penlight and ruler rather than a
pupilometer. This practice typically places the optician further away from
the patient.
o Maintaining as much distance as possible when taking other
necessary measurements.
o Asking patients to put on and remove frames themselves wheneverpossible.
o Dispensing glasses without an adjustment. This should only be done if, using
professional judgment, the optician believes it to be a low-risk practice. In this
scenario, it should be well documented in the patient record that glasses were
dispensed without an adjustment and explained to the patient that this isnot
usual or best practice. Patient should be encouraged to return later for their
adjustment (this should also be documented in the patient record.
Infection Control Procedures
• Alberta Health Services has provided a series of Interim Infection Prevention and
Control (IPC) recommendations for health care workers, including opticians, to
follow in addition to routine practices. These recommendations include
continuous masking in health care settings for all staff providing direct
client/patient care or working in client/patient care areas where physical
distancing or barrier are not possible. and detailed information about the use of
other PPE. More information can be found in the PPE section of this notice.
• The COVID19 virus can survive for several days on different surfaces and
objects. Frequent cleaning and disinfection are important to prevent spread of
Last Updated January 25, 2021 7the disease.
• Workplaces should implement enhanced infection control procedures.
• Common areas and other high-touch surfaces and objects should be cleaned and
disinfected after each use, including reception counters, seating areas (including
clinic room seats), doors, handrails and objects, tools, or machines.
o Commonly touched areas also include light switches, door handles,
toilets, taps, handrails, counter tops, touch screens/mobile devices and
keyboards.
• Wherever possible, discourage staff from sharing phones, desks, offices and other
tools and equipment.
• Towels or any other items contacting a patient or staff member should be
discarded or properly laundered or disinfected between each use.
• Clothing and fabric items should be laundered and dried on the highest
temperature setting possible. Ensure items are thoroughly dried.
• Hand washing stations and/or approved alcohol-based hand sanitizers
(minimum 60%) should be available, and patients should be encouraged to use
them upon entering and exiting. Ensure hand sanitizers are approved by Health
Canada (DIN or NPN number).
• All regulated health professionals and staff must practice effective hand hygiene after
each patient.
o Perform hand hygiene using alcohol-based hand sanitizer (minimum 60%) or
soap and water as described in Routine Practices from Alberta Health
Services.
o For more information on hand hygiene, refer to Alberta Health Services
Resources for Hand Hygiene.
Cleaning and Disinfection Guidelines
The Government of Alberta has published guidelines for environmental cleaning of public
facilities. Additional information for employers and practitioners is also outlined below.
What do I need to know?
• The COVID-19 virus can survive for several days on different surfaces and objects.
• Frequent cleaning and disinfection are important to prevent spread of the disease.
• Many common household and commercial disinfectant products will destroy the
COVID-19 virus.
• Some disinfectants will have an eight-digit Drug Identification Number (DIN).
These products are approved for use by Health Canada.
• Household bleach (five per cent sodium hypochlorite) may not have a DIN but
maybe used following the instructions below.
Last Updated January 25, 2021 8What do I need to do?
• Clean often. Areas visited by people should be kept clean and free from clutter.
• Common areas and other high-touch surfaces and objects should be cleaned and
disinfected after each use This includes reception counters, seating areas (including
clinic room seats), doors, handrails and objects, tools or machines, light switches,
door handles, toilets, taps, handrails, counter tops, toys, touch screens/mobile
devices and keyboards.
• Clothing and fabric items should be laundered and dried on the highest
temperature setting possible. Ensure items are thoroughly dried.
• Workplaces should provide employees with resources such as tissues, no-touch
trash receptacles, hand soap, alcohol-based hand sanitizers (minimum 60%),
disinfectants, and disposable towels to promote a safe and hygienic work
environment.
Is there a difference between cleaning and disinfecting?
• Cleaning products remove dirt, dust, and oils, but do not always killgerms.
• Cleaning is required prior to disinfection to remove soil and ensure the
effectiveness of disinfection (unless otherwise indicated by manufacturer).
• Disinfectants are applied after cleaning to destroy germs.
• Common disinfectants include bleach solutions, quaternary ammonium (QUAT),
alcohol (70 per cent) and peroxide. Vinegar, tea tree oil solutions, etc. are not
proven to be effective disinfectants.
How do I make disinfecting solution?
• Always read product labels and follow the manufacturer's directions. Do
not use expired products.
• According to Health Canada, a disinfecting solution can be made by mixing one
part of bleach into nine parts of water.
• Do not mix soap or other cleaners into the bleach and water solution.
• Apply the disinfecting solution using a spray bottle or a clean wiping cloth.
• Always use appropriate PPE for working with bleach, including protective gloves.
• If using disinfectant wipes, the manufacturer's recommended contact time (i.e.
how long the surface remains wet) must be met. Disinfectant wipes are not
recommended for heavily soiled surfaces.
Last Updated January 25, 2021 9Personal Protective Equipment (PPE) Guidelines
January 25, 2021 Update: The Notifiable Disease Guidelines for COVID-19 were
updated and can be found at https://open.alberta.ca/publications/coronavirus-covid-
19. One of the key changes is a shift in the additional PPE section. The guidelines have
been updated as follows:
“Eye protection is now recommended as an additional layer of protection for all patient
interactions within two metres in areas where there are ongoing high levels of
community transmission.”
May 20, 2020 Update: Alberta Health Services has provided a series of Interim Infection
Prevention and Control (IPC) recommendations for health care workers, including
opticians, to follow in addition to routine practices. The IPC recommendations include
guidelines for continuous masking in health care settings and detailed information on
the use of other PPE.
May 4, 2020 Update: These guidelines require the use of surgical/procedure masks in
the workplace in the following circumstances:
• If you are involved in direct client/patient contact,
• If you cannot maintain adequate physical distancing (2 meters) from clients/patients
and co-workers, and
• If you are not protected by a physical barrier (e.g., plexiglass)
• There is currently a global shortage of PPE that is affecting the healthcare system. N95
respirators, surgical/procedure masks, protective eye wear/face shields, gloves, and
gowns are critical PPE required to protect healthcare employees.
• Employers who have created PPE policies specifically to protect employees from the
COVID-19 virus are encouraged to re-examine these policies to ensure valuable PPE
resources are not unnecessarily diverted from the healthcare system.
• Important Note: This is not intended to change established PPE requirements for an
employee's day-to-day work activities. Employers and staff should adhere to the basic
requirements of frequent handwashing, physical distancing and staying home when ill.
PPE Use in the Healthcare System
• As with other sectors, the healthcare system uses engineered controls, administrative
controls, and PPE to address the many hazards faced by health care employees. There
are extensive PPE requirements for employees in the health care system.
• The appropriate use of PPE to protect against the COVID-19 virus is based on
established infection prevention and control measures implemented by health
authorities.
Last Updated January 25, 2021 10• For the purposes of this process, PPE includes: alcohol based hand sanitizer
(minimum 60%) and dispensers, surface wipes (disinfectant), surgical masks, N95
respirators, disposable gowns and coveralls, Tyvek boot covers, disposable aprons,
safety glasses/goggles, face shields, disposable gloves, and infrared thermometers.
• Specific to Opticians: The most common PPE in use will be those products used for
infection control procedures, including alcohol-based hand sanitizer (minimum 60%)
and disinfectant wipes, masks, and gloves.
o Alberta Health Services has published guidelines on routine practices,
including the use of PPE in specific circumstances, such as when splashes of
fluids or contact with bodily fluids may occur.
o Registered opticians and registered contact lens practitioners must use their
professional judgment to follow guidelines and determine what PPE they
require to provide care to each patient. Members should also consider what
practice adjustments can be made to increase the safety of patients and
practitioners while reducing the need to rely on PPE (e.g., reducing proximity
to patients and focusing sanitation efforts on high-touch surfaces).
o Masks and other disposable PPE can be discarded into a plastic-
lined garbage container.
o Non-PPE controls should also be put into place by employers as often as
possible to protect unregulated staff and patients they interact with, such
as installing a plexiglass barrier in reception areas.
What is the difference between a surgical/procedure mask and an N95 respirator?
• A surgical/procedure mask prevents droplets from an infected source from
contaminating the skin and mucous membranes of the nose and mouth of the
wearer.
o These masks can be worn by people infected with the COVID-19 virus to
trap droplets expelled when coughing or sneezing. Healthcare employees
routinely use surgical masks as part of their PPE requirements.
• N95 is an air-purifying, particulate filtering, disposable, half-face piece respirator.
These devices are designed to protect users from inhaling hazardous airborne
particles and aerosols, including dusts and infection agents such as the COVID-19
virus. An N95 respirator is a common protective device in health care settings.
o N95 respirators require initial and ongoing training, as well as an approved
method for fit testing to ensure a tight facial seal. Without this training and
fit- testing, N95s may not be effective against the COVID-19 virus.
Last Updated January 25, 2021 11Left: Surgical/procedure mask. Right: N95 respirator
Non-Medical (Cloth) Mask Guidelines
• While the primary cause of COVID-19 transmission is people who are
symptomatic, there is increasing evidence that some COVID-19 infected people
never develop symptoms or are not yet sick and are able to transmit the virus.
• Health officials have agreed that wearing a non-medical mask, even if you have
no symptoms, is an additional measure you may take to protect others around
you, particularly in situations where the recommended physical distancing
cannot be maintained such as public transit.
• Wearing a non-medical mask will not prevent you from getting sick. However, it is
another way of covering your mouth and nose to prevent your respiratory droplets
from contaminating others or landing on surfaces.
• People should also be aware that masks can become contaminated on the outside or
when touched by hands. Avoid moving the mask around or adjusting it often and do
not share your masks with others.
• A homemade mask does not replace proven public health measures. The best way
to prevent the spread of COVID-19 is to continueto:
o stay home as much as possible,
o practice physical distancing,
o wash your hands for at least 20 seconds with soap and water, and
o cover your cough or sneezes with tissues or your sleeve.
• Individuals choosing to wear a non-medical mask need to understand
their limitations and how to safely use them.
o Information is available on the Public Health Agency of Canada
website: Considerations in the use of homemade masks to
protect against COVID-19.
Employer/Employee Planning
Orders from the Alberta Chief Medical Health Officer, Dr. Deena Hinshaw, represent the
minimum standard that employers must meet.
Last Updated January 25, 2021 12The Government of Alberta has also published resources to support employers and
business owners during the re-opening process.
To address COVID-19 health and safety concerns in the workplace, employers may also
review the following questions:
1. How are you telling your employees about COVID-19 (i.e., exposure to COVID-19 in your
workplace)?
• Employers must ensure all staff are aware of current COVID-19 guidelines
and policies as they become available.
2. Do you have a system in place where employees can inform you of concerns relating to
being exposed to COVID-19 in the workplace?
• Find out if there are any specific tasks that concern them (e.g., tasks that
involve interacting with others). It is important to identify exposure hazards
and develop measures to control exposure.
3. What are you doing to prevent your employees from being exposed to COVID-19?
• Have you done a walk-through of your workplace to identify specific
conditions or tasks that may increase the risk of exposure of your
employees to COVID-19?
• Have you asked your employees where potential exposures may occur and
how they think exposures can be controlled?
• Are tasks that require PPE necessary at this time or can they wait?
4. Have you developed controls that will eliminate or minimize the risk of exposure?
• What are those controls?
• Have you put them in place?
• How are they working (are they effective)?
• How do you know how they are working?
5. How are you controlling the number of employees and other people at your workplace?
• Do all your employees need to come to work?
• Can some work from home?
• Can you stagger shifts to reduce the numbers present at onetime?
• Are you ensuring there is adequate cleaning between shifts?
• Can you prioritize the work that needs to be done at the workplace to help
your business operate as close to normal under the circumstances?
• This will require a determination of core work and where it can
safely and productively be performed.
6. If you have employees who need to come to the workplace, how are you ensuring
the following steps are being taken to reduce their risk of COVID-19 exposure?
Last Updated January 25, 2021 13• Different workplaces will have different needs, but the following steps
are a good start:
o Workplaces may have physical barriers in place.
o Position employees to allow for physical distancing. Keep two
meters between employees, as well as your patients/customers.
o Provide soap and water or alcohol-based hand sanitizers
(minimum 60%) and encourage employees to wash their hands
frequently.
o Enhance cleaning and disinfecting of the workplace,
particularly high-contact items such as door handles, faucets,
keyboards, and shared equipment (e.g., photocopiers).
o Food contact surfaces should be disinfected regularly and
rinsed with fresh water after disinfecting.
o Staffrooms and break rooms should be arranged to follow
physical distancing practices. Consider staggered break times
to reduce employee gathering numbers.
o Provide employees with resources such as tissues, no-touch
trash receptacles, hand soap, alcohol-based hand sanitizers
(minimum 60%), disinfectants, and disposable towels to
promote a safe and hygienic work environment.
7. How are you checking and tracking whether the above steps are being taken?
Last Updated January 25, 2021 14You can also read
