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January 25, 2021
  • THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION
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COVID-19

Aged Care information on COVID-19

January 15, 2021 by Gia Hayne 8 Comments

The NSW Nurses and Midwives’ Association is providing support and advice to any members seeking information regarding the novel coronavirus (COVID-19).

Ensure you’re covered at work by joining the NSWNMA.

If you’re working for a private aged care provider, please check this page for information around self-isolation and your workplace entitlements

Click here for the latest advice from the Chief Health Officer

The evolving nature of the COVID-19 outbreak means our public health advice will continue to change. One thing remaining consistent however, is the contribution frontline nurses and health sector professionals are making to address it.

The Commonwealth Department of Health website contains detailed guidance for health sector workers and is updated regularly.

On 14 January 2021, NSW Health released amended advice for Residential Aged Care Facilities (RACFs) to be followed until further notice.

Visitor Restrictions – Northern Beaches, Wollongong, Cumberland, Canterbury, Mt Druitt and Rooty Hill

​​​All residential aged care facilities in the Northern Area of the Northern Beaches, City of Wollongong, Cumberland City Council, the Canterbury Ward of Canterbury Bankstown Council, Mt Druitt (suburb) and Rooty Hill (suburb).

  • must exclude all visitors, except those performing essential caring functions
  • all staff and visitors must wear a surgical mask while in a residential aged care facility
  • should avoid residents leaving the facility unless it is essential (for example, a medical appointment) or for exercise
  • should ensure that residents are provided with appropriate PPE and infection control advice if they need to leave the facility.

Visitor Restrictions – all other RACFs in NSW

Until further notice, all staff and visitors must wear a surgical mask while in a residential aged care facility. In addition:

  • ensure residents in Greater Sydney (including Blue Mountains and Central Coast Local Government Areas) have a maximum of only two visitors each day. They may have different visitors each day.
  • exclude all staff and visitors who have been to the Grand Chancellor Hotel in Brisbane since 30 December 2020.
  • exclude visitors from the Northern Area of the Northern Beaches, City of Wollongong, Cumberland City Council, the Canterbury Ward of Canterbury Bankstown Council, Mt Druitt (suburb) and Rooty Hill (suburb).
  • exclude visitors and non-essential staff who have been in the following Local Government Areas of Queensland since 2 January 2021: City of Brisbane, Logan City, City of Ipswich, Moreton Bay Region, Redland City, Lockyer Valley Region, Scenic Rim Region or Somerset Region .  Visitors from these regions should be excluded.
  • staff who have been to the Queensland local government areas of City of Brisbane, Logan City, City of Ipswich, Moreton Bay Region, Redland City, Lockyer Valley Region, Scenic Rim Region or Somerset Region since 2 January 2021 and are essential for maintaining the service should have a risk assessment performed in consultation with the local public health.

NSW public orders and guidance from the Chief Health Officer must be followed and applied across the state at this point in time. This means that the current NSW Health advice supersedes national guidance in the Industry Code for Visiting Residential Aged Care Homes during COVID-19 and the COVID-19 Escalation Tiers and Aged Care Provider Responses.

Support for residents
Where visit restrictions are in place, arrangements should be put in place for residents and their families to regularly communicate. If residents are not able to get together with their loved ones during the festive season, providers can:

  • ensure residents can continue to move freely around the facility wherever possible to ensure personal welfare and mental health
  • help facilitate phone calls or video conferencing between residents and families when possible
  • continue to run / expand their usual activities for residents
  • expand and roster on additional lifestyle staff.

Asymptomatic testing for residents and workers
The Australian Government has expanded capacity for testing asymptomatic aged care residents and workers in Sydney’s Northern Beaches. Residential aged care services in this area have been or will be contacted to offer in-reach testing for aged care residents and workers. The testing provider will then contact the services directly to arrange for the testing teams to come on site.

Testing will be carried out on a voluntary basis but all services are strongly encouraged to take up the asymptomatic testing service.

Single site employment (Northern Beaches)

On 13 January 2021, the federal government removed the ‘Commonwealth Hotspot’ declaration previously applied to the Northern Beaches LGA. As a result, the additional support provided by the government for hotspots will now begin to taper. This includes the supplementary funding to RACFs to support the single site employment framework set out in the previous update to members from 23 December, 2020.

Recognising that RACF providers and workers will need time to transition to new rosters and that RACFs may continue to incur costs as they transition, the federal government has agreed that the arrangements will be funded for a further two weeks beyond the removal of the declaration, in this case till 29 January 2021. This means 18 December 2020 to 29 January 2021 is the period that federal funding will be available to providers to underpin these arrangements.

The Association, and indeed provider representatives, have indicated to the federal government that this transitional period of some two weeks is the bare minimum required to facilitate an orderly return to ‘usual’ working/rostering arrangements.

Additional Resources

Guiding Principles for NSW RACFs – single site employment

Support Hub for RACFs


Visitor Guidelines for RACFs:

Directives around masks and visitors

Exclude staff and visitors who:

  • live in a household with a person who is currently self-isolating
  • have been to any of the latest COVID-19 locations in NSW at the times and dates listed, excluding the monitor for symptoms list
  • have been to the Grand Chancellor Hotel in Brisbane since 30 December 2020
  • have a fever (37. 5°C or higher) or symptoms of COVID-19 (acute blocked nose congestion has been added to the list of symptoms)
  • are a close contact of a person with confirmed COVID-19 and are within their self-isolation period.

Visit the NSW COVID-19 website at least daily for updates on areas of active community transmission.

In response to questions received from residential aged care facilities about implementing this guidance, a series of FAQs is available here.

Refer to the Infection Control Expert Group (ICEG) Guidelines on the use of face shields and other protective eyewear in health and residential care facilities.

Visitor guidelines

All residential aged care facilities in NSW should support visits for residents, unless they are experiencing a COVID-19 outbreak, or in a situation where restriction of access is required (see below). Allowing visits while maintaining appropriate screening and infection prevention measures improves the health and wellbeing of your residents. Please note that extra precautions may be required for some visitors – as detailed below.

Visitor access should be in line with the screening requirements set out in the Public Health (COVID-19 Aged Care Facilities) Order (No 3) 2020, and the guidance outlined in the Industry Code for Visiting Residential Aged Care Homes during COVID-19 and the CDNA National Guidelines for the prevention, control and public health management of COVID-19 outbreaks in residential care facilities in Australia.

Facilities are asked to:

  • Record every visitor’s name and contact details, electronically where possible
  • Ensure children are closely supervised
  • Ask visitors to undertake hand hygiene on entering and leaving the facility, and on entering and leaving the resident’s room (or designated visiting area)
  • Encourage visitors to remain within the resident’s room, or go to a designated outdoor area or alternative room where the resident and their visitors can keep apart from other residents
  • Allow no more than two visitors per resident at a time – this does not mean only the same two people can ever visit a resident.

Situations where extra precautions are needed

Visitors who have been in the last 14 days:

  • in an area with increased testing or
  • to large shopping centre listed on the monitor for symptoms web page marked as “not excluded from visiting a residential aged care facility or residential disability care facility” must wear masks while in the facility and be escorted by facility staff when going to and from a resident’s room (or designated visiting area).

Facilities located in area with increased testing may accept visitors, however extra precautions are required. Facilities must ensure that visitors wear a mask while in the facility and are escorted by facility staff when going to and from the resident’s room (or designated visiting area).


Access to the Commonwealth Pandemic Leave Disaster Payment

The NSW Premier has partnered with the Commonwealth to give workers without leave entitlements access to the Pandemic Leave Disaster Payment arrangements. The media release can be accessed here.

To access the Pandemic Leave Disaster Payment – New South Wales, a worker will need to meet several criteria, set out here.  Below is an extract of the criteria:

You may be eligible if NSW Health has told you to self-isolate or quarantine. They need to give you these directions for any of the following reasons:

  • you have coronavirus (COVID-19)
  • you’ve been in close contact with a person who has COVID-19
  • you care for a child, 16 years or under, who has COVID-19
  • you care for a child, 16 years or under, who’s been in close contact with a person who has COVID-19.

You may also be eligible if you’re caring for someone who has COVID-19.

You must also meet all of the following:

  • you’re at least 17 years old and live in New South Wales
  • you’re an Australian resident or hold a visa that gives you the right to work in Australia
  • you’re unable to go to work and earn an income
  • you have no appropriate leave entitlements, including pandemic sick leave, personal leave or leave to care for another person
  • your period of quarantine is after 17 September 2020.

It is also noted that:

You won’t be eligible if, during your 14 day isolation period, you get:

  • any income, earnings or salary from paid work
  • any income support payments, ABSTUDY Living Allowance, Paid Parental Leave or Dad and Partner Pay
  • JobKeeper Payment.

If workers or their households are struggling, there are other financial supports that may be available in NSW, and if considered this may be of some assistance to them or their families. Click here for a full listing.

3rd Workforce Retention Bonus Payment

The government will provide a third Workforce Retention Payment, based on employment, at 30 November 2020.

The final Aged Care Workforce Retention Payment will be paid in January 2021. The value of this payment will be equal to the second payment, unless a variation to funding is required.

This third payment will have the same eligibility criteria as the first two rounds (the first paid in July, the second scheduled for September) of the workforce retention bonus.

  • Eligible residential care workers will receive up to $800 before tax, per quarter, for two quarters.
  • Eligible home care workers will receive up to $600 before tax, per quarter, for two quarters.

Your employer must have made an application for the retention bonus in order for you to receive it.

The government has released frequently asked questions (FAQs) to provide further information:

  • FAQs for care workers

The ANMF has also released an information sheet on the retention bonus for workers:

  • ANMF information sheet for workers

Use this template letter to ask your employer if they have applied on your behalf.

National Aged Care Emergency Response Program

The government has announced a National Aged Care Emergency Response (NACER) Program, which aims to mobilise aged care staff from areas across Australia not experiencing community transmission, to assist in caring for people in aged care facilities impacted by COVID-19.

NACER is seeking experienced Registered Nurses, Enrolled Nurses, Personal Care Workers and Cleaners who are currently working in aged care to provide surge workforce support. A remuneration and support package is on offer, including a $5,000 bonus for successful completion of a rotation.

Ideally teams of six will be coordinated by the aged care provider and sent on placement for four weeks, followed by two weeks of quarantine.

Employers will need to endorse staff as having the right character, skills and experience, and the ability to work under pressure and in confronting environments.

Employers should carefully consider their own operational needs before agreeing to release staff – they will still be required to provide adequate staffing levels across all their sites to meet residents’ needs.

Further information on the NACER Program is available on the department’s website.

Precautions for caring for residents with suspected, probable, or confirmed COVID-19

When caring for residents with suspected, probable or confirmed COVID-19 in aged care homes, staff must use personal protective equipment (PPE) as recommended in the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019) and by their state or territory.

For areas with significant community transmission of COVID-19, the Infection Control Expert Group has provided guidance regarding use of P2/N95 masks and protective eye wear/face shields in aged care homes. Specific national guidance has also been developed to support aged care homes’ response to COVID-19.

The Australian Commission on Safety and Quality in Health Care (the Commission) has developed this poster to support aged care workers with step-by-step instructions on how to put on and remove PPE, and how to fit check P2/N95 respirator masks, where they are required to be used.

Advice for home care service providers in NSW

NSW Health recommends the implementation of the following measures:

  • Any staff with fever or respiratory symptoms, even mild, should be excluded from work. They should be advised to isolate at home and seek COVID-19 testing.
  • Any staff who have been in any of the locations listed on the self-isolate and get tested immediately page, at the times and dates listed should not attend work
  • When providing care to clients who live in, or have visited the above areas, staff must wear a surgical mask while providing services.
  • Staff actively ask clients about symptoms on arrival. If staff become aware of a client with symptoms, that client should be isolated from others, and arrangements made for COVID-19 testing.

Process for requesting PPE

The Australian Government is prioritising Personal Protective Equipment (PPE) distribution from the National Medical Stockpile to aged care services that are most in need.

To ensure PPE from the National Medical Stockpile is effectively prioritised on a needs-basis, providers are being asked to complete a new Aged Care PPE Request Form. This form will be sent to you via email after an initial inquiry is made via the agedcarecovidppe@health.gov.au email address.

Providers will be asked a number of questions relating to their PPE needs, including staff numbers (or home client visits per day), number of care recipients, PPE supplies on hands, and PPE requirements. It is recommended someone with an appropriate level of operational knowledge complete the form.

If you have a confirmed or suspected case of COVID-19, a case manager will work with you on your PPE requirements.

At this stage, generally only masks are being distributed to residential and in home aged care services who are in a priority category.

A priority category is a residential or in home aged care service who:

  • cannot access PPE through their usual means, and
  • the Australian Government or State or Territory Government requires workers to wear masks in relation to a community transmission region, or
  • they deliver personal care or other activities that require close physical contact, where:
    • there is an outbreak or suspected case of COVID-19 or another notifiable infectious respiratory disease, or
    • there is an immediate threat to the continuity of safe quality care due to a lack of access to PPE supplies.

Providers should also continue to try to source the PPE through suppliers while awaiting a response. Providers need to establish an ongoing general PPE supply.

Providers should be undertaking routine screening of staff and visitors on entry irrespective of size or location. It is especially important for residential services located in communities (and/or drawing their staff from communities) where there is a local cluster of people with confirmed or suspected COVID-19, or which are considered to be at higher risk of an outbreak.

Entry screening advice for residential aged care facilities can be found here.

Use of face masks in the community to protect against COVID-19

The Australian Commission on Safety and Quality in Health Care has developed new resources to provide guidance to consumers on the use of face masks to protect against COVID-19. Wearing a face mask is now recommended by Australian health experts in areas where community transmission of COVID-19 is high, if physical distancing is not possible.

Fact sheet and FAQs from the Australian Commission on Safety and Quality in Health Care
The new fact sheet and answers to frequently asked questions will assist people to decide whether to wear a mask in the community, and provide advice on how to use face masks safely.

  • Fact sheet on COVID-19 and face masks for consumers
  • FAQs on community use of face masks

Current advice
The new resources support the recommendation of the Australian Government and Victorian Government to wear face masks in areas where there is community transmission of COVID-19. They explain how to safely put on and remove face masks, and reinforce the importance of existing prevention measures.

Wearing a face mask is currently recommended to help protect against droplets when a person with COVID-19 coughs, speaks or sneezes, if you are less than 1.5 metres away. Wearing a mask will also help protect others if you are infected with the virus.

Translation of COVID-19 Resources

For more translated resources, the Department of Home Affairs has a dedicated website – COVID-19 information in your language. This provides culturally and linguistically diverse communities with a single source of information in 63 languages other than English.

Updates to the CDNA Guidelines for Public Health Units

The Communicable Diseases Network Australia (CDNA) guidelines for public health units have been updated to include a new section on outbreak investigation and management in high-risk settings, including residential aged care.

The purpose of the guidelines is to provide nationally consistent advice and guidance to public health units in responding to a notifiable disease event. These guidelines capture the knowledge of experienced professionals, built on past research efforts, and provide advice on best practice based upon the best available evidence.

Face to face assessments

From 25 May, Regional Assessment Services (RASs) and Aged Care Assessment Teams (ACATs) should offer face to face aged care assessments, where it is possible and safe to do so.

However, it is important to note that while COVID-19 circumstances continue, face to face assessments are not mandatory where this would be unsuitable or inappropriate for a client, service provider or assessment organisation. RAS and ACATs will continue to consider their local circumstances and client choice when determining whether aged care assessments are conducted face to face or by telephone or telehealth.

Outbreak management

When an Outbreak is Suspected: Providers must immediately notify their local Public Health Unit (PHU), and the Australian Government Department of Health.

  • The PHU manages the outbreak, for example testing, contact tracing and infection control.
  • The Department of Health will work with the provider to support them to identify whether an outbreak has occurred, and deliver additional support if required, such as in-reach pathology testing, access to PPE and workforce assistance.

Workforce Management: A critical aspect in the preparation phase is understanding the workforce impact and needs. It is essential providers put in place strategies to identify where and how they will get additional staff if there is an outbreak. Aged care providers must exhaust all possible avenues including contacting other providers for support; contacting recruitment agencies; reaching out to local and private district hospitals. The workforce surge measures that are in place are a last resort and work to complement the workforce that providers have sourced. They are not the full solution for a provider.

When an Outbreak is Confirmed: When an outbreak is confirmed, providers must establish an outbreak management team to direct, monitor and oversee the outbreak, confirm roles and responsibilities and liaise with their relevant Australian Government Department of Health state/territory officer. Providers will also need to put in place additional infection prevention and control measures, including:

    • Isolation or cohorting of affected residents
    • Maintaining hand hygiene
    • Wearing appropriate PPE
    • Practising cough and sneeze etiquette
    • Enhanced environmental cleaning
    • Placing signage at entrances and other locations in the facility
    • Screening of staff and visitors.

The Department of Health’s guide to outbreak management outlines how to identify if there is an outbreak at your facility and the steps to take to manage the outbreak. Access the guide here.

Inform the Federal Department of Health of any confirmed COVID-19 cases via agedcareCOVIDcases@health.gov.au – this will facilitate Australian Government support for PPE and staff supplementation.

The Department can help with information on resources to manage an emergency or service delivery issues. If you need urgent assistance outside of normal business hours please contact the department on 1800 852 649.
This information is also available on the department’s website.

The Communicable Diseases Network of Australia also have National Guidelines for the Prevention, Control and Public Health Management of COVID-19 Outbreaks in Residential Care Facilities in Australia. This visual flowchart summarises the key steps aged care providers need to take around COVID-19 in an easy to read and understand format.

Outbreak management training

The outbreak management training module for aged care workers has been updated in accordance with the latest information from the CDNA.

Aged care workers are encourage to complete this updated training.

The training takes approximately 8 minutes to complete, and by the end of the module participants will be able to:

  • Identify what a COVID-19 outbreak is
  • Demonstrate the appropriate infection prevention control measures for a COVID-19 outbreak
  • Explain how to isolate and cohort residents during a COVID-19 outbreak
  • Identify appropriate cleaning and waste disposal procedures during a COVID-19 outbreak.

Access the Aged Care training modules here.

If you would like to access the aged care training, users will need to register their workplaces as ‘aged care’. If you have already registered for online training but not with ‘aged care’ as your workplace, email support@covid-19training.gov.au for a priority response.

Influenza vaccine requirement for workers

New legislation now requires all aged care workers to be vaccinated against Influenza

  • from 1 May, you must have had your influenza vaccination to work in or visit an aged care facility
  • if you’re a residential aged care worker, you must not go to work if you have a fever or symptoms of a respiratory illness

Your employer should be making sure all staff receive a vaccination as soon as possible and meet the cost.

An aged care worker who is unable (or their facility is unable) to access an influenza vaccination is able to continue employment beyond 1 May 2020 on the basis that the vaccination has not been available to the person (5(d)).

NSW Ministry of Health have stated those who have actively sought a flu vaccine before 1 May 2020 but have not yet received one because of shortage in supply may still attend work. However, they must have a vaccine as soon as one becomes available to them.

Aged care providers having trouble with supply can report this to the Department of Health at COVID-19FluVaccine@health.gov.au 

The Commonwealth is currently seeking to improve access to the vaccine:

  • The Australian Government has secured three million additional doses of seasonal influenza vaccine bringing the total number of flu vaccines to 16.5 million
  • To assist access to the flu vaccine, Primary Health Networks (PHNs) have been contacting all residential aged care providers by region to undertake a needs assessment and coordinate influenza vaccination programs for those services with an identified need. The provisions may include sourcing vaccine supply and qualified vaccine administrators (see here for further details).

Personal Protective Equipment (PPE)

Where you require PPE to do your job safely, it is your employer’s obligation to provide it. If you are caring for a resident who is suspected or confirmed COVID positive you should be provided with a surgical mask, disposable gloves, a long sleeved gown and goggles or a face mask. This should be put on before entering the resident’s room and removed on exit.  You shouldn’t reuse any PPE unless it is marked as reusable, and then only where it has been properly cleaned in line with the manufacturer’s instructions before you reuse it.  If you don’t have the PPE that you need to do a task safely, then you should not do that task until the PPE is provided.

Read more about PPE here.

Guidance for Symptom Monitoring

This guidance was developed by the Communicable Disease Network of Australia (CDNA) and endorsed by the Australian Health Protection Principal Committee (AHPPC).

This guidance is intended for health and residential aged care settings considering monitoring for symptoms. Health screening for health and aged care workers for symptoms of COVID-19 in these settings may be used as one of a suite of measures to detect and prevent outbreaks.

You can find the guidance here.

Screening

Recommendations on screening of people entering residential facilities from the Aged Care Quality and Safety Commission (22 April 2020):

  • Ideally, there should be a single point of entry to the facility, with someone tasked to continuously monitor that entry
  • Every staff member or visitor arriving at the facility should be asked, at the point of entry, to respond to a standard set of risk screening questions. Services may want to consider giving these questions to each staff member or visitor on a pre-printed form on arrival to assist with understanding and recording

The screening questions could include:

  • Have you been overseas in the last 14 days?
  • Have you been in contact with a confirmed or suspected case of COVID-19 in the last 14 days?
  • Are you in close contact with or caring for someone who is currently unwell?
  • Have you currently or within the last 7 days been unwell or been aware of any of the following symptoms:

– fever, night sweats or chills
– cough
– runny nose
– sore or scratchy throat
– shortness of breath

The staff member or visitor’s accurate response to the question about fever can be supported through temperature testing on entry. If temperature testing is used in addition to the standard screening questions, it is recommended that a no-touch method is adopted such as an infra-red temperature detection “gun” device.

Important processes

A reminder on some important processes that should be followed at all aged care facilities:

  • If there is an outbreak in your facility, all staff and residents should be tested for COVID-19. An outbreak is when there is two or more confirmed cases in three days.
  • Facilities should be recording if any of their staff work at multiple facilities or across services, whether for the same employer or another. This is important to contact trace if there is a suspected or confirmed case of COVID-19.

Discharging new and returning residents during COVID-19

The NSW Ministry of Health has developed advice for the safe and efficient discharge from hospital of new and returning residents of residential aged care facilities (RACFs). The advice includes a screening process and a discharge summary template.

A consistent approach will provide confidence that all new and returning residents at the time of discharge from hospital to RACFs have been screened by an appropriate medical officer and:

  • were not experiencing acute respiratory symptoms or fevers compatible with COVID-19 and
  • had not had any close contact with a confirmed COVID-19 patient in hospital.

NSW Health will now include a letter in the discharge paper work signed by the treating team confirming the person has been screened for COVID-19 symptoms. A template can be found here. 

Workers in RACF admitting residents returning from hospital should ensure they receive a copy of the discharge paperwork as part of their infection control management arrangements.

International Student Nurses

On 18 March, the Commonwealth Government announced it will relax international student nurse visa work conditions to provide workforce continuity for aged care facilities, home care providers and other health care workers.

This will allow international student nurses and other aged care workers to work more than the 40 hours a fortnight that they are currently. This measure will be examined on an ongoing basis. There are currently around 900 approved providers of residential aged care employers and around 1,000 approved providers of Home Care Packages. There are currently around 20,000 international student nurses studying in Australia.

COVID-19 support packages

On 31 August, the Federal Government announced an additional $563.3 million to extend support for the aged care sector’s response to COVID-19.

This takes government support to aged care to over $1.5 billion since the pandemic began.

On 1 May, the Prime Minister announced a COVID-19 specific support package for residential aged care providers, totalling $205 million. This translates to around $900 per resident in major metropolitan areas and around $1350 per resident in all other areas.

The funds are “aimed at ensuring aged care providers can offer reinforced levels of safety and care for those who need it most”.

The Australian Nursing and Midwifery Federation (ANMF) says the Federal Government must guarantee the funding is fully and directly used to employ more nurses and suitably-qualified care staff and ensure the availability of appropriate personal protective equipment (PPE) to combat the COVID-19 pandemic.

Aged care providers must address chronic understaffing and the ongoing shortages of PPE as a matter of urgency if Australia is to ensure the safety and protection of all residents.

Additional Commonwealth Funding

On 20 March, an additional $444.6 million in funding, including a retention bonus for workers, was announced for the aged care sector:

  • $234.9 million for a COVID-19 ‘retention bonus’ to ensure the continuity of the workforce for staff in both residential and home care. This means:

– Full-time direct care workers in residential care facilities will receive a payment of up to $800 after tax per quarter, paid for two quarters.
– Full-time home care workers will receive payments of up to $600 after tax per quarter, paid for two quarters.
– Part-time direct care workers receive a pro-rata payment for the amount of time you work. For example, if you work two days a week, you’ll receive 40 per cent of the payment.
– Payments will be made via your employer with the first payment expected in June (for the preceding quarter). The second payment will be paid in September.

The Australian Government Department of Health has been working on the mechanisms, processes and guidelines in order to release these funds for workers and providers.

In addition:

  • $78.3 million in additional funding for residential care to support continuity of workforce supply.
  • $26.9 million to increase the residential and home care Viability Supplements and the Homeless Supplement (including increased viability payments for National Aboriginal and Torres Strait Islander Flexible Aged Care Program providers and Multi-Purpose Services).
  • $92.2 million in additional support to home care providers and organisations which deliver the Commonwealth Home Support Programme, including for services such as meals on wheels.
  • An extra $12.3 million to support the My Aged Care call centre to respond to the needs of older Australia.

Prior to this, the Commonwealth Government announced a $2.4 billion health care package, with $101.2 million dedicated to the aged care sector to:

  • educate and train more aged care workers in infection control;
  • enable aged care providers to hire extra nurses and aged care workers for both residential and home care; and
  • bolster the Aged Care Quality and Safety Commission’s capacity to ensure providers are stepping up infection control measures.

Other useful resources

  • This document outlines special precautions when entering COVID-19 designated zones.
  • COVID-19 factsheet for aged care workers.  This is a 4 page document with information on things like visit restrictions, changes to work visa hours arrangements, when people should or shouldn’t come to work etc.
  • Cleaning – the Health Department has provided guidance on Environmental cleaning for residential aged care facilities.
  • Information for in-home care clients – “Its OK to have home care” – is designed so carers can print off and distribute before entering their clients home to reassure them that it is OK to continue to receive care
  • Flowchart/poster on when to use PPE in aged care settings
  • This document provides more detail on what kind of PPE to wear when treating suspected or confirmed cases of COVID-19 and how to wear it
  • PPE video from Australia’s Chief Nursing and Midwifery Officer, which provides a demonstration on how to appropriately use PPE

NSWNMA Support

If members are concerned their employer is not following the appropriate guidelines, the NSWNMA can provide assistance to ensure appropriate measures are in place. Contact us here.

Further information on PPE

Further information for private health nurses and midwives

 

Private health employee information for COVID-19

December 24, 2020 by Danielle Mahoney Leave a Comment

The NSW Nurses and Midwives’ Association is providing support and advice to any members seeking information regarding the novel coronavirus (COVID-19).

Ensure you’re covered at work by joining the NSWNMA.

The Commonwealth Department of Health website contains detailed guidance for health sector workers and is updated regularly.

If members are concerned their employer is not following these guidelines, the NSWNMA can provide assistance to ensure appropriate measures are in place. Contact us.

Employers offering leave assistance for COVID-19

  • Healthscope
  • BUPA
  • St John of God

Disability workers seek $5-an-hour pandemic allowance

Unions and an employer group have applied to introduce a temporary hourly allowance of almost $5 an hour for disability workers to compensate the sector’s low-paid workers during the COVID-19 pandemic.

FWC President, Justice Iain Ross, yesterday issued directions for the application to vary the Social, Community, Home Care and Disability Services Industry Award 2010, setting a hearing date of Monday, May 4.

Objectors have until 4pm Friday to lodge a submission.

It seeks to insert a new clause in the award covering social and community services employees undertaking disability services work.

The clause relates to employees who are required to work with a client who has to self-isolate due to COVID-19, or a client who is suspected of having the virus or has been confirmed as having it.

The variation seeks for employees to be paid an hourly allowance of 0.5% of the standard rate for a social and community services employee level 3 at pay point 3 in clause 15.3 of the Award, which is currently $988.80 for a 38-hour week.

This hourly COVID-19 allowance would be $4.94 an hour for all disability workers, translating to $187.72 for a 38-hour week.

Government guarantee to private hospital sector

Thanks to ongoing pressure from unions and employers, on 31 March, the Australian Government announced a partnership with the private health sector to secure 30,000 hospital beds and 105,000 nurses and staff.

The federal government has agreed to contribute 50% towards activity funding, provided private providers retain their workforce. For further detail on the guarantee, refer to this document.

The Commonwealth will offer agreements to all 657 private and not-for-profit hospitals to ensure their viability, in return for maintenance and capacity during the COVID-19 response.

State and territory governments will also complete private hospital COVID-19 partnership agreements in the coming days.

Leave (COVID-19)

In the first instance, enquire with your employer whether it has published a policy in relation to COVID-19 and self-isolation. You may also be able to access such a policy on your employer’s intranet if it has one.

If you’re directed not to attend work because you have COVID-19, are sick and/or exhibiting flu-like symptoms, then generally you will be required to take personal leave or sick leave. If you’ve run out of personal leave or sick leave then you should be able to access your other paid leave entitlements.

Leave entitlements during self-isolation

The Commonwealth Government requires people to self-isolate for 14 days if they have come into contact with a confirmed case of COVID-19 or have returned from overseas travel from any country from midnight 16 March 2020. If you’ve been directed not to attend work due to these requirements then your employee entitlements will depend on your employer’s policy and the provisions of your award or enterprise agreement (see links to Industrial Instruments below).

Most private hospital nurses and midwives are covered by an enterprise agreement. Check it for relevant leave provisions, including personal/carer’s leave, and whether there are any stand down provisions that apply. If you require assistance identifying or interpreting your enterprise agreement then we’re here to help. You can contact us using this web form.

If you’re employed under the Nurses Award 2010 (only those without an enterprise agreement) and are required to self-isolate then it is reasonable for your employer to direct you onto personal/carer’s leave because you’re not able to work. If you’ve run out of personal/carer’s leave then you should be able to access other forms of paid leave that you have accrued.

Casual employees

Casual employees generally do not have the leave entitlements available to them that permanent employees have. If you’re a casual employee and required to self-isolate then your employer should consider standing you down on pay for any rostered shifts, although you are unlikely to have a legal right to the payment of wages for this time. Particular regard should be given by your employer to the length of your employment and whether you work on a regular and systematic basis.

Support

If your employer has directed you not to attend work for reasons related to COVID-19 and you have not been in contact with a confirmed case of COVID-19 or returned from overseas travel, then please contact NSWNMA for assistance.

Unfortunately employees in the private sector are not automatically entitled to the 20 days special leave made available by the NSW Government to its employees.

The above is intended as general information only and the advice in relation to each case will depend on its particular circumstances.

The NSWNMA will continue to provide further updates for members as we receive them. Contact us here.

Current Industrial Instruments

  • Nurses Award 2010
  • Private Hospital enterprise agreements
  • Aged Care enterprise agreements

Further information for aged care nurses

Further information on PPE

 

Personal Protective Equipment (PPE)

December 21, 2020 by Avelia Gandarasa Leave a Comment

The NSW Nurses and Midwives’ Association is providing support and advice to any members seeking information regarding the novel coronavirus (COVID-19).

Join the NSWNMA to ensure you’re covered at work.

The Commonwealth Department of Health website contains detailed guidance for health sector workers and is updated regularly.

Escalation to moderate risk

Given the current context of local transmission, NSW Health is advising Local Health Districts (LHDs) and Specialty Health Networks (SHNs) to escalate to a moderate risk level (Amber). This requires all health workers wear a surgical mask if they are within 1.5m of patients. Patients are also required to wear a mask, where possible.

The new advice on mask use is underpinned by expert risk assessments. The recommendations are detailed in the COVID-19 Infection Prevention and Control Response and Escalation Framework and this poster.

Access Frequently Asked Questions (FAQs) about the escalation to Amber Alert here.

Your rights

If you are providing care for patients who have or are suspected to have COVID-19 or are working in a high-risk clinical area, your employer must provide you with appropriate PPE to ensure you can do your job safely. Such as:

  • You are to wear prescribed PPE as instructed (your employer needs to ensure you are trained in how to use PPE safely).
  • Do not undertake tasks requiring PPE if the PPE is not available for use. Any such tasks are not to proceed until required PPE is readily available.
  • If you are concerned for your safety, you must raise your concerns immediately with your manager.

Where staff are performing tasks requiring P2/N95 mask use under the CEC guidelines and where the employee has fit checked the available P2/N95 mask sizes and these sizes are not a correct fit, then the employee is to be temporarily redirected to work which does not require the use of a P2/N95 mask until suitable masks with correct fit become available.

CEC guidelines around Respiratory Protection in Healthcare also state:

In NSW, LHDs/SHNs are required to implement respirator fit testing in their facilities for health workers (HWs) performing respiratory Aerosol Generating Procedures (AGPs) on patients with COVID-19 or providing clinical services to patients on airborne precautions in high risk areas.

What PPE do I need?

Refer to CEC guidance to determine the correct use of PPE in your area:

  • Special Precautions for COVID-19 Designated Zones (added 28/4/2020)
  • Infection Prevention and Control COVID-19 Personal Protective Equipment (added 28/4/2020)
  • Quick Guide to PPE for the Emergency Department (05/01/20)
  • Application of PPE in Response to COVID-19 Pandemic (added 05/01/2021)
  • Principles of fit checking: how to don and fit check P2 and N95 masks (updated 19/3/2020)

Fit testing program

The NSW Government and Clinical Excellence Commission (CEC) have recognised the need for clearer and consistent fit testing thanks to ongoing campaigning from unions. A fit testing program is now recognised as an addition to current infection prevention and control education and guidance on the adequate use of PPE.

Further details to ensure the safety of NSW Health workers at all times and during the COVID-19 crisis, can be found here.

When do I need to wear PPE?

Guidance on from the Clinical Excellence Commission directs nurses working in high-risk areas to wear PPE (previously it was only when working with confirmed or suspected cases).

Health workers caring for patients in high-risk clinical areas (see list below) should comply with contact and droplet precautions for all close contacts (gown, surgical mask, eye protection and gloves). When performing aerosol generating procedures, comply with contact, droplet and airborne precautions.

High-risk clinical areas include:

  • Intensive Care Units (ICU)
  • Emergency Departments (ED)
  • COVID-19 Wards
  • Acute Respiratory Assessment Clinics

A dedicated floor plan in Emergency Departments should be established that clearly designates areas assigned for suspected or confirmed COVID-19 patients. If possible, consider rostering of staff to support the separation of areas and resourceful use of PPEs. For staff working directly in the area of suspected or confirmed cases of COVID-19, PPE should be worn accordingly.

National guidelines

The Australian Government has also published recommendations for the use of PPE when caring for people with possible COVID-19 infection.

  • Using Personal Protective Equipment (PPE) during hospital care
  • Using PPE during non-inpatient care

Report PPE concerns

If you have concerns that your employer is not providing you with the necessary PPE (or is making it very difficult to access) and/or is not training people in its safe use, then you should:

  1. Put in an incident report at your workplace
    AND
  2. Escalate your concerns to your manager in writing and ask for an urgent response

If your concerns are not being taken seriously, we can assist to ensure appropriate measures are in place. Contact us here. You can also contact SafeWork NSW on 13 10 50.

Further information for public health nurses and midwives

Further information for private health nurses and midwives

Further information for aged care nurses

 

Union Win for Public Health Nurses! Fit testing now required in high risk areas

August 14, 2020 by Cameron Ritchie Leave a Comment

The NSW Nurses and Midwives’ Association has been fighting make sure fit testing is undertaken for all health workers who wear P2/N95 masks.

We now have official acknowledgement from the Clinical Excellence Commission (CEC) that fit testing should be required in all NSW Local Health Districts for nurses working in high risk areas or performing certain procedures on patients with COVID-19. This is a win for members and a great achievement for those who have been active in the campaign to ensure safety at work.

New advice states:
In NSW, LHDs/SHNs are required to implement respirator fit testing in their facilities for health workers (HWs) performing respiratory Aerosol Generating Procedures (AGPs) on patients with COVID-19 or providing clinical services to patients on airborne precautions in high risk areas.

This is a huge acknowledgement of the importance of fit testing in protecting health care workers by reducing the risk of potential exposure to any pathogens.

It’s not temporary

There’s now an ongoing requirement for your employer to implement a fit testing program if you are using these masks for any airborne spread infection:

Fit testing of P2/N95 respirators must be provided for HWs responsible for routinely and regularly attending to patients in isolation for airborne spread infections, for example caring for patients with pulmonary or laryngeal Tuberculosis or those who are performing respiratory AGPs.

In addition, adequate training must be provided and a fit testing program implemented:

Health workers required to wear a respirator must be trained and assessed for competency in the use of all PPE as part of an ongoing training program.

The need for a fit testing program extends beyond COVID-19 and therefore an LHD/SHN fit testing program requires careful and planned implementation.

If your management has not already implemented fit testing in line with these new requirements, it’s important for you to let us know and we can make it happen together. Contact the NSWNMA here.

The new recommendations Respiratory Protection in Healthcare are available to view in full here.

Unsure about the difference between fit checking and fit testing?

Watch our Webinar here.

 

Report PPE concerns

If you have concerns that your employer is not providing you with the necessary PPE (or is making it very difficult to access) and/or is not training people in its safe use, then you should:

  1. Put in an incident report at your workplace
    AND
  2. Escalate your concerns to your manager in writing and ask for an urgent response

If your concerns are not being taken seriously, we can assist to ensure appropriate measures are in place. Contact us here. You can also contact SafeWork NSW on 13 10 50.

Further information for public health nurses and midwives

Further information for private health nurses and midwives

Further information for aged care nurses

The NSW Nurses and Midwives’ Association is providing support and advice to any members seeking information regarding the novel coronavirus (COVID-19).

Join the NSWNMA to ensure you’re covered at work.

Mask mayhem putting life-saving nurses at risk

August 10, 2020 by Gia Hayne 2 Comments

The NSW Nurses and Midwives’ Association (NSWNMA) has joined a chorus of health organisations demanding improved protocols and better Work Health and Safety standards for all health workers responding to the coronavirus pandemic.

NSWNMA General Secretary, Brett Holmes, said despite a NSW Health issued ‘amber alert’ last month for public health workers to wear masks within 1.5 metres of all patients, access to Personal Protective Equipment (PPE) to enhance workplace safety was an ongoing concern.

“At a minimum, nurses and other health workers in settings with confirmed or suspected COVID-19 patients should be protected with P2/N95 masks and fit tested to ensure they properly seal to their face,” said Mr Holmes.

A recent survey of 1,270* nurses and midwives in NSW has found almost half (44.8%) of those required to wear P2/N95 masks have not been fit tested to limit their exposure from the wrong size mask.

Alarmingly for public hospital nurses, only one-in-four working in a COVID-19 ward and one-in-three working in an intensive care unit said they had undergone a fit test.

A further 41% of respondents indicated they were worried about exposure at work due to interaction with potentially contagious patients who may be asymptomatic or untruthful during screening.

“For six months, frontline nurses and midwives have been going to work not knowing what will unfold, if they’ll be at risk, or worse, be exposed because of inadequate protection,” Mr Holmes said.

“Many nurses and midwives are still dealing with ongoing issues regarding access to adequate PPE and conflicting infection prevention advice. This cannot continue.

“We’re still hearing of ICU nurses being told fit testing is not needed and despite being told stocks are ‘plentiful’, they are guarded under lock and key, or rationed out, with nurses left feeling guilty if they approach managers for additional supplies.

“Sadly, over 1,700 dedicated health workers have contracted COVID-19 in Victoria, with the majority just trying to care for patients and protect the community.

“We also stand with our health colleagues in calling on the federal Health Minister to increase the use of P2/N95 masks during the care of suspected or confirmed COVID-19 patients.

“Here in NSW, all health workers deserve to be acknowledged and deserve recognition for their ongoing sacrifices.

“At the end of the day, our public sector nurses and midwives just want to be paid fairly and be safe at work. Is that really too much to ask?” said Mr Holmes, referring to the public sector wage freeze debate.

The NSWNMA returns to the NSW Industrial Relations Commission from today (10-12 August) alongside other public sector unions to fight the Berejiklian Government’s planned wage freeze.

*The NSWNMA survey of 1,270 nurses and midwives in public and private hospitals, community health and aged care settings was conducted over three weeks from 23 July – 6 August 2020.

Sacrifice and betrayal

July 27, 2020 by Rayan Calimlim Leave a Comment

The NSW Industrial Relations Commission is hearing a case against the wage freeze brought by Unions NSW and public sector unions, including the NSWNMA.

The coronavirus has seen nurses increase their skills, broaden their responsibilities and improve their productivity, Angela Gittus told the IRC.

Angela, who is a CNS in emergency at a regional hospital, said “since COVID-19 was declared a pandemic our ED has been very busy preparing for all the potential issues that we might have to deal with, being the front door to healthcare in uncertain times”.

She said nurses have had “to learn completely new ways of doing things, and practice these new skills frequently to ensure we get it right when it matters”.

“We have worked together as a team to train in new ways of doing procedures such as intubation or management of severe shortness of breath.”

She says nurses have “waded through mountains of new information, policy and procedures, sometimes changing daily how we conduct our core business”.

“Infection control procedures for anyone with fever, cough or shortness of breath plus the donning and doffing of PPE with a buddy required to observe has put a strain on resources within the ED.”

Angela says ED nurses have also helped nursing staff from the operating theatre to orientate and learn how to be emergency nurses.

“The mentoring and education has grown a much more flexible and mobile workforce, while providing meaningful work for nurses whose regular work was abruptly stopped due to COVID-19.”

Angela told the Commission that the pay freeze was “bad for nurses, bad for communities but also bad economics”.

Losing the 2.5 per cent pay rise would be devastating for rural communities, she says.

“My money is spent locally and on supporting my family. It stays in my community and supports local businesses.

“In many of the small towns, around the state, it’s the wages of nurses and midwives and other public service workers that keep the town afloat.

“In many of these towns nurses and midwives now find themselves the sole breadwinner. Drought and fire and high unemployment in the bush have meant job losses for many. Those nurses and midwives struggling to keep a family going, are also being counted on to keep their town going.”

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