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.

Refer to NSW Health advice for Residential Aged Care Facilities (RACFs) for latest advice.

New precautions for staff and visitors in RACF

Until the extent of the current incidence of community transmission in Sydney is better understood, the Ministry has revised advice to residential aged care facilities dated 5 May 2021, which essentially reverts RACFs in metropolitan Sydney back to the precautions that existed earlier in the year.

For residential aged care facilities within the Greater Sydney area, including metropolitan Sydney, Nepean Blue Mountains and Central Coast:

• All staff and visitors must wear a surgical mask
• Residents may have a maximum of two visitors each day. They may have different visitors each day.

Flu vaccine requirements

From 1 June to 30 September 2021, all visitors and staff entering a residential aged care facility should be required to provide evidence that they received a dose of the 2021 influenza vaccination. For further information please see Exceptional circumstances for visiting an RACF.

Workforce COVID-19 vaccination rollout

The Australian Government has revised the COVID-19 vaccine pathways for workers in residential aged care, as agreed at the National Cabinet meeting on 22 April 2021. The revised rollout aims to make it as easy as possible for workers to get vaccinated quickly and safely.

National Cabinet agreed that:

• People aged under 50 will access the Pfizer COVID-19 vaccine
• People aged 50 and over will access the AstraZeneca COVID-19 vaccine.

The Department of Health has developed a factsheet and infographic to support residential aged care workers understand where and how they can access a vaccination. This includes detailed information on the options available.

The factsheet is currently being translated into 19 languages.

An information pack has been distributed to all residential aged care facilities with materials for distribution to their workforce.

In summary:

Residential aged care workers 50 years and over can access an AstraZeneca COVID-19 vaccine at:

• Available now: GP clinics, GP respiratory clinics or Aboriginal Community Controlled Health Services.
• State and territory clinics coming on line progressively: State and territory AstraZeneca COVID-19 vaccine clinics.

Residential aged care workers under 50 can access a Pfizer COVID-19 vaccine at:

• State and territory clinics coming on line progressively: State and territory Pfizer COVID-19 vaccination clinics.
• Clinics commencing from 3 May: Commonwealth Pfizer COVID-19 vaccination clinics dedicated to residential aged care and disability workers only. The first of these clinics will be available in Sydney from 3 May. Information on these clinics has been sent directly to all Sydney-based facilities.

Information on state and territory vaccination clinics and participating GPs can be accessed through the COVID-19 Vaccine Eligibility Checker. If you can’t find details for nearby clinics, please check regularly as the listings will be updated as clinics become available.

Available now for residential aged care facilities that wish to participate: In addition, residential aged care facilities can choose to hold an on-site vaccination clinic for their workforce. These clinics will deliver the appropriate Pfizer or AstraZeneca COVID-19 vaccine, in line with the Australian Technical Advisory Group on Immunisation (ATAGI) recommendations for those aged under 50 or aged 50 and over.

All residential aged care facilities should distribute this factsheet to residents, their families and carers to provide advice on the aged care vaccine rollout.

Update to COVID-19 vaccine dose policy

The COVID-19 vaccine dose policy has been updated in line with current medical advice recommending Pfizer as the preferred COVID-19 vaccine for people aged under 50.

With the exception of residents, individuals aged under 50 should be prioritised to receive excess Pfizer doses in residential aged care, while still ensuring prioritisation principles are followed as below:

1. Any residents who have not provided advance consent, however are able to provide consent on the day of vaccination, including respite residents who are expected to be at the RACF at the time for the second dose.
2. Individuals aged under 50
   1. Vaccine workforce provider staff
   2. Residential aged care facility staff
   3. Essential care persons
   4. Other regular visitors to RACFs including aged care advocates, Dementia Australia staff and Community Visitors Scheme visitors
   5. Family member of residents on site for the day of vaccination.

Residential aged care facilities must adhere to these new guidelines by following the updated COVID-19 vaccine dose policy published on the Department of Health website.

Australian Technical Advisory Group on Immunisation (ATAGI) advice on the AstraZeneca

‘Thrombosis with thrombocytopenia syndrome’ (TTS) is a newly described serious condition, with unusual blood clots in the brain (cerebral venous sinus thrombosis) or in other parts of the body, associated with low platelet levels and can cause serious long term disability or death.

The evidence that connects TTS to receipt of the AstraZeneca vaccine has been reviewed by ATAGI and the Therapeutic Goods Administration (TGA) and subsequently, ATAGI has recommended new changes to the Australian COVID-19 Vaccine Program, including a preference for the use of the Comirnaty (Pfizer) vaccine in adults aged under 50 years.

The ATAGI statement (found here) provides further information on the key considerations.  Amongst these were the following:

• TTS remains an extremely rare event among vaccine recipients. Experience in Europe has shown approximately  4 – 6 people in every one million people develop TTS in the 4-20 days after the first dose of vaccine. However higher rates have been reported in some countries, and among younger people. One person in Australia developed the syndrome after receiving the AstraZeneca vaccine.
• While Australia currently has very low or no community transmission of COVID-19, this could change. The risk of serious disease and death in Australia remains, even as border controls and other measures continue.
• The individual benefit-to-risk balance of vaccination with COVID-19 vaccine AstraZeneca in Australia varies with age. The risk of ongoing health issues and death from COVID-19 is highest in older age groups, particularly rising from 50 years of age. By comparison, the rate, and so possibility of disability and death from TTS may be higher in younger people.

ATAGI has further recommended that:

• The AstraZeneca vaccine should only be used in adults aged under 50 where the benefits clearly outweigh the risk for that individual and the person has made an informed decision based on an understanding of the risks and benefits.
• People who have had the first dose of COVID-19 Vaccine AstraZeneca without any serious adverse effects can be given the second dose, including adults under 50 years.

New and updated resources are now available on the department’s website.

These documents include:

• Preparing for your COVID-19 vaccination
• COVID-19 vaccine consent form
• Pfizer vaccine information sheet
• AstraZeneca vaccine information sheet
• After your AstraZeneca vaccine
• Patient information on AstraZeneca

Visit the department’s website regularly for the most up to date information.

FAQs

Is the AstraZeneca vaccine safe?

Yes. The individual benefit-to-risk balance of vaccination with the AstraZeneca COVID-19 vaccine varies with age. This balance is based on factors including the increased risk of complications from COVID-19 with increasing age and the potential lower risk of this very rare, but serious, adverse event with increasing age. ATAGI has recommended the AstraZeneca vaccine remains safe to be given to people aged 50 years and over.

I have had my first dose of the AstraZeneca vaccine, what do I do now?

If you have had your first vaccine dose without this side effect or other serious adverse effects, you should receive your second dose as planned.

What if I am worried about side effects?

If you have recently had your first vaccine dose and are experiencing any side effects that you are worried about, see your doctor.

I’m booked in for my first dose of the AstraZeneca COVID-19 vaccine, what do I do?

If you are an adult aged under 50 years, you should only receive a first dose of AstraZeneca COVID-19 vaccine where the benefit of receiving the vaccine clearly outweighs the risk in your individual circumstance. You may wish to discuss your individual benefit-to-risk balance with your doctor.

Generally, if you have not already received a first dose of the AstraZeneca COVID-19 vaccine, then the Pfizer COVID-19 vaccine is preferred in adults aged under 50 years.

If you are 50 years of age or older, you can still receive your AstraZeneca COVID-19 vaccine.

Screening advice

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 any areas of concern in New Zealand
• 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
• are waiting for a COVID-19 test result.

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.

Visit the NSW COVID-19 website at least daily for updates on areas of active community transmission. A series of FAQs is also  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.

Influenza vaccinations in residential aged care facilities

Guidance about influenza vaccination and the COVID-19 vaccination program is now available on health.gov.au.

The timing of residential aged care facilities’ COVID-19 vaccination clinics and influenza clinics will need careful consideration to maintain the recommended minimum 14 day interval.

Flu vaccinations for residents and staff should occur:

• 14 or more days before their first Pfizer dose
• 14 or more days after their second (and final) Pfizer dose
• 14 or more days before or after their first AstraZeneca dose, or
• 14 or more days before or after their second (and final) AstraZeneca dose.

Where services have already scheduled an in-reach influenza vaccination program for residents and staff, this can be considered in the scheduling of a COVID-19 vaccination clinic. This is to ensure the preferred minimum interval between the two.

Residential aged care facilities that have scheduled their flu vaccinations, but have not yet been scheduled for a COVID-19 vaccine in-reach clinic, should immediately contact their Primary Health Network (PHN). Your PHN will liaise with the vaccine workforce suppliers on your behalf.

Watch the COVID-19 vaccine roll out in aged care webinar

If you weren’t able to join the COVID-19 vaccine rollout webinar, you can now view the recording on the department’s website.

Questions that could not be answered during the webinar will also be posted.

Make up doses for people who miss a second COVID-19 vaccine dose

The department has updated its COVID-19 vaccine doses policy. This includes guidance on how to manage make up doses for people who miss a second COVID-19 vaccine dose.

In the early stages of the rollout, vaccine workforce providers were encouraged to vaccinate workers and others in residential aged care facilities with leftover vaccine doses after all consenting residents had been vaccinated, in line with an excess dose policy.

The updated policy specifies that people should only be vaccinated if they expect to be at the facility to receive both doses.

Importantly, first doses of the COVID-19 vaccine should not be delivered at a second dose clinic.

There are some people who received a first dose in line with the previous excess doses policy. PHNs will work with facilities and vaccine workforce providers to identify and enact local solutions to ensure these people receive their second dose.

Residential aged care facilities should contact their local PHN if there are residents or staff in their facility that did not receive their second vaccine at a vaccination clinic.

COVID-19 vaccine update for residential aged care staff

It is a priority to deliver choice and flexibility in accessing COVID-19 vaccinations for aged care staff as quickly as possible in the safest way. The department has published an update for residential aged care staff to inform them on when and how they can access a COVID-19 vaccination.

The delivery model enables aged care staff to access a COVID-19 vaccination through a mix of in-reach and out-reach options which provide flexibility and choice:

• GP Respiratory Clinics. Aged care workers can book an appointment now at the nearest clinic.
• GP clinics through the online Vaccine Information and Location Service or directly through a participating GP clinic. Bookings can be made now subject to availability.
• Dedicated aged care worker clinics for residential aged care staff. Aged care workers will be able to book an appointment. Details on the first of the pop-up locations will be made available in early April 2021. More pop up locations will follow.
• Dedicated and Government approved in-reach vaccination clinics at some residential aged care facilities. Your residential aged care facility will be able to let you know if an in-reach clinic will be available.

A factsheet is available for all residential aged care workers.

COVID-19 administration of vaccination FAQs

To access FAQs on administering COVID-19 vaccines, click here.

COVID-19 vaccine toolkit

The Department of Health has published a readiness toolkit about preparing for the roll-out of COVID-19 vaccines and obtaining and recording consent for residents. You can also share the relevant information below with residents and their families, carers and loved ones.

Employers should familiarise themselves with this information and start planning. Your employer should also identify ahead of time if you need to roster on additional skills sets (eg RNs) or staff (eg AiNs) to support residents and efficiently operate the clinic on the day.

The following resources are now available here for residential aged care facilities:

• Planning checklist for vaccination day
• Consent process flow-chart
• Site readiness checklist
• Clinical governance requirements
• Consent in the residential aged care context

The following information is also available for facilities, workers, residents and their families, carers and loved ones:

• Information on COVID-19 Pfizer (Comirnaty) vaccine
• Preparing for COVID-19 vaccination
• What to expect before, and on, the day of vaccination
• After your COVID-19 vaccination
• Consent form

Australian Health Protection Principal Committee advice
While the Australian Health Protection Principal Committee (AHPPC) strongly encourages COVID-19 vaccination, at this time AHPPC does not recommend mandating COVID-19 vaccination for the aged care workforce. The AHPPC will continue to monitor the situation.

You can read more about this on the department’s website.

Keep up to date
You can find more information, including translated information, and subscribe to receive the COVID-19 Vaccines Updates here.

Position statements and supportive evidence

As professional leaders in this area, nurses and midwives can find the NMBA’s position statement on vaccination here.

Ahpra’s position statement on Registered health practitioners and students and COVID-19 vaccination is available to view here.

The National Boards and Ahpra have published a joint statement to help registered health practitioners and students understand what’s expected of them in giving, receiving and advising on and sharing information about COVID-19 vaccines. It can be viewed here.

The ANMF’s policy on vaccination is here.

ANMF Evidence on the COVID vaccine is here.

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Commonwealth Pandemic Leave Disaster Payment

The NSW Premier 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.

Workforce Retention Bonus Payment

The final Aged Care Workforce Retention Payment was paid in January 2021.

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

• Eligible residential care workers received up to $800 before tax, per quarter, for two quarters.
• Eligible home care workers received 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 released frequently asked questions (FAQs) to provide further information:

• FAQs for care workers

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

• ANMF information sheet for workers

National Aged Care Emergency Response Program

The government 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 seeks 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 offered, including a $5,000 bonus for successful completion of a rotation.

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.

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.

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

The Australian Commission on Safety and Quality in Health Care has developed 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 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.

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.

A number of questions will be asked relating to 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.

RACFs 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.

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.

CDNA Guidelines for public health units

The Communicable Diseases Network Australia (CDNA) guidelines for public health units 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.

Outbreak management

When an Outbreak is Suspected: RACFs 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 RACFs 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, RACFs 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 2020, 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)).

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 may 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 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 was adopted to 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 now includes 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 2020, 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 allowed international student nurses and other aged care workers to work more than the 40 hours a fortnight than they were currently. At the time of the announcement, there were around 900 approved providers of residential aged care employers and around 1,000 approved providers of Home Care Packages. There were 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.

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) said 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.

Commonwealth funding

On 20 March 2020, $444.6 million in additional 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, which means:

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

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 5 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