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.

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Visitors

From 1 November 2021 residents are permitted to have two fully vaccinated visitors aged 12 years and over plus two children aged under 12 years per day.

• Visitors aged 12 years and over must have received a second dose of a COVID vaccination at least 14 days prior to their visit.
• Children under 12 years are permitted to visit provided they are accompanied by a fully vaccinated person
• Where visits include a child under 12 it is strongly recommended, where possible:
  • the visit is in an outdoor area
  • the child should wear a mask
  • arrange Rapid Antigen Testing (RAT) prior to a visit

People who are providing a service to the resident including a health service or professional or other service are not included as part of the visitor limitations.

All visitors must wear a surgical mask while visiting indoors. Visits may be permitted in either the resident’s room or an outside area but not in any inside communal areas. For reasons when masks can be removed please see Additional Advice.

There is an exception for up to two unvaccinated people to visit a resident for an end of life visit. They must always wear a surgical mask and the visit must be solely inside the resident’s room. Facilities should consider Rapid Antigen Testing (RAT) if readily available for visitors attending an end of life visit.

Visitors must not enter an RACF at all if they:

• have been to any close or casual locations in NSW OR Victoria, Australian Capital Territory, Queensland, Tasmania OR New Zealand in the last 14 days;
• have COVID-19 symptoms
• are a close contact of a person with confirmed COVID-19 and are within their isolation period.
• live in a household with a person who is currently isolating.
• are waiting for a COVID-19 test result.

For the latest advice for home care service providers, click here.

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Single Site Employment arrangements

On 1 November 2021, the Commonwealth Chief Medical Officer signed off on the conclusion of single site employment (‘SSE’) arrangements in NSW and the ACT, with a sector-wide transition over two weeks before the end of SSE on 15 November, 2021.

This decision recognises the vaccination status of aged care workers, residents and the community as NSW moves towards lesser restrictions. This move is supported by the relevant advisory agencies (such as the Australian Health Protection Principal Committee) as being a safe, sound and reasonable move.

Each state and territory will still be able to apply its own directives to the sector, such as restrictions on the number of visitors and the requirements visitors must meet.

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Mandatory COVID-19 Vaccination – 17 Sep

From 25 October 2021 staff are not permitted to enter an aged care facility unless they have received their second dose of a COVID-19 vaccine.

From 31 October 2021 any health practitioners or students attending a residential aged care facility must have at least 1 dose of a COVID-19 vaccination and have received their second dose by 9am 4 December 2021.

In late June, National Cabinet agreed to a requirement for all aged care workers to receive at least one dose of the COVID-19 vaccine by 17 September, 2021. Evidence of vaccination compliance or a medical exemption must have been provided to your employer. If not, workers are not be permitted to enter and work at the facility. 

Public Health (COVID-19 Aged Care Facilities) Order 2021 [NSW]

The NSW Minister of Health signed off on this Public Health Order (PHO) on 26 August 2021.

The terms of the PHO apply to all those working in a residential aged care facilities.

Exemption

An exemption is possible on medical grounds, using this form approved by the NSW Chief Health Officer.

The PHO also requires employers to take all reasonable steps to ensure compliance by their workers.

For more detailed information on the workforce affected by mandatory vaccination and possible exemptions, refer to the Mandatory Vaccination of Aged Care Workers.

The NSWNMA continues to strongly encourage aged care nurses and carers to receive COVID-19 vaccines.

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Personal Protective Equipment (PPE)

All staff working in NSW must wear a surgical mask. For detailed advice on PPE, visit this page.

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Aged Care COVID-19 grief and trauma response

A new training program will be piloted to help care workers look after themselves and the people they work with.

The trauma training program, funded by the NSW Government, will see existing aged, disability and community services workers learn about the effects of trauma on themselves and others, and how to maintain their own personal health.

The Department of Health has also created resources to help share information about the grief and trauma supports for those living, working and caring in the aged care sector, who have been impacted by COVID-19.

Many people may be suffering grief and loss from the passing of a loved one because of COVID-19, or feeling the loss of their routines, visitors and important events. People may also be experiencing trauma as a response to isolation, physical distancing, COVID-19 hotspot lockdowns, and visitor restrictions in aged care.

The intended audience includes aged care residents, home care recipients; their families, friends, family of choice, loved ones, community visitors and representatives; and aged care staff.

• Coronavirus (COVID-19) – Grief and Trauma Support Services – Brochure
• Coronavirus (COVID-19) – Grief and Trauma Support Services – Poster

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COVID-19 vaccine resources

COVID-19 administration of vaccination FAQs

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

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.

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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.

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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.

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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.

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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.

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Outbreak management training

Aged care workers are encouraged to complete the outbreak management training module.

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.

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Influenza vaccine requirement for workers

Guidance about influenza vaccination and the COVID-19 vaccination program is 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.

Legislation 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

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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.

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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.

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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.

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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.

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International student nurses

On 18 March 2020, the Commonwealth Government announced it would 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.

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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 have received 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

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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.

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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