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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

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Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

CATEGORY: Procedure,

CLASSIFICATION: Clinical, PURPOSE To enable appropriate social distancing and

infection control for patients, carers and staff within UHB Urology Procedure areas

Controlled Document Number:

C134

Version Number: Version 1 Controlled Document Sponsor:

Martin Richardson

Controlled Document Lead:

Prashant Patel

Approved By: MSAG

On: 17/06/2020 Review Date: 17/06/2021

Distribution:

• Essential Reading for:

• Information for:

All members of staff who work within the Urology Procedure areas at UHB, medical, nursing and admin staff.

All Divisional and Corporate Outpatient booking teams

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

Contents

Page

1 Introduction 3

2 Reason for development 3

3 Scope 3

4 Urology Outpatient Procedures 4

5 Staff Infection Control Measures 5

6 Information for Patients Pre Attending Clinics 5

7 Hand Hygiene 5

8 Accompanying Visitors 5

9 On arrival at the Out Patients Department Personal protective Equipment 6

10 Social Distancing 6

11 General Cleaning 6

12 Flow of Patients 6

Appendices

Appendix 1 Patient letter Insert 7

Appendix 2 Screening Questionnaire on Arrival 10

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

1. Introduction

During the initial COVID-19 pandemic period, Urology outpatient procedures were

rapidly ceased with no face to face elective procedures.

In the initial recovery phase, there is a need to restart these services in Urology with

strict control of the number of patients per list, to address the backlog of cases

particularly the two week wait referrals for the service.

These guidelines will be reviewed regularly and updated to reflect any changes in

national or local guidance, or community prevalence of COVID-19.

2. Reason for development

During the initial recovery phase of COVID-19, it is vital that, within the Urology

Outpatient Procedure areas, UHB has consistent, visible infection control and social

distancing measures to provide safe and reassuring care.

To allow provision of such care, there is a requirement to significantly reduce footfall

from pre-COVID-19 levels. Such reduction has to occur within a suite of alternative

care options to ensure provision of on-going safe care.

This document describes processes to enable appropriate social distancing and

infection control for patients and carers visiting UHB Urology Outpatient Procedure

areas.

3. Scope

These processes must be followed in all areas where urology outpatient procedure

care is provided, irrespective of who manages formally, unless alternative guidance

has been approved.

These procedures will take place in the following locations;-

Queen Elizabeth Hospital- East Block, Heritage Building,

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

Good Hope Hospital- Treatment Centre

Solihull Hospital – Minor Injuries unit

Each site must have an agreed maximum number of patients per list which must not

be exceeded and there must be a nominated member of the Urology Nursing Team

who oversees correct pathway implementation on a daily basis.

4. Urology Outpatient Procedures

All patients for the below procedures must be reviewed and risk assessed by Consultant / Clinical Nurse Specialist prior to appointment being offered. (eg elderly, vulnerable, self – shielding)

Procedure QEH

Max. no. Patients

per List

GHH

Max. no. Patients

per List

SOL

Max. no. Patients

per List

Flexible

Cystoscopy +/-

planned stent

removals

6

5

5

TRUS Biopsies 3 3 3

Trail without

Catheter

6/day

2/4

Dependent on

room availability

2/4

Dependent on

room availability

Urodynamics –

Not agreed to

recommence

n/a

Change of Hot Clinic 4 4

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

Catheter

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

5. Staff Infection Control Measures

Staff to wear surgical masks at all times within the unit.

Staff to wear surgical mask and visor in procedure room (can be sessional use) with the addition of apron and gloves at point of care (single patient / task).

Room, Toilets (when applicable) and equipment to be thoroughly cleaned between patients with clinell wipes (including phones, keyboards, chairs, etc).

Minimal equipment to be kept in rooms.

Unit and toilets to be wiped down at the end of each session with chlorclean.

6. Information for patients before attending clinics

This will be provided in clinic appointment letters, via text (including links to trust

website) as clinic reminders, and on approach and inside clinical areas. Letter

appendix 1.

7. Hand hygiene

This remains a key element of infection control. Alcohol gel will be available at the

front door and throughout clinical areas.

8. Accompanying visitors

Due to limited space and the need to abide to social distance, patients are

requested to attend appointments unaccompanied. The only exception allowed

will be advocates for patients who do not have the capacity to make decisions for

themselves. The advocate would have to adhere to the wearing of fluid – resistant

surgical masks at all times. If visitors are present to aid travel then they will be asked

to wait in their vehicle.

.

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

9. On arrival at the Out Patients Department

9.1 Screen for symptoms

All people entering the outpatient areas, whether patient or visitors should be

screened for COVID-19 symptoms using outpatient screening tool (Appendix 2). This

augments pre-clinic information. Privacy should be maintained and the patient /

visitor cohorted in a separate area if the screening answers require direct discussion

with relevant clinic team. It is recognised that COVID-19 symptoms are not unique

and outpatient review may still be appropriate

9.2 Masks

As per government advice, patients and visitor will be required to wear a clean mask

when visiting the outpatient areas. If they do not have one or have symptoms that

are may indicate COVID-19 or are shielding, a fluid resistant surgical mask should

be provided.

10 Social distancing seating

11 Seating areas will be reviewed and clearly marked as how to use. Any marking should allow easy cleaning of seating areas. Seating will be allocated for each clinic and carefully monitored to ensure correct usage without clinic overcrowding. Templates for seat allocation will be reviewed regularly.Cleaning

All touched surfaces must be cleaned down between patients using Clinell wipes. This includes waiting room and clinic room seating, and frequently touched surfaces.

12 Flow of Patients

A designated entrance and where possible, provision of different routes for in and outward should be identified.

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

Appendix 1

COVID-19: Advice for patients attending UHB hospitals for Urology outpatient

procedures

We know that coming to hospital during the current COVID-19 pandemic might

cause our patients some anxiety and worry. We want to reassure you that the NHS

is here for you and we have your safety in mind. We have made some changes to

our hospitals to reduce the risks so if you have visited before, you might find things

are different. For example, please be advised that catering will not be available and

to bring a small snack if required.

Please read the following guidance carefully before your visit. If you have any

questions, please telephone the number on your appointment letter.

Before your appointment

Patients advised to self-isolate for 7 days prior to appointment

Please don’t come to the hospital if you are unwell with the symptoms of COVID-19

and can answer YES to either of the questions below, or by government guidance

should be self-isolating. If this means you will not be able to attend your

appointment, please call the number on your letter and we can rearrange it.

In the last 14 days, have you been diagnosed with COVID-19 or been in close

contact with someone diagnosed with COVID-19?

1. Have you or any of your close contacts developed any of the following

new symptoms in the last 14 days?

a new continuous cough

a high temperature

a loss of, or change in, your normal sense of taste or smell (anosmia)

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

Please wear a clean mask or cloth face covering to come into the hospital. If you do

not have one, we can give you a mask when you arrive.

Please do not bring visitors with you if at all possible, if you do they will be asked to

wait outside of the hospital. If you do need help coming to the hospital, ideally the

person accompanying you should be from your household. We ask that your visitor

leaves you in the waiting area and waits elsewhere. We have very limited space in

the clinic area to ensure that we can maintain social distancing. We ask that you

arrive 10 minutes before your appointment time but no earlier as space is very

limited.

Coming into the hospital

You must telephone the unit on arrival and wait in their car until instructed by unit

staff. Telephone number …………………………….

The Unit will telephone you when the unit is clear and advised you to make your way to the unit entrance, wearing surgical mask provided.

One-way systems might be in place so please observe signage to make sure you

enter and exit the building at the right place.

Please don’t linger in entrance areas and foyers and keep moving when inside the

hospital building.

Inside the hospital

Please stay at least two metres apart from others (outside your household) at all

times – this includes in car parks, corridors, and waiting areas.

Please clean your hands with alcohol gel as soon as you arrive in the hospital. This

will be available for your use.

Please avoid touching your face and cough or sneeze into a tissue and then bin it

safely. If you don’t have a tissue, please cough or sneeze into your arm.

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

Please try to restrict your movement on site so you only visit areas essential for your

visit.

Please take note of all signage and follow any guidance given. For example, lifts will

have signs displaying the maximum number of occupants allowed inside at any one

time.

Reception and check-in areas

Please remain at a two metre distance from reception staff and use hand gel if you

use the touch-screens to check in.

Please observe the signs placed on waiting area seats as we need to maintain social

distancing.

We will be asking some questions when you get to the hospital to ensure we don’t

need to take extra precautions with your care.

Please be reassured that we are working hard to reduce the risks at our

hospitals.

By following the guidelines above, we can work together to help protect each

other. Thank you.

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020

Appendix 2

Appendix 2.0: screening questionnaire on arrival

1) In the last 14 days, have you been diagnosed with COVID-19 or been in close contact with someone diagnosed with COVID-19?

Yes/No

If yes, you must inform clinic staff as soon as possible and await further instruction.

If no, go to question 2.

2) Have you or any of your close contacts developed any of the following new symptoms in the last 14 days?

a new continuous cough a high temperature a loss of, or change in, your normal sense of taste or smell (anosmia)

If yes to any of the above, you must inform clinic staff as soon as possible and await further instruction.

If no, please return completed form and await further instruction.

Please ensure you keep 2 metres apart from others at all times and follow instructions provided by staff.

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CDN: C134 V1

Standard Operating Procedure for Providing Face to Face Urology Outpatient Procedures during COVID-19 recovery phase

Issued: 17/06/2020