COVID-19: Student Summer School

Get up to speed with the latest College guidelines for practising during the COVID-19 pandemic.

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Over the next few weeks, we’ll be sending you mini-lessons to help you understand remote consultations, PPE and Infection control, and will post them here too. If there are any topics you'd like to see a lesson on - let us know.

Lesson one: Remote triaging and consultation 

As part of clinics, or your role in practice, you might be asked to carry out remote triaging, or remote consultations – so here is our guidance on working with patients remotely:

• When a patient contacts your practice to book an appointment, ask them the reason for their booking. Low risk, asymptomatic patients should be less of a priority than those reporting symptoms. Follow your practice's guidance on booking patients for appointments.
 
• Contact patients before their appointment and take as much of their symptoms and history as you can, by phone or video. Use our remote clinical review form to make sure you get all the relevant detail (You'll need to be signed in to download it).
 
•    Steps to take during a remote triage/consultation:

1. Introduce yourself to the patient, confirm their identity and contact details.
2. Conduct the phone/video consultation in a private place, just as you would in the practice.
3. Check that the patient is happy to have a conversation. They might want to move to somewhere more private themselves.
4. If a patient has COVID-19 symptoms as well as symptoms of a life- or sight-threatening condition, do not see them in practice. Contact your local hospital for advice, telling them that the patient has symptoms of COVID-19.

• Be mindful of people who can’t talk confidentially at home, and of those with additional communication needs, such as those who have hearing loss.
 
• If the remote consultation does not happen on the same day as the appointment, confirm on the day that nothing has changed since you last spoke. If you need to discuss things with a patient when they are in the practice (before or after the consultation), do so at a distance of at least two metres. 

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Lesson two: PPE

All practice staff should wear appropriate PPE if they need to see patients at a distance of less than two metres, unless they are behind a screen. National guidance says that, even if your patient is not a possible or confirmed case of COVID-19, all clinicians should wear:

  • single-use disposable aprons (changed for each patient)
  • single-use disposable gloves (changed for each patient).

In addition, national guidance advises optometrists to risk assess whether they need to wear:

  • a fluid resistant face mask or ‘surgical mask’ (type IIRR) and/or;
  • eye or face protection, if there is anticipated risk of splashes with blood or body fluids.

If masks and/or eye/face protection are used, they can be worn for examining multiple patients, rather than being changed after each one, unless they become soiled, damaged or uncomfortable.

The College recommends that all optometrists working within two metres of a patient should wear fluid resistant surgical masks. Although you can wear the same mask to examine multiple patients, you should be careful to avoid touching the mask, do not take it off between patients, and do not let it rest on your neck or chest.

Hand hygiene should be practised and extended to exposed forearms after removing any element of PPE.

Watch these NHS and Public Health England videos on putting on PPE and removing PPE. You can also look at our course on practising safely during the pandemic.

You should not deliver face-to-face care at less than two metres if you do not have appropriate PPE.

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Lesson three: Infection control

You may need to assist with infection control measures in your practice - here is the College’s current guidance:

Disinfecting

Every surface that a patient has come into contact with must be disinfected. This includes clinical equipment, and non-clinical items, such as clipboards. Open doors for patients, to avoid them touching the handle. If the patient touches the door handle, disinfect it.

The World Health Organisation (WHO) recommends 70% ethanol solutions to disinfect reusable equipment such as chin rests, handles, and trial frames. 

For frequently touched surfaces, the WHO recommends 0.5% sodium hypochlorite. You should check the manufacturer’s advice to ensure disinfectants are not likely to damage equipment or surfaces. You can also use microbial wipes, as long as they contain the correct concentration of ethanol. 

Wear an apron and disposable or washing up gloves when cleaning. When you’ve finished, these should be double bagged and stored securely, then thrown away in the regular rubbish. 

In practice

If you need to use a focimeter on a patients’ spectacles, provide them with a wipe to sanitise their frames before you touch them.

Practise regular hand hygiene and encourage your patients to do the same.

Remember that objects in staff areas, such as kettles, should also be disinfected frequently.

You can also look at our online course on practising safely during the pandemic for more information on infection control. 

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