Increased Safety For Frontline Nurses

In collaboration with the Chief Medical Officer of Health, and after consulting with the Ontario Nurses’ Association (ONA), Ontario Health, Ministry of Labour, Training and Skills Development (MLTSD), and the Ontario Hospital Association (OHA), the province of Ontario has developed further measures to ensure the health and safety of frontline nurses during the COVID-19 pandemic that has affected nearly 1 million people across the globe.

The province has issued a directive to upgrade health and safety standards and maintain this protocol in order to prevent or minimize exposure and spread of the novel coronavirus that originated in Wuhan, China, early December 2019. The directive addresses the following:

• A point-of-care risk assessment (PCRA) must be performed before every patient interaction. If a health care worker determines, based on their professional and clinical judgement that health and safety measures may be required in the delivery of care to the patient, then the worker shall have access to the appropriate health and safety control measures, including an N95 respirator. The employer will not unreasonably deny access to the appropriate PPE.
• At a minimum, contact and droplet precautions must be used by health care workers for all interactions with suspected, presumed or confirmed COVID-19 patients. Contact and droplet precautions includes gloves, face shields or goggles, gowns, and surgical/procedure masks.
• All health care workers who are within two metres of suspected, presumed or confirmed COVID-19 patients shall have access to appropriate PPE. This will include access to: surgical/procedure masks, fit tested NIOSH-approved N-95 respirators or approved equivalent or better protection, gloves, face shields with side protection (or goggles), impermeable or, at least, fluid resistant gowns.
• The employers commit to provide all health care workers with information on safe utilization of all PPE and employees shall be appropriately trained to safely don and doff all of these supplies.
• The PCRA should include the frequency and probability of routine or emergent Aerosol Generating Medical Procedures (AGMPs) being required. N95 respirators, or approved equivalent or better protection, must be used by all health care workers in the room where AGMPs are being performed, are frequent or probable, or with any intubated patients.
• The Organizational Risk Assessment must be continuously refreshed ensuring that it assesses the appropriate health and safety control measures to mitigate the transmission of infections, including engineering, administrative and PPE measures. This will be communicated to the Joint Health and Safety Committee including the review of the environment when a material change occurs.
• The parties agree with the importance of conservation and stewardship of PPE and will assess the available supply of PPEs on an ongoing basis. The parties commit to continue to explore all available avenues to obtain and maintain a sufficient supply.

“We are collaborating with our partners in the health system to implement this new directive to ensure that nurses have the protection they need to safely provide the best care for their patients,” said Christine Elliott, Deputy Premier and Minister of Health.