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Long-term Care and Retirement Homes - Infection Prevention and Control (IPAC)

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Halton Region provides the following information, forms and posters that can help with the identification and/or management of an outbreak in your long-term care or retirement home.

Updates

The Ontario E-Health Critical PPE Intake Form and WEST LHINs Swab and Rapid Test Intake Form were discontinued on March 31st, 2023. Requests for PPE, swab kits and rapid tests must be submitted to the Ministry of Public and Business Service Delivery (MPBSD) through the Ontario PPE Supply Portal. The MPBSD has provided all long term care homes and retirement residences access to the portal. If facilities have difficulties or cannot access the Ontario PPE Supply Portal (external link) they can contact sco.supplies@ontario.ca.

COVID-19 and Other Respiratory Virus Updates

Steps for Early Identification of Outbreaks

Conduct Surveillance

  • Entry screening for symptoms and exposures in staff, visitors and returning residents.
  • Daily resident screening for respiratory and gastrointestinal symptoms in residents:
    • Respiratory symptoms: runny nose or sneezing, stuffy nose, cough, congestion, sore throat or hoarseness or difficulty swallowing, fever or abnormal temperature, chills, difficulty breathing, loss of appetite, malaise, muscle pain or headache.
    • Gastrointestinal symptoms: at least two unexpected episodes within 24 hours of diarrhea (loose/watery bowel movements) and/or vomiting.

Suspect an Outbreak

Notify the Halton Region Health Department

Respiratory

  • Two or more symptoms of acute respiratory illness occurring in two or more residents within 48 hours, with a common epidemiological link (such as same unit or floor); or
  • One laboratory-confirmed case of COVID-19 or influenza.

Gastrointestinal

  • Symptoms of gastrointestinal illness occurring in two or more residents within 48 hours, with a common epidemiological link (such as same unit or floor).

Contact the Halton Region Health Department early if you suspect an outbreak

Outbreak Management

  • Follow Infection Prevention and Control Measures (IPAC) to reduce further transmission of illness.
  • Start two separate line lists for each resident home area affected:
    • one for residents; and
    • one for staff.
  • Submit outbreak line lists to the Health Department daily by 11 a.m.:
  • Contact the Public Health Department by calling 311 to report an outbreak, and indicate the type of outbreak (enteric or respiratory).
  • Consult with Public Health before collecting outbreak specimens for laboratory testing (NP swabs for respiratory symptoms, stool samples for gastrointestinal symptoms).
  • Maintain daily contact with the Public Health Department to review the outbreak status (new cases, hospitalizations, death).

Guidelines for outbreaks for residents, families, and visitors

Outbreaks of illness in long- term care homes (LTCH) or other healthcare facilities can be very stressful for residents, staff, visitors and family members. However for residents/patients, outbreaks can be more than just stressful, they can be lifethreatening. For the health and wellbeing of residents/patients it is important to control and stop outbreaks as quickly as possible.

Follow these steps to help stop the spread of illness:

Check-in at the front desk and nursing station

Control measures may change during an outbreak. Staff at the nursing station will provide you with information on control measures that are being used at that time, and help answer your questions.

Keep your hands clean

Wash hands using soap and warm water or use an alcohol-based hand sanitizer:

  • Immediately when you enter the facility and as you leave
  • Before entering a resident’s room and as you leave a resident’s room
  • Before and after feeding a resident or providing care to a resident
  • Before eating
  • After using the washroom

Do not visit if you are ill

Visiting a resident when you are not feeling well puts everyone in the facility at risk. Keep infants and children at home if they are not feeling well. Do not visit if you have a cold or any of the following symptoms:

  • Fever, cough, runny nose, sneezing, stuffy nose, sore throat, or rash
  • Diarrhea, upset stomach, vomiting, or nausea

If a resident is ill, visit the resident in their room only

Ill residents should remain in their rooms. Avoid taking an ill resident to a common area during your visit.

If visiting an ill well resident, follow the facility’s infection prevention and control instructions and wear personal protective equipment (PPE) to protect yourself (e.g. gowns, gloves, mask and eye protection).

Do not visit more than one resident

After visiting a resident/patient, leave the facility immediately. To protect yourself, avoid common areas (e.g., dining room).

Get a flu shot (influenza vaccine) annually

Influenza can cause serious complications such as pneumonia or death, for the elderly and people at highrisk. You can pass influenza to others before you start to show any symptoms. To protect yourself and your family, get your flu shot. Even though residents of LTCH receive annual flu vaccine, science shows there is waning immunity in the elderly. Therefore to further protect residents it is important for caregivers, families and visitors to be immunized with flu vaccine each year.

Follow the facility’s infection prevention and control instructions

The Halton Region Health Department consults with facilities to discuss ways to control and prevent outbreaks. Follow the facility’s instructions for precautions or personal protective equipment (e.g., gloves, masks, eye protection or gowns), if required.

If followed by everyone, infection control measures can help control an outbreak.

Who can I call for more information?

For more information about controlling Outbreaks in Healthcare Facilities talk to a health care provider in the facility, or call the Halton Region Health Department at the number below.

Outbreaks of illness in retirement homes (RH) can be very stressful for residents, staff, visitors and family members. However for residents, outbreaks can be more than just stressful, they can cause serious illness. For the health and wellbeing of residents it is important to control and stop outbreaks as quickly as possible. Your co-operation is essential.

Please follow these steps to help stop the spread of illness:

Check-in at the front desk and nursing station

Control measures may change during an outbreak. Staff at the front desk or nursing station will provide you with information on control measures that are being used at that time, and help answer your questions.

Keep your hands clean

Wash hands using soap and warm water or use an alcohol-based hand sanitizer:

  • Immediately when you enter the facility and as you leave
  • Before entering a resident’s room and as you leave a resident’s room
  • Before and after feeding a resident or providing care to a resident
  • Before eating
  • After using the washroom

Do not visit if you are ill

Visiting a resident when you are not feeling well puts everyone in the facility at risk. Keep infants and children at home if they are not feeling well. Do not visit if you have a cold or any of the following symptoms:

  • Fever, cough, runny nose, sneezing, stuffy nose, sore throat, or rash
  • Diarrhea, upset stomach, vomiting, or nausea

If a resident is ill, visit the resident in their room only

Ill residents should remain in their rooms. Avoid taking an ill resident to a common area during your visit. If visiting an ill well resident, follow the facility’s infection prevention and control instructions and wear personal protective equipment (PPE) to protect yourself (e.g. gowns, gloves, mask and eye protection).

Do not visit more than one resident

After visiting a resident, leave the facility immediately. To protect yourself, avoid common areas (e.g., dining room). For your protection, be sure to wash or hand sanitize your hands upon leaving the facility.

Get a flu shot (influenza vaccine) annually

Influenza can cause serious complications such as pneumonia or death, for the elderly and people at highrisk. You can pass influenza to others before you start to show any symptoms. To protect yourself and your family, get your flu shot. Even though residents may receive annual flu vaccine, studies show there is waning immunity in the elderly. Therefore, to further protect residents it is important for caregivers, families and visitors to be immunized with flu vaccine each year.

Follow the facility’s infection prevention and control instructions

The Halton Region Health Department consults with facilities to discuss ways to control and prevent outbreaks. Follow the facility’s instructions for precautions or personal protective equipment (e.g., gloves, masks, eye protection or gowns), if required. If followed by everyone, infection control measures can help control an outbreak.

Infection Prevention and Control (IPAC) Resources

Outbreak Management Resources

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