COVID-19 Protocols and Guidelines

Coronavirus (COVID-19) Infection Prevention & Control Protocols and Guidelines for Refine Me / Crendon Skin Clinics

The global pandemic has affected us all in some way and I sincerely hope that you and your family have kept safe and well during this time.

I have missed not being able to see you and offer you the treatments I know that you love and am looking forward to getting back to some level of normality.

The pandemic has created a requirement for many adjustments to the way the clinic is run to mitigate transmission of C0VID-19.

As an aesthetic nurse my main goals and priorities are to protect you our patient, myself and the general public by only delivering safe and appropriate treatments for the current evidence, guidance and regulations. It is my duty of care to continually review the circumstances which may mean regular adjustments to clinical practice.

This protocol will be used in conjunction with guidelines from the Government, relevant associations and professional governing body’s; mine being The Nursing and Midwifery Council.

Social Distancing

The Government currently advises public and workers to adhere to a 2-metre distance from one another and this appears to be a safety precaution that will be in place for the foreseeable future, including within all business formats.

The government also recognises that this may not be possible in all circumstances depending on the nature of the business, therefore further precautions must be put in place; to adhere to these guidelines and for protection of us all it has been necessary to change how we function as a clinic.

Booking Appointments

All appointments must be booked via telephone or electronically through our online booking system; no appointments will be booked in clinic to reduce the length of time you are in clinic for.

The 48-cancellation fee is void for the time being and you will not be charged if you cancel within 48 hours of your appointment due to ill health.

Booking fees can be rescheduled until further notice but cannot be refunded.

If I personally feel ill or have symptoms of C0VlD-19 myself, it will also be necessary to cancel your appointment at short notice.

Should either of these scenarios occur a self-isolation period of 14 days must be carried out before returning to clinic.

I appreciate this may be inconvenient and apologise in advance, but it is done entirely for everyone’s safety.

If your appointment is cancelled for any reason, I will aim to get you booked back in as soon as possible following a return to full health and a period of 14 days of self-isolation has been carried out.

No un-arranged walk in options will be available. If you do not have an appointment you will not be allowed to enter the clinic facility.

48-72 Hours Before your Appointment

To minimise cross contamination risks the clinic is now paperless so all consultation and consent forms will be sent to your email address and must be signed and returned electronically prior to your appointment; in the absence of returning your completed forms your appointment will be delayed to a later date. No exceptions will be made.

Additional Treatment Risks

The current situation poses additional risks to various treatments including dermal fillers and plasmage. For this reason, these treatments may be phased back into clinic slower than other treatments until deemed to be safer and carry less associated risk. Once these treatments are available it is important that you thoroughly read your consent forms that will be emailed 72-hours in advance of your treatment to gain a full understanding of the associated risks before consenting to having treatment. The 72-hour time frame should also enable enough time to ask any associated questions and gain further clarity to decide whether you still want to go ahead with your appointment.

Furthermore, there is the additional risk in the event of a future lockdown or if either one of us is required to go into self-isolation for a period of 14 days that you are unable to receive the appropriate aftercare required.

24 Hours Before your Appointment

Before each appointment you will be placed into a triage system in which you will have to complete a pre-appointment wellness health-screening check. This will be carried out electronically through your email address; depending on your answers you may need a follow up telephone call before being able to attend clinic.

This process is solely reliant on your honesty so please for the sake of myself, all other clinic patients and their loved ones be honest.

Please DO NOT attend clinic for your appointment if:

  • You are feeling at all unwell
  • You are feeling feverish
  • You have shortness of breath
  • You have flu-like symptoms such as fatigue, headache
  • You have nausea or diarrhoea
  • You have chills or shivering
  • You have muscle pains or rash
  • You have loss of taste AND / OR smell
  • You have a sore throat
  • You have had a new cough or other respiratory tract signs develop in the last 14 days
  • Your temperature is or has been above 37.3 °C in the last 14 days
  • If any member of your household is feeling unwell or has any of the above symptoms
  • If you or a family member has any C0VID-19 symptoms
  • If you or any member of the same household have travelled overseas in the last 15 days
  • If you or any member of the same household have attended an in-person event in the last 15 days

As stated above this advice also applies should any member of the same household feel ill or display any symptoms of C0VlD-19; if this should happen please advise me as soon as possible and DO NOT COME TO THE CLINIC FOR YOUR APPOINTMENT.

You will be turned away if you show any signs of being unwell; even if you are convinced it is a common cold PLEASE DO NOT VISIT.

Further considerations that may affect whether you are able to attend clinic at the present time:

  • If you are over 70 years of age
  • If you suffer from any of the following:
    • Diabetes
    • Cardiovascular disease, including hypertension
    • Chronic lung disease
    • Immunodeficiency
    • Cancer under active treatment

Consultations and Reviews

All consultations and review appointments will be carried out via video link in the first instance; ONLY after this and if it appears necessary will a face to face consultation or review appointment be booked.

Visiting the Clinic for Appointments

Please go to the toilet before arriving for your appointment to reduce the use of the clinic toilet as it is advised the toilet facilities to be out of use.

We do however understand that it is sometimes unavoidable; if you do use the toilet facilities, please flush the toilet with the lid down.

Please attend your appointments as close to the appointment time as possible. Please do not arrive early for appointments as the door will be locked so please wait to be let in.

The waiting area is out of use, no exceptions will be made. We apologise for any inconvenience.

Please attend your appointment alone in order to reduce human contact.

The only person that will be allowed to enter the clinic facility will be the named person for the appointment at the specific time, so please can we ask you don’t attend with family, friends or children as they won’t be allowed in.

If you usually travel or attend with another person, please can we ask that they wait in the car as the waiting area is out of use.

If both of you have an appointment you will each need to attend your individual appointment times separately so again, please can one person wait in the car. I understand that you may be from the same household, but this is in order to protect myself and other patients that visit the clinic.

Please do not attend your appointment with shopping or excess belongings.

Please adhere to the 2 metre social distancing guidelines until it is time for your treatment; no handshakes or hugging (sorry).

On arrival your temperature will be checked and on satisfactory reading of a temperature below 37.3°C will you be invited in.

At this point we will provide you with a disposable, single use face mask for additional protection and you will then be guided to sanitise your hands; hand washing will also be a requirement prior to leaving the facility.

All beverage facilities will be removed, if you know you usually need a drink please bring water with you but please drink it in the car and do not bring into clinic.

You will then be taken directly to the treatment couch where a further face to face risk assessment will be carried out.

All paper literature, forms and leaflets will be unavailable for the current time. You will however have access to the same paperless literature to read on your computer, phone or other electronic device in the comfort of your own home.

Please be ensured a full risk assessment has been carried out on each clinic location to ensure they adhere to all safety guidelines set at this current time.

Your treatments

A full risk assessment has been carried out for each available treatment and will be continually reassessed so that I am confident I can continue to provide them safely.

As already stated, certain treatments may be phased back into clinic slower than other treatments until deemed to be safer and carry less associated risk.

During your treatment

We understand the importance of hand hygiene and will ensure that all hand washing is carried out in accordance with NHS recommendations before and after every treatment.

All measures have been taken to make your treatment as safe, comfortable and enjoyable as possible. If you have any concerns about your treatments, please let us know. We will do whatever we can to satisfy you.

After the treatment

In order to avoid handling of cash, it would be preferable if you could pay for your treatment by card, apple pay or bank transfer (bank transfer must be paid in advance only).

As stated above any further appointments must be booked after leaving the clinic facility either by telephone or through the online booking system.

Prior to leaving the clinic facility it is required that you wash your hands again.

Product Purchases

If you require to purchase any products this can be done at the time of treatment otherwise, they can be posted directly to you.

Our Duty of Care & Responsibility to You

Cleaning

Standard infection control precautions will continue to be carried out as usual. In addition, the clinic will be cleaned between every appointment; this includes but is not limited to all surfaces, treatment couch, chairs, mirrors, keyboards, counter tops, desk, door handles, taps, card machine, toilet facilities, and any other touch points between patients and staff. The clinic windows will also be opened between appointments to allow as much room ventilation as possible.

When cleaning the clinician will be bare below the elbows and wear appropriate PPE to prevent any contamination to the person or uniform; clean single use disposable apron and gloves will be used and changed immediately after cleaning prior to the next patients’ arrival. A single use face mask and reusable face visor will also be worn at all times.

To allow time for the cleaning process, it has been advised that a 30-minute gap be left between appointments. For this same reason if you arrive early for your appointment please wait in your car until your allocated appointment time.

This also reduces the risk of patients crossing paths and reduces the risk of transmitting the virus between each other.

All tools and equipment will be disinfected or sterilised in line with the specific manufacturers’ instructions for your safety.

All cleaning products adhere to the Public Health England guidance.

All disposable items will be disposed of using NHS England C0VID-19 waste management standard operating procedure.

Wherever possible environmentally friendly, single use items will be used during treatments that will be disposed of safely after use in order to protect you from cross infection.

PPE

Clinicians will wear PPE in keeping with PHE guidelines, safe systems of working guideline and best practice local protocols. PPE will be applied and removed following the NHS guidelines to further reduce the risk of spreading the virus.

All gloves and aprons will be single use, changed and disposed of after each patient appointment. Visors will be also be cleaned and sanitised after each patient appointment.

Clinic uniform has been changed to adhere to current recommendations of washing all clinic wear on a 60°C wash following each clinic day and as always, we will remain bare below the elbow, hand washing will be extended to include both forearms and hair will be tied back.

Final Thoughts and Thank you

As I’m sure you’re aware these measures cannot completely remove all risk in relation to Covid-19 but will play a vital role in helping I will continue to take advice from the Government, relevant aesthetic bodies as well as the NHS regarding the most up to date guidelines and safest practices and will amend clinic protocols as necessary

I understand these new protocols are extremely strict and a lot to take in, you will be guided every step of the way to make sure you have a full understanding.

They are vital at the moment for the safety of everyone and to allow the clinic to function with as minimal risks as possible.

Hopefully in the not too distant future they will be able to relax slightly but for the time being I’m very grateful for your understanding so thank you and again I apologise for any inconvenience caused.

Much love
Mel

References

  • https://www.ncbi.nlm.nih.gov/pubmed/32035997
  • https://www.hse.gov.uk/research/rrpdf/rr1087.pdf
  • https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881 489/COVID-19_Infection_prevention_and_control_guidance_complete.pdf
  • https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0284-ppe-gowns- letter-qa-sa.pdf
  • https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/ 881489/COVID-19_Infection_prevention_and_control_guidance_complete.pdf
  • https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/ 877658/Quick_guide_to_donning_doffing_standard_PPE_health_and_social_care_poster__.pdf
  • https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881 489/COVID-19_Infection_prevention_and_control_guidance_complete.pdf
  • https://www.ncbi.nlm.nih.gov/pubmed/32035997
  • https://www.aop.org.uk/coronavirus-updates/coronavirus-how-to-disinfect-optical-equipment-and- premises
  • https://www.dovepress.com/delayed-hypersensitivity-reaction-to-hyaluronic-acid-dermal-filler-fol-peer- reviewed-fulltext-article-CCID
  • https://www.hse.gov.uk/news/assets/docs/face-mask-equivalence-aprons-gown-eye-protection.pdf
  • https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/87 9498/Guidance-for-businesses-ppe-regulations-version-2.pdf
  • https://www.bmla.co.uk/clinical-guidance-for-laser-procedures-during-the-covid-19-pandemic/
  • https://www.schuco.co.uk/surgical-smoke-plume/
  • https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-aerosol- generating-procedures
  • https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-non- aerosol-generating-procedures
  • https://www.who.int/news-room/articles-detail/updated-who-recommendations-for-international- traffic-in-relation-to-covid-19- outbreak#:~:text=Temperature%20screening%20alone%2C%20at,tracing%20of%20incoming%20traveller s.
  • https://www.who.int/infection-prevention/campaigns/clean-hands/5moments/en/
  • https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881 489/COVID-19_Infection_prevention_and_control_guidance_complete.pdf
  • https://www.jccp.org.uk/ckfinder/userfiles/files/Preparing%20for%20return%20to%20practice%2018May.pdf
  • https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk-from-coronavirus/whos-at- higher-risk-from-coronavirus/

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