Post on 20-Sep-2020
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NSW Health COVID-19
Maternity, Neonatal, Special Care Nurseries and Child and Family Health
Community of Practice
30 July 2020
Respiratory Pandemic Preparedness
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Today’s Agenda
►Welcome and update from Dr Nigel Lyons
►Pandemic Kindness Movement, Linda Soars, ACI
►Feedback from issues arising in last week
►Prof Michael Nicholl (Maternity)
►Dr Srini Bolisetty (NICU & SCN)
►A/Prof Elisabeth Murphy (Child and Family Health)
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Clinical Communities of Practice (CoPs)
Update from Dr Nigel Lyons, Deputy Secretary
► Continuously monitoring the situation - visit the CEC and NSW Health COVID-19
pages regularly
► Clinical Communities of Practice
► Bendelta consultations complete – report by August 2020
► What’s new this week
► Accelerating virtual care and telehealth
► PPE, surveillance and medication updates
► The Clinical Council – met on 22 July
► Clinical guidance and resources
► New, revised and under development
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DATA – from Jan 2020 – date
► Twenty-one pregnant women have been diagnosed with COVID-19. This represents a small
proportion of all COVID-19 cases (0.63%). None of these women identify as Aboriginal.
► Of the 21 cases, 7 most likely acquired their infection overseas and the remaining 14 acquired
their infection locally in NSW. Of those who acquired their infection in NSW, 11 were linked to a
family member who was a confirmed case or a venue where there was known transmission.
The source of infection is unknown for three of the cases whose infection was locally acquired.
► Most symptoms that pregnant women reported were mild. Of the 20 women who were
symptomatic, 15 have fully recovered. Recovery status is not yet known for the remaining
pregnant women at this stage. There have been no deaths in pregnant women.
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DATA – From Jan 2020 to dateChildren 0 – 2 years
► Twenty-eight children aged 0-2 years have been diagnosed with COVID-19. This represents a
small proportion of all COVID-19 cases (0.84%). Most (68%) of cases are male (noting small
case numbers), and one child identifies as Aboriginal.
► Of the 28 cases, 12 most likely acquired their infection locally in NSW and 16 acquired theirs
overseas. Of those who acquired their infection in NSW, 10 were linked to a family member
who was a confirmed case or venue where there was known transmission.
► There is low positivity across all children aged 0-2 years who were tested for COVID-19
suggesting low rates of COVID-19 infection among this cohort.
► Most symptoms that children reported were mild. Of the 15 children who were symptomatic, 11
have recovered. Recovery status is not yet known for the remaining children at this stage.
There have been no deaths in children aged 0-2 years.
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Updated guidance available
► Guidance for maternity and newborn services (V4)
► https://www.health.nsw.gov.au/Infectious/covid-19/Pages/guidance-for-maternity-services.aspx
► Guidance for pregnant women and new parents
► https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-practice/Pages/guide-pregnant-women-and-new-parents.aspx
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Relevant issues for all areas
Important elements to remember
► Case Definitions available – CDNA National Guidelines for Public Health Units
► Confirmed case
► Probable case
► Suspect case
► Update on vertical transmission
► CEC Document – Management of COVID-19 in Healthcare settings V3.2 -http://www.cec.health.nsw.gov.au/data/assets/pdf_file/0019/582112/Management-of-COVID_19-in-Healthcare-Settings.pdf
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Relevant issues for all areas
Important elements to remember
► NSW Health has moved to a moderate risk level of Amber
► Information available in the COVID-19 Infection Prevention and Control Response and escalation framework by the CEC
► Watch PPE training videos in My Health Learning
► Mandatory training must continue
► Safe working environment
► Resources from HETI
► https://www.heti.nsw.gov.au/resources-and-links/covid-19/virtual-environments
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NATIONAL COVID-19 CLINICAL EVIDENCE TASKFORCEhttps://covid19evidence.net.au/
Provides: Living Guidelines, Clinical flowcharts, Evidence under review, Opportunity to ask a clinical question
Pregnancy and perinatal care living guideline – includes conditional recommendations
- Mode of Birth: For pregnant women with COVID-19, mode of birth should remain as per usual care
- Breastfeeding: Breastfeeding is supported irrespective of the presence of COVID-19. However, women with COVID-19 who are breastfeeding should use infection control and prevention measures (mask and hand hygiene) while infectious.
- Rooming-in: For women with COVID-19 who have given birth, support rooming-in of mother and newborn. However, women with COVID-19 should use infection control and prevention measures (mask and hand hygiene) while infectious
Listen to Professor Caroline Homer speak about the recommendations and their development.
Membership includes:
- Includes Cochrane Australia, Professional Associations, Councils and Colleges, Universities, Vic Health
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Linda Soars,Clinical Associate Director,Agency for Clinical Innovation
ACI Workforce Wellbeing Initiative
Linda Soars, Clinical Associate Director, Agency for Clinical Innovation
Focusing on the wellbeing of our health workforce during the COVID-
19 pandemic
ACI acknowledges the traditional owners of the land that we work on.
We pay our respect to Elders past and present and extend that respect
to other Aboriginal peoples present here today.
Pandemic Kindness Movement - A clinician wellbeing initiative
The Agency for Clinical Innovation (ACI) is supporting the Pandemic Kindness
Movement through a clinician-led “way-finder” website that supports the wellbeing of
all health workers during the COVID-19 pandemic.
It is based on Maslow's Hierarchy of Needs
It consists of 6 working groups of subject matter experts who curated wellbeing resources that
are:
• Up-to-date
• Evidence-informed
• Succinct
• Relevant
A collaboration with SA, Queensland and Victoria
Pandemic Kindness Leads
Tracey Tay - Clinical Executive Director, Care across the Lifecycle and Society CATALYST ACI
Samantha Bendall - Emergency Physician, Retrieval Physician at CareFlight & Ambulance NSW
Lynne McKinlay - Medical Director, Learning and Workforce
Jane Munro - Head of Rheumatology at The Royal Children's Hospital
Shahina Braganza - Emergency Physician Gold Coast Health
Mary Freer - Director, Freer thinking & Executive Producer Compassion Revolution
Kym Jenkins - President of the Royal Australian and New Zealand College of Psychiatrists
Why Maslow’s Hierarchy of Needs?
Maslow's Hierarchy of Needs provides a comprehensive view of wellbeing - physical, psychological and spiritual.
The Pandemic Kindness Movement uses a modified version to develop a broad approach to caring for our health
workforce.
The goal is to protect and boost the physical and
psychological health and wellbeing of our workforce.
There is no intention to offer any clinical or public
health advice or information, or training, except as it
relates to self-directed training in well-being
strategies.
All information links will point to advice that has
been endorsed by the expert PKM team and the ACI.
Jacqui Cross, Chief Nurse and Midwifery Officer
acknowledges the contribution and support
particularly in these current times.
https://youtu.be/bMaOxVHu33A
Podcast
Clinicians can prioritise their own
wellbeing and ease anxiety
33min Dr Lynne McKinlay Qld Health
Australian Red Cross
Pandemic Kindness Movement PKM
Lifeblood donation give blood save lives
https://www.donateblood.com.au/lifeblood
-teams/join
Responding to stress experienced
by hospital staff working with
COVID19 ….early interventions
The Kings Fund UK
2 minute toolkit – set the scene
#1 introduction video
#2 simulation video
https://vimeo.com/413005874
https://vimeo.com/413007940
Clinician wellbeing in the time of COVID19 resource examples
Accessibility to resources and support - Website
Website is hosted by ACI.
The Website is a responsive web design
(mobile/tablet compatible) to enhance accessibility
for all health staff.
Appropriate due diligence and governance of content
is carried out in accordance with existing health
policies and processes.
Physical/psychological safety is always paramount.
The Web build will ensure appropriate language is
used to support trauma-informed care and trauma-
informed kindness.
67,458 page views since launch
Most commonly “clicked” is Basic
Needs
Most popular resource set
Latest analytics
Trauma-informed kindness
Level 4, 67 Albert Avenue
Chatswood NSW 2067
PO Box 699
Chatswood NSW 2057
T + 61 2 9464 4666
F + 61 2 9464 4728
aci-info@health.nsw.gov.au
www.aci.health.nsw.gov.au
• Pandemic Kindness Movement
ACI-Kindness@health.nsw.gov.au
@PKMAUS1
• COVID Connexion – 24 hour
phone line 1300 509 989
Trusted and confidential advice for
health workers
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Specific issues and information week ending 30 July 2020
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Maternity
Issue What we know
Number of support people
allowed during labour and
birth, and number of visitors
In Victoria, new restrictions have been placed on support persons and visitors during
labour/birth and postpartum which reflect the high community transmission of COVID-
19.
NSW Health continues to maintain a conservative approach to the number of support
people allowed during labour and birth, and the number of visitors.
The Guidance for maternity and newborn care (V4) document advises that:
• for women at low risk of COVID-19, one support person may be present during
labour and birth, and one visitor postpartum, noting partners and carers should not
be considered visitors.
• for women who are suspected, probable or confirmed cases of COVID-19, one
consistent support person may be present during labour and birth, and one visitor
postpartum, noting partners and carers should not be considered visitors.
• Any compassionate or cultural considerations should be locally managed
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Neonatal
Issue What we know What we are doing Next steps
Does vertical
transmission of
COVID-19 occur?
A small number of cases have been reported, but
larger numbers in case studies have shown low
rates of transmission overall.
Irrespective of the possibility of vertical transmission
there is no requirement at this stage to change
guidance around clinical management, including the
use of personal protective equipment.
Providing clear direction in NSW Health
guidance for the COVID environment
(see links above)
Notify the
CoP if this
changes
The latest Guidance for maternity and neonatal services can be found here:
• Neonatal Services https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-practice/Pages/nicu-and-special-care-
nursery.aspx
• Maternity and Newborn https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-practice/Pages/maternity-and-newborn-
care.aspx
• The Safety Notice regarding the use of viral filters can be found here:
Use of Viral Filters for Respiratory Care in Neonates http://internal.health.nsw.gov.au/quality/sabs/
• Management of COVID-19 in Healthcare Settings Version v3.2
http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0019/582112/Management-of-COVID_19-in-Healthcare-Settings.pdf
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Neonatal
Issue What we know What we are doing Next steps
Is a screaming baby
considered an
aerosolising event?
A newborn baby who screams is not an aerosolising event.
The PPE Staff should wear when caring for the baby will be
guided by the individualised care plan developed following a
risk assessment.
At birth the PPE required when caring for the baby will mirror
the PPE required for the mother
Providing clear direction in
NSW Health guidance for the
COVID environment (see
links in slide above)
Encouraging clinicians to
develop individualised care
plans for women and babies
who are positive for COVID-
19
Notify the
CoP if this
changes
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Child and Family HealthNew and emerging issues
Issue What we know What we are doing Next steps
Guidance on Child and Family
Health Services
Version 5 is currently being
drafted.
Developing advice that is
focused on continuing to offer
a service adhering with the
current PPE requirements.
Districts to continue to offer
CFH services with use of a
mix of modalities.
Advice on groups Advice is required on
conducting groups in a COVID
safe manner.
Guidance is currently being
developed by the CEC and will
be available shortly.
Districts to be able to offer
group services to families.
PPE Healthcare workers are
required to wear a mask if
caring/working within 1.5m of
any patient.
Seeking specific advice on
how this applies to Child and
Family Health service delivery.
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Child and Family HealthResources for Parents and Carers
• Information for parents and carers,
Raising Children’s Network
• World Health Organisation,
#HealthyAtHome- Healthy Parenting
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Child and Family HealthResources for Clinicians
• Leading through COVID-19: Supporting health
and care leaders in unprecedented times, The
King’s Fund
• Families in Australia Survey, Life during COVID-
19, Report 1: Early Findings, Australian Institute
of Family Studies
• Stress, Resilience, and the Role of Science:
Responding to the Coronavirus Pandemic,
Centre on the Developing Child, Harvard
University
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Australian Institute of Family Studies
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Thank youAsk questions via:
MOH-maternityNICU-SCN-CFH-COVID-
19@health.nsw.gov.au
Find COVID-19 NSW Health Information:
www.health.nsw.gov.au/Infectious/diseases/Pages/coronaviru
s.aspx
Next meeting: 9am 27 August 20