May 26, 2020:
We've revised and reordered the content below in response to feedback from nurses—click here to visit the new webpage.
The following guidance has been developed collaboratively by the BC Health Regulators with expertise and direction provided by the Provincial Health Officer (PHO), the BC Centre for Disease Control (BCCDC) and WorkSafeBC. It is intended for all registrants in community practice and is applicable for the duration of the COVID-19 pandemic.
Note that this guidance reflects
the best evidence available at this time and it will change as required to reflect updates in our understanding of the virus and its transmission. Resources that are linked to in the guidance are also subject to change, and registrants need to be watch closely for updates from BCCNP as well as updated guidance from the Provincial Health Officer, BC Centre for Disease Control and WorkSafeBC.
During COVID-19, registrants of the BC College of Nursing Professionals (BCCNP) were directed to reduce all non-essential and elective services involving direct physical contact with patients and clients to minimal levels, and to provide virtual care whenever possible except for rare circumstances that might lead to imminent patient harm.
With recent announcements from Premier John Horgan and Dr. Bonnie Henry, the provincial health officer, registrants can begin to resume in-person practice in a way that promotes safe care to patients and, continues to prevent the spread of the virus. As this new normal is being defined, registrants will have to adjust how they deliver care, conduct business, and attend to physical environments to ensure best infection and prevention control practices. In some cases, the ongoing use of digital technology to provide virtual care may still be a very good option.
This guidance to registrants will assist in determining which services are reasonable to resume in the coming weeks. BCCNP recognizes that registrants would like very clear and specific direction on what is considered
reasonable; however, it is not possible to address all scenarios.
As professionals, BCCNP expects registrants to collaborate with colleagues in similar practices when making these decisions and to use professional judgement to determine what is in the client's interest. BCCDC has developed interim guidance for registrants who work in outpatient and ambulatory care settings which has been approved by the PHO. BCCNP expects registrants to read this guidance and follow the expectations for infection prevention and control as they resume work in community settings.
BC Centre for Disease Control: Infection Prevention and Control for COVID-19: Interim Guidance for Outpatient and Ambulatory Care Settings.
Note: this document is expected to be available shortly; please check the BCCDC website regularly for updates.
BCCNP encourages all registrants to take the time required to review all guidance documents and make the necessary adjustments to community practice to ensure safe practice. While in-person services may resume on May 19th there is no requirement to re-open by this date.
The following guiding principles and assumptions have been identified as foundational for reintroducing health-care services in the context of COVID-19:
When services resume, registrants may face difficult decisions regarding which patients to see and the prioritization of service provision. The registrant is accountable for prioritizing access to in-person services based on clinical judgment and with consideration given to the patient perspective and the referral source (if applicable).
When determining priority for in-person care, registrants should reflect upon the following considerations:
Public health officials have indicated that COVID-19 is expected to continue to circulate in the general population for an extended period. As such, ongoing measures to control the spread of the disease are anticipated, including requirements to practise physical distancing of at least two metres (six feet) and increased screening for signs, symptoms and risk factors for COVID-19.
Recommendations regarding use of PPE in the practice environment should follow the directives and recommendations provided by BCCDC and WorkSafeBC. BCCDC has general PPE information on their website, which is anticipated to be updated next week, so please check the BCCDC website regularly for updates.