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Role of nurse at Community
Health Centre in covid-19
Alka Mishra
Public Health Nurse
VMMC & Safdarjung Hospital New Delhi
Content
• What is Covid-19?
• How its spread?
• Sign and symptoms
• Diagnosis
• Role of Nurse at CHC
• Prevention
• Detection
• Response
What is covis-19
• COVID-19 is the infectious disease
caused by the most recently discovered
coronavirus. This new virus and disease
were unknown before the outbreak
began in Wuhan, China, in December
2019. COVID-19 is now a pandemic
affecting many countries globally.
How it spreads
• Spreads primarily from person to person through small droplets
from the nose or mouth
• These droplets can land on objects and surfaces around the
person such as tables, doorknobs and handrails.
• People can become infected by touching these objects or
surfaces, then touching their eyes, nose or mouth
Sign & Symptoms
• Fever
• Dry cough, and tiredness
• Some patients may have aches and pains,
• Nasal congestion,
• Sore throat or diarrhoea.
• Most people (about 80%) recover from the disease without needing
hospital treatment.
• Around 1 out of every 5 people who gets COVID-19 becomes seriously ill
• People with co-morbidities are at greater risk for complications
Diagnosis
• Confirmation of diagnosis based on lab
test
• A swab test: The lab will take a special
cotton swab and sample the inside of the
throat or nose
• A nasal aspirate: The lab will inject a
saline solution into your nose, then
remove the sample with gentle suction.
• A tracheal aspirate: A thin, lighted tube
called a bronchoscope goes into your
lungs, where a sample will be collected.
• A sputum test: Sputum is a variation of
mucus from your lungs that can be
coughed out or sampled from the nose
with a swab
Role of Nurse at CHC
• Prevention
• Control
• Response
Prevention
Prevention at
Community
level
Prevention at
Community
Health Centre
Prevention at
individual
level
Prevention at community level
Organize and carry out
social media campaigns
to promote social
distancing and advocate
for timely policies.
01
Encourage strategies in
their neighbourhoods
and online to promote
mental and physical
health and resilience.
02
Arrange food and
medications to the
elderly, poor,
immigrants, and other
vulnerable residents.
03
What Health Teaching Should I Be Providing To Community
Members?
Hand washing-
• Frequency and
• Technique
1
Respiratory
hygiene
2
What to do if
feeling sick
3
Hand washing
• Regular proper handwashing with soap and water
• After contact with high-touch surfaces
• Before and after touching the face o
• Before and after handling food
• After using the washroom o
• Use alcohol-based (minimum 60% ethyl alcohol) hand sanitizers
if soap and water are not available
• Regularly cleaning high touch surfaces
• Closing the lid of the toilet when flushing o There is a risk of
“fecal shedding” with COVID-19
Respiratoty hygiene
Staying home
when sick
Avoiding close
contact with
people who are
sick
Covering cough
and sneezes
Coughing into
flexed elbow
Coughing into
tissues and
discarding
Wear mask
How to dispose
masks
What to do if feeling sick
Calling the clinic
before visiting
if you are
experiencing any
Influenza-Like Illness
(ILI) or COVID-19
symptoms
Prevention at Community Health Centre
Triage of patients
Arrange separate
waiting area for
patients with ILI
Identify a Lead within
your Health Centre or
Nursing Station who will
complete and regularly
review COVID-19
Readiness Assessment for
Nursing Stations and
Health Centres
Follow routine
infection practices
which include:
Applying basic
principles of
Infection Control
and additional
precautions
Respiratory hygiene: If
patients have refused
to mask, ask patient to
cough into tissue and
to discard, then wash
hands
• Perform hand
hygiene immediately
after contact with
respiratory secretions
Appropriate
equipment and
cleaning materials
should be available
and used
Regularly cleaning
and disinfection
environmental
surfaces.
Educate all staff about
this situation and
specifically about how
the virus is spread.
Ensure that you have
the appropriate
Personal Protective
Equipment (PPE)
available.
Keep up to date with
the latest information
and clinical guidelines
When to
wash hands
Disinfection of all
the surfaces and
equipment once
daily or each time
after coming in
contact with
patients. Using 1%
sodium
hypochlorite
01
Patient care items
and surfaces that
can contribute to
the spread of
infection include:
02
· Stethoscopes ·
Blood pressure cuffs
· Monitors ·
Stretchers,
backboards, and
immobilization
devices ·
Laryngoscope
blades
Radios/mobiles ·
Shelves · Door
handles · Other
items and surfaces
which are touched
very often
Managing community services
With help of ASHA’s and ANM’s
inform community about
cancellation of immunization
Schedule
Telephonic follow up
with the specific sub-
population groups such
as-
Pregnant women with
EDD in current month &
all High-risk pregnancy
New-Borns, Children
due for immunization,
Children with SAM
(severe or acute
malnourishment),
Patients on treatment for TB, leprosy,
HIV and viral hepatitis, patients with
hypertension, diabetes, COPD, mental
health, etc
Prevention at individual level
1
Take droplet
and contact
precautions
while
dealing with
patients.
2
Use PPE
depending
upon type of
potential
exposure
3
Clean your
hands often.
Use soap and
water, or an
alcohol-based
hand rub.
4
Maintain a
safe distance
from anyone
who is
coughing or
sneezing.
5
Don’t touch
your eyes,
nose or
mouth.
6
Cover your
nose and
mouth with
your bent
elbow or a
tissue when
you cough or
sneeze.
7
Stay home if
you feel
unwell.
8
If you have a
fever, a cough,
and difficulty
breathing,
seek medical
attention
9
Remaining
calm: high
stress
increases the
risk of
becoming
vulnerable to
many illnesses
Detect
Learn the signs and
symptoms of COVID-19
and help staff to answer
questions from the
public.
Refer possible COVID-19
patients to Physician
locate their nearest
testing centre and
organize transportation.
Respond
Call
people with
COVID-19
who are in
self-isolation
with mild
symptoms
and monitor
them for
worsening
symptoms.
Special
Emphasis
Special
emphasis on
patients
with co-
existing
diseases
Provide
Provide
moral
support and
organize
food
deliveries
for people
with COVID-
19 at home.
Monitor
patients for
worsening
symptoms
and support
rapid
referral of
people who
require
hospitalizati
on.
Support
*contact tracing
*symptom
reporting
monitoring of
contacts of
COVID-19 patients
* ensure access
to testing and
treatment for
people who
develop signs and
symptoms.
Help
Help
hospitals
and non-
profits raise
funds for the
most
vulnerable.
Resources
1. https://www.who.int/news-room/commentaries/detail/advice-on-
the-use-of-point-of-care-immunodiagnostic-tests-for-covid-19
2. https://www.mohfw.gov.in/pdf/Poster_Corona_ad_Eng.pdf
3. https://www.mohfw.gov.in/pdf/EssentialservicesduringCOVID19upd
ated0411201.pdf
4. https://www.mohfw.gov.in/pdf/StandardOperatingProcedureSOPfo
rtransportingasuspectorconfirmedcaseofCOVID19.pdf
 Call at Ministry of Health, Govt. of
India’s 24X7 control room number
 +91-11-2397 8046
 Email at ncov2019@gmail.com

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Role of Nurses in COVID-19 Detection at CHCs

  • 1. Role of nurse at Community Health Centre in covid-19 Alka Mishra Public Health Nurse VMMC & Safdarjung Hospital New Delhi
  • 2. Content • What is Covid-19? • How its spread? • Sign and symptoms • Diagnosis • Role of Nurse at CHC • Prevention • Detection • Response
  • 3. What is covis-19 • COVID-19 is the infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019. COVID-19 is now a pandemic affecting many countries globally.
  • 4. How it spreads • Spreads primarily from person to person through small droplets from the nose or mouth • These droplets can land on objects and surfaces around the person such as tables, doorknobs and handrails. • People can become infected by touching these objects or surfaces, then touching their eyes, nose or mouth
  • 5. Sign & Symptoms • Fever • Dry cough, and tiredness • Some patients may have aches and pains, • Nasal congestion, • Sore throat or diarrhoea. • Most people (about 80%) recover from the disease without needing hospital treatment. • Around 1 out of every 5 people who gets COVID-19 becomes seriously ill • People with co-morbidities are at greater risk for complications
  • 6. Diagnosis • Confirmation of diagnosis based on lab test • A swab test: The lab will take a special cotton swab and sample the inside of the throat or nose • A nasal aspirate: The lab will inject a saline solution into your nose, then remove the sample with gentle suction. • A tracheal aspirate: A thin, lighted tube called a bronchoscope goes into your lungs, where a sample will be collected. • A sputum test: Sputum is a variation of mucus from your lungs that can be coughed out or sampled from the nose with a swab
  • 7. Role of Nurse at CHC • Prevention • Control • Response
  • 9. Prevention at community level Organize and carry out social media campaigns to promote social distancing and advocate for timely policies. 01 Encourage strategies in their neighbourhoods and online to promote mental and physical health and resilience. 02 Arrange food and medications to the elderly, poor, immigrants, and other vulnerable residents. 03
  • 10. What Health Teaching Should I Be Providing To Community Members? Hand washing- • Frequency and • Technique 1 Respiratory hygiene 2 What to do if feeling sick 3
  • 11. Hand washing • Regular proper handwashing with soap and water • After contact with high-touch surfaces • Before and after touching the face o • Before and after handling food • After using the washroom o • Use alcohol-based (minimum 60% ethyl alcohol) hand sanitizers if soap and water are not available • Regularly cleaning high touch surfaces • Closing the lid of the toilet when flushing o There is a risk of “fecal shedding” with COVID-19
  • 12. Respiratoty hygiene Staying home when sick Avoiding close contact with people who are sick Covering cough and sneezes Coughing into flexed elbow Coughing into tissues and discarding Wear mask How to dispose masks
  • 13. What to do if feeling sick Calling the clinic before visiting if you are experiencing any Influenza-Like Illness (ILI) or COVID-19 symptoms
  • 14. Prevention at Community Health Centre Triage of patients
  • 15. Arrange separate waiting area for patients with ILI Identify a Lead within your Health Centre or Nursing Station who will complete and regularly review COVID-19 Readiness Assessment for Nursing Stations and Health Centres Follow routine infection practices which include: Applying basic principles of Infection Control and additional precautions Respiratory hygiene: If patients have refused to mask, ask patient to cough into tissue and to discard, then wash hands • Perform hand hygiene immediately after contact with respiratory secretions Appropriate equipment and cleaning materials should be available and used Regularly cleaning and disinfection environmental surfaces. Educate all staff about this situation and specifically about how the virus is spread. Ensure that you have the appropriate Personal Protective Equipment (PPE) available. Keep up to date with the latest information and clinical guidelines
  • 17. Disinfection of all the surfaces and equipment once daily or each time after coming in contact with patients. Using 1% sodium hypochlorite 01 Patient care items and surfaces that can contribute to the spread of infection include: 02 · Stethoscopes · Blood pressure cuffs · Monitors · Stretchers, backboards, and immobilization devices · Laryngoscope blades Radios/mobiles · Shelves · Door handles · Other items and surfaces which are touched very often
  • 18. Managing community services With help of ASHA’s and ANM’s inform community about cancellation of immunization Schedule Telephonic follow up with the specific sub- population groups such as- Pregnant women with EDD in current month & all High-risk pregnancy New-Borns, Children due for immunization, Children with SAM (severe or acute malnourishment), Patients on treatment for TB, leprosy, HIV and viral hepatitis, patients with hypertension, diabetes, COPD, mental health, etc
  • 19. Prevention at individual level 1 Take droplet and contact precautions while dealing with patients. 2 Use PPE depending upon type of potential exposure 3 Clean your hands often. Use soap and water, or an alcohol-based hand rub. 4 Maintain a safe distance from anyone who is coughing or sneezing. 5 Don’t touch your eyes, nose or mouth. 6 Cover your nose and mouth with your bent elbow or a tissue when you cough or sneeze. 7 Stay home if you feel unwell. 8 If you have a fever, a cough, and difficulty breathing, seek medical attention 9 Remaining calm: high stress increases the risk of becoming vulnerable to many illnesses
  • 20. Detect Learn the signs and symptoms of COVID-19 and help staff to answer questions from the public. Refer possible COVID-19 patients to Physician locate their nearest testing centre and organize transportation.
  • 21. Respond Call people with COVID-19 who are in self-isolation with mild symptoms and monitor them for worsening symptoms. Special Emphasis Special emphasis on patients with co- existing diseases Provide Provide moral support and organize food deliveries for people with COVID- 19 at home. Monitor patients for worsening symptoms and support rapid referral of people who require hospitalizati on. Support *contact tracing *symptom reporting monitoring of contacts of COVID-19 patients * ensure access to testing and treatment for people who develop signs and symptoms. Help Help hospitals and non- profits raise funds for the most vulnerable.
  • 22. Resources 1. https://www.who.int/news-room/commentaries/detail/advice-on- the-use-of-point-of-care-immunodiagnostic-tests-for-covid-19 2. https://www.mohfw.gov.in/pdf/Poster_Corona_ad_Eng.pdf 3. https://www.mohfw.gov.in/pdf/EssentialservicesduringCOVID19upd ated0411201.pdf 4. https://www.mohfw.gov.in/pdf/StandardOperatingProcedureSOPfo rtransportingasuspectorconfirmedcaseofCOVID19.pdf
  • 23.  Call at Ministry of Health, Govt. of India’s 24X7 control room number  +91-11-2397 8046  Email at ncov2019@gmail.com