Office Protocols for COVID-19 prevention | Adoro Medical Spa

Patient Instructions Prior To Arrival

1. When an appointment is made, let the patient know that we are asking for a phone call from them the day of the visit to complete a pre-arrival screening. Instruct each patient to take their temperature with a thermometer prior to the screening call, and to be prepared to wear a fresh mask during their visit. During this call, we will ask the patient:
   1. What is your temperature today?
   2. Do you have the sniffles?
   3. A sore throat
   4. A cough
   5. Shortness of breath
   6. Loss of smell or taste
   7. Nausea/vomiting/diarrhea
   8. Contact with anyone with COVID
   9. Contact with anyone with any of the above symptoms

2. Once Ok to come in, ask that they call us again on arrival in the parking lot
3. If the front desk is clear the patient may come up, if not, have them wait in their car and we will call them to come up when we are ready for them to come into the office
4. Meet the patient at the elevator, take their temperature and assess smell (Shell) bring a Cavi wipe
5. Using the Cavi wipe, open the doors for patient, and Instruct the patient to come in with their mask on.
6. Let them know that we will ask them to accept hand sanitizer on arrival, or they must wash hand for 20 seconds on arrival
7. Disinfect thermometer and place at front desk in holder

Procedure for flowing the patient through the office

1. Signing in-done by the front desk, not the patient. Remove pens
2. Dispense the hand sanitizer with gloved hands, N95 mask and shield
3. Hand patient a sanitized pen if signatures needed and or consents need to be signed, and sanitize pen again once patient is done using it
4. Tech takes the patient to the lane where patient will be seen and drop off purse /jackets/phone/any personal items on a chair or sink counter, and then proceed to the photo room
5. The patient may remove their mask once in the photo room for photos
6. Bring the patient to the lane and prep for treatment. Check that all appropriate consents have been signed.
7. Once the treatment is completed, the patient may mask again prior to leaving the lane
8. Sanitize the lane according to protocol (see next list)
9. Prior to patient leaving room, the assistant will buzz the font desk to make sure it is clear of other patients, and to also check that no one is on their way up from car. If not clear, ask patient to wait until Front Desk calls back with the clear.
10. At check out, offer the credit card reader for the patient to insert their card so we don’t need to handle those if at all possible. If you must handle the credit card, have a tissue in your hand to handle it and give it back, then sanitize your hands/gloves
11. Skin Care products will be bagged in closet with gloved hand (washed) and placed on counter for patient to take home.

Procedure for sanitizing the lanes:

1. Wash outer gloves once patient leaves the room
2. If a pillow was used, remove the cover and place a new one on the pillow. Place it back in the cabinet.
3. Replace clear headrest cover.
4. Cavi wipe the items on the counter. This includes anything that was used.  Start with the least contaminated, ie. counters, all handles, surfaces, cabinet fronts, alcohol dispensers, 2×2 container, mouse, keyboard, phone buttons, pens, and finish with the most contaminated, door handles inside door and out, and lastly the exam chair.
5. Discard wipe inside the outer gloves, and discard outer gloves too.
6. Wash the gloves that remain.
7. Allow 10 minutes before using the room again.

PPEs

1. Clinical staff and Laura when in a lane interacting with patients will wear:
   1. An N95 mask – each will have four (4) masks labeled with our name, date of initial use and Monday, Wednesday, Thursday and Friday. The day’s mask will be used throughout that day’s clinic, removed with gloved hands without touching the exposed surface, sprayed with Isopropyl Alcohol at the end of the day and hung to dry for at least 72hrs. With four masks in rotation for each clinical employee, each mask will be used once a week. Studies have shown that properly sanitized masks remain effective for at least ten (10) weeks of continuous use unless soiled or torn. A soiled or torn mask will be discarded and replaced with a new one.
   2. A shield – each employee will have one shield which will be worn when patients are in the office, and will be cleaned with soap and water at the end of each day. Please label your shield. We don’t have too many of these, so treat them with care and avoid scratching the surface.
   3. Gloves – clinical staff will wash their hands before starting work and don a pair of nitrile gloves. These gloves will be our hands while in clinic and they will be washed and sanitized as if they were our bare hands, thus preventing over-drying or making our skin raw from all the hand washing and sanitizing solutions.
   4. A second pair of gloves will be worn for each patient encounter, and that pair will be discarded before we exit the exam room.
   5. A disposable gown – I am open to comment here, since gowns will mainly serve to keep our clothes clean for when we go home, and are less crucial to keep from having the virus enter our bodies.
2. Non-clinical staff will also wear an N95 mask, a face shield (at the front desk) and gloves. Gloves will be sanitized between patients with hand sanitizer and may be washed with soap and water.
3. All Staff will wear regular surgical masks (not N95) on non-patient days.

Guidelines for general social distancing and mask wear while at work, and kitchen use

1. We will maintain a minimum of six feet of distance between staff members at all times, unless we are in full PPE getup and proximity is called for during patient care activities.
2. Each employee will be asked to dispose of their gloves and wash their hands for at least 20 sec in the bathroom prior to entering the kitchen. Up to 2 people only in the kitchen at one time, keeping the full six feet of distance at all times.  Keep masks on while preparing food.  Only remove mask once seated and eating.   Only one person should be preparing food at a time. (2^nd person should be seated).    Upon leaving the kitchen, each employee will be responsible for sanitizing their chair, the table and kitchen counter surfaces, microwave, the refrigerator handles, cabinet handles, soap dispenser handles, the faucet, water dispenser toggles, any other surface in contact, and the door handle prior to exiting the kitchen.   **** Then it will be a sanitized environment prior to the next employee entering.
3. Surgical masks will be worn properly by each of us and at all times to minimize non-filtered air. No one should be in the building at any time with their mask off, or mask not fitted properly.   Filtering as much of the inhaled and exhaled air as possible is important. Masks will only be removed in the kitchen while on lunch break. 

Please encourage each other to comply with the above to ensure our safety, the safety of our families, and the safety of our patients.    Let us be comfortable reminding each other of the protocols, if you see anything that needs to be addressed.