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Covid-19 HSE Clinical Guidance and Evidence

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Cancer Care Rapid Access Clinics

NCCP advice for Medical Professionals on minimising COVID-19 risk in the Symptomatic Breast Disease Clinics (CD19-103-002 / 01.10.20)


  • This document relates to patients who do not have COVID-19 or are not suspected of having COVID-19.
  • Current events surrounding the COVID-19 pandemic are challenging and all public health bodies are placing the safety of patients, staff and communities first in all decisions.
  • This is an evolving situation. This advice is based on current information, it is additional to the advice of the NPHET, the HSE and the DoH, and will be updated as necessary.
  • The NCCP acknowledges that each hospital is working under individual constraints, including staff and infrastructure, and as a result will implement this advice based on their own unique circumstances.
  • The purpose of this advice is to maximise the safety of patients and make the best use of HSE resources, while protecting staff from infection. It will also enable services to match the capacity for cancer care to patient needs if services become limited due to the COVID-19 pandemic.
  • Any clinician seeking to apply or consult these documents is expected to use independent medical judgement in the context of individual clinical circumstances to determine any patient's care or treatment.

 


NPHET, HSE and DoH advice

Hospitals will operate under the overarching advice of the National Public Health Emergency Team (NPHET), the HSE and the DoH. Information is available at:

 


Purpose
  • The purpose of this document is to provide guidance to medical professionals on what infection control measures should be employed in Symptomatic Breast Clinics during the COVID-19 pandemic.

 


Knowledge of patient’s COVID-19 exposure risk prior to appointment
  • Patients should be contacted to ascertain their COVID-19 exposure status 24 hours prior to SBD appointment. The appointment should be deferred if a patient is any of following:
  1. Confirmed COVID-19 positive
  2. Unconfirmed, but displaying symptoms of COVID-19
  3. A close contact of a confirmed case of COVID-19
  4. In a household with somebody displaying symptoms of COVID-19
  • Patients who are confirmed COVID-19 positive or are displaying symptoms of COVID-19 are required to self-isolate until they have had no fever for five days AND it has been 10 days since their symptoms first developed. Their appointment should be deferred accordingly.
  • Patients who are a close contact of a confirmed case of COVID-19, or are in a household with somebody displaying symptoms, should have their appointments delayed for a minimum of 14 days.

 


Attendance at the SBD Clinic

Consult the most up-to-date information for health care professionals on the HPSC website and link with your local infection prevention and control team for specific advice.

  • Ensure there are hand hygiene facilities with appropriate signage.
  • Stagger appointments to facilitate social distancing.
  • Ensure social distancing practises are facilitated in clinic waiting areas where possible.

 


Clinical exam, radiological exam and biopsy

Consult the most up-to-date information for health care professionals on the HPSC website.

  • All clinicians should take use standard precautions including hand hygiene.
  • Hand hygiene, gloves and an apron should be used if there is a chance the clinician will come in contact with blood or bodily fluids.
  • A fluid-resistant mask and eye protection (goggles or visor) should be used if there is a risk of splashing into the face or eyes of the clinician. 
  • Use of scrubs is as per local protocol.

 


Guidance Development Group
  • Dr Eve O’Toole, Guideline Lead
  • Ms Maeve Cusack, Programme Manager
  • Ms Juliette Buckley, Consultant Breast Surgeon
  • Dr Sorcha McNally, Consultant Radiologist
  • Mr Martin O’Sullivan, Consultant Breast Surgeon
  • Dr Niamh Kilgallen, Senior Research Officer
  • Dr Helena Gibbons, Senior Research Officer
  • Mr John Gleeson, NCCP
  • Mr Pat Cafferty, NCCP
  • Ms Laura Loughrey, NCCP
  • Dr Una Kennedy, GP/NCCP
  • Mr Mitchel Barry, Consultant Breast Surgeon
  • Dr Carmel Ann Daly, Consultant Radiologist
  • Dr Deirdre Duke, Consultant Radiologist
  • Prof. Arnold Hill, Consultant Surgeon
  • Ms Liz Connelly, Consultant Surgeon
  • Mr Terry Boyle, Consultant Surgeon
  • Mr Damian McCartan, Consultant Surgeon
  • Prof. Michaela Higgins, Consultant Medical Oncologist

National Health Library & Knowledge Service. Health Service Executive. Dr. Steevens' Hospital, Dublin 8. Tel: 01-6352555/8. Email: hselibrary@hse.ie

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