Keeping You Safe: There’s More To It Than Meets The Eye

11/06/2020

As I stated in my very first ‘Blog’ of 25^th March:

‘The Meltdown Stops: Tactics Begin’.

We are well over that stage. We are ready and very keen to roll out our experience of operating under full lock down to our routine work.

Throughout lockdown we had a vital obligation to remain open with a ‘Medical Optometrist’ on-call for emergencies outside normal hours. Our goal always was, and remains, to ensure no one is needlessly referred to the hospital. During lockdown we ‘non-furlough 4’, had 2 months to prepare entire practice processes, not simply protective barriers. Vitally, this means when allowed to open fully, our physical protective screening has been stress tested in ‘real world’ conditions AND new practice processes, practice layout honed to ensure patient and colleague safety.

Understanding and controlling practice flow is as important, if not more so, than masks and aprons. Mouth masks and gloves may give a sense of security, but it is social distancing, full face and equipment screens and correct handwashing that protects us all.

We are fortunate to have two floors; one optometrist will be upstairs and one downstairs. There will be no mixing. Further, each optometrist has 2 rooms each. While one is being used the other is thoroughly cleaned. Equipment is sterilized in a UVC unit. We will only have two optometrists in per day, initially. One-hour tests are planned to absolutely ensure there is no overlap or delay.

Practice flow will be one way in, one way out.

The optometrists will certainly have a new ‘look’: scrubs, face shields, full apron smocks and disposable gloves during examinations.

Outside the clinic room, gloves are NOT recommended, and in fact help contaminate. The priority on the floor is equipment and dispensing shields, face shields for dispensing staff as well as strategic antiseptic dispensers. Three levels of sterilising are recommended

1. 50:1 Domestos
   1. Used for surfaces, door handles, large industrial reusable gloves for door opening and carrying anything from outside (post, broken frames)
2. Soap and Water
   1. This destroys the virus membrane and remains the gold standard for hand cleaning – must be done properly – see Handout
3. Antiseptic gels
   1. Between hand washes, and if your hands are clean, antiseptic wipes are effective but do not replace thorough hand washing.

At the point of dispensing spectacles, we will do all the work. You remain at a shielded dispensing desk. Measurements are computer generated without physical contact. As well as the desk shields the dispenser themselves will be wearing a face shield.

All frames are brought to you. Prior to bringing an initial selection to you it is important to discuss what you need and what you value. We have no right to dictate what we think you want: our role is to ensure you have the fullest choice. After the initial assessment of your needs, frames will be brought to you, and choices honed as we identify your requirements.

After physical contact, all frames are placed immediately in one of our 6 UVC sterilisers before being returned for general display. No one else will ever contact an unsterilised frame.

All visits are by appointment only to ensure we all keep distanced and patient flow can be controlled.

We have developed an excellent remote triaging technique for emergencies while in lock down. The patient is remotely triaged first with a full case history. If necessary, photographs of the eye(s) are emailed to the practice. After photograph analysis the patient is re-contact and a clinical management plan discussed. This works extremely well and only a minority of patients are required to physically attend the practice. Remote reviews are continued until full resolution is confirmed.

We will continue this for more routine situations, with the patient’s consent. Contact Lens ordering, assessment of broken spectacles, trouble-shooting spectacle difficulties; ideally pre-empting a solution before you come to the practice or perhaps avoid a visit completely.

While patients are in practice, we are keeping the amount of people who can access the practice limited. For this reason, we ask for you to attend appointments alone and only if necessary, one other person.