Update to Point-of-Care Risk Assessment Process Confirmed
The BC Centre for Disease Control (BCCDC) has updated its point-of-care risk assessment (PCRA) routine practice document to include considerations for when to wear a respirator instead of a medical mask.
This incremental change has the potential to make it easier for members to access an N95 respirator when they deem it necessary, but the update should have come long ago. BCNU remains concerned that the application of the PCRA process will continue to lack consistency in its application until the provincial Personal Protective Equipment (PPE) Allocation Framework is amended to recognize the aerosolized spread of COVID-19 and remove reference to droplet precautions.
According to the BCCDC, the following are examples of scenarios with an elevated risk of COVID-19 aerosol transmission:
- being in a room or unit with multiple patients who are suspected or confirmed to have COVID-19 (e.g., cohort unit or COVID-19 test collection and assessment centres)
- being in a room or unit where frequent or unexpected aerosol-generating medical procedures (AGMPs) may occur
- when there is prolonged close proximity to the patient (e.g., more than 15 minutes of face-to-face contact)
- when the patient has excessive and sustained coughing without wearing a medical mask for source control
- when it is anticipated that the patient will be doing an activity with heavy expiratory exertion (e.g., shouting)
Other scenarios may exist, and this list is not exhaustive. The updated PCRA document continues to state that an N95 respirator will be provided when a health-care worker determines that there is an elevated risk of transmission of COVID-19.
In all cases, BCNU believes that employers must respect the clinical judgment of nurses to protect themselves adequately, and that members be provided with a respirator in situations where the member determines an elevated risk of aerosol-based transmission for COVID-19 exists.
Members who have not been provided with a respirator following a PCRA have additional rights and are asked to contact BCNU directly at healthandsafety@bcnu.org for further information and support.
All members are encouraged to download and review the updated BCCDC PCRA tool.
Throughout the COVID-19 pandemic, BCNU has been steadfast in its call that nurses and other health-care workers receive the highest levels of required PPE, including N95 respirators. The union has directly called on Health Minister Adrian Dix to expand access to respirators, especially in light of growing evidence of the risk of aerosol-based transmission of the Omicron variant.
BCNU will continue to call for the updating of the provincial PPE Allocation Framework to recognize aerosolized spread of COVID-19, and to allow nurses unfettered access to N95 respirators when they deem it necessary.
This update applies to all health care settings including community, long-term care and acute worksites. In order to be effective, a respirator must be fit-tested to the individual user and prior to use, the employer must provide users with training in donning and doffing and performing seal checks.
Understanding the Amended BCCDC COVID-19 PCRA Tool
Resources for OHS representatives and steward teams
