COVID-19 Office Protocols
Training and Educating Our Team
One of the most important things we are doing during this time is to train and educate our staff at Susan
• Our team has had refresher training in proper hand washing techniques. This may seem basic;
however, it is the most important thing we can do to prevent spread of the virus yet research shows
that it is often poorly complied with and usually not done well. Consequently, we have spent a lot of
time ensuring that our team does it well and often, especially before and after every patient encounter.
• We practice the appropriate use of personal protective equipment (PPE) prior to caring for a patient to
• We encourage staff that is not feeling well to proactively stay home for two weeks.
• We have everyone in the office take their temperature at the beginning of every day and we will
immediately send home anyone with an elevated temperature (100.4 F and above).
• We limit the numbers of staff providing their care to facilitate social distancing within the office and
among team members.
• We have created a specific checklist of recommendation for our team to follow so that they arrive to
work healthy and go home to their families without worry. (see Checklist of Recommendations for Our
Recommendations for Our Team Before coming to work
• Take temperature (do not go in to work if you or any other family member are experiencing
symptoms; cough, sore throat, fever…etc.)
• Remove watch and rings and leave at home
• Tie hair up, keep nails short
• Avoid extra accessories
• If bringing a lunch, place in disposable wrapping
• Bring work clothes in a washable bag (i.e. pillow case)
• They have practiced the appropriate use of personal protective equipment (PPE) prior to caring for a
patient to prevent contamination.
• Change into scrubs and work shoes as soon as you arrive
• Use PPE as appropriate
• Leave all clutter (pens, phones, etc.) outside of patient op rooms
• We discourage workers from using other workers phones, desks, offices and other work tools and
equipment when possible.
• Clean phone handset after use
• Discourage cell phone use at work
• Wash hands and arms with soap
• Remove scrubs and place in washable bag or leave at work
• Wash hands and put clean clothes on
• Sanitize phone, glasses, etc
• Wash hands again
• Do not touch anything
• Remove shoes and clothes
• Wash clothes/scrubs in washing machine with detergent and hot water
• Shower immediately with soap and water before touching anything (including loved ones)
Patient Interviews and Social Distancing
Before patient arrival every effort is made to:
• Filter patients during the phone call when scheduling appointments for care using established and
recommended screening checklists and scripts
• Prepare scripts and questions to recognize potential carriers
• Reschedule patients who show any signs of a cough or fever or who describe having any concerning
• Instruct patients to call ahead and reschedule their appointment if they develop symptoms of a
respiratory infection (e.g., cough, sore throat or fever) on the day they are scheduled to be seen.
To promote social distancing
• Prioritize high risk patients (immune compromised, over 60 years. etc.) with early morning
appointments so less contact with other people
• When booking patients, we are spreading out the schedule so there are less people in the waiting
room (A maximum of two people at a time)
• If a patient is being accompanied, their escort should wait in the car to limit the number of people in
the waiting room and promote social distancing
• Utilizing a “virtual” waiting room: patients will be asked to wait in their car or outside the office where they
can be contacted by mobile phone when it is their turn to be treated.
Safety measures taken upon arrival
• Limit points of entry to the clinic.
• Post visual alerts (e.g., signs, posters) at the entrance door advising patients of the COVID-19 risk and
advising them not to enter the facility when ill.
• Masks and tissues are made accessible immediately upon entry and instructions are provided on how
to use tissues to cover nose and mouth when coughing or sneezing, to dispose of tissues and
contaminated items in waste receptacles.
• Provide supplies such as alcohol-based hand rub (ABHR) with 60-95% alcohol, tissues and no-touch
receptacles for disposal, at the entrance, in waiting rooms and at front desk.
ALL these measures can help to prevent transmission to others.
Measures Upon Arrival
• Immediately asked to use hand sanitizer
• Asked about the presence of symptoms of a respiratory infection and history of travel or contact with
possible COVID-19 patients.
• Assessed for respiratory symptoms and fever (with a non-contact digital infrared forehead
thermometer) and they will be asked to sign a health declaration form.
• If fever temperatures of 100.4 degrees F or higher or respiratory symptoms are present, they will be
advised to seek medical treatment and their visit will be rescheduled.
• As testing for the virus becomes more available, we will be incorporating this added benefit to screen
• Escorted into an examination room as quickly as possible upon arrival to avoid lingering in front office.
We will then have patient rinse with a hydrogen peroxide solution. We will take patient vitals such as
Blood Pressure and Pulse.
Measures Taken Upon Patient Entry to the Clinic
• If an examination room is not readily available, ensure social distancing in the waiting room by placing
seating a minimum of 6 feet apart.
• Remove all clutter and anything that is not easily disinfected from the waiting room (magazines, area
rugs, pillows, toys, etc)
• Frequent wipe down of waiting rooms, bathrooms, door handles, tables, light switches,
Reception Room and Front Desk Safety Measures
• Headphone use is encouraged, so hands are free and only one person uses it.
• Place air-handling systems (with appropriate filtration, exchange rate, etc.)
Protocols of the Clinical Team
We adhere to usual standard and transmission-based precautions in operatory but with greater
attention to detail and ensure that procedures are followed consistently and correctly.
Furthermore, we will be cleaning, sterilizing, disinfecting and wiping down everything in the operatories
and in the waiting room; chairs, handles, light switches, tables…etc on a regular basis.
Hand Hygiene is Performed by our Staff
• Before and after all patient contact, contact with potentially infectious material, and before putting on
and after removing personal protective equipment (PPE), including gloves.
• After removing PPE in order to remove any pathogens that might have been transferred to bare hands
during the removal process.
• Washing hands with soap and water for at least 20 seconds
Personal Protective Equipment
• Wear PPE (masks, gloves, cap, eye protection, face shields, gowns (N95 masks when around confirmed
• Masks are one time use and replace if soiled
• N95 respirators should be used instead of a face mask when performing or present for an aerosolgenerating
• Put on eye protection (i.e., goggles or a disposable face shield that covers the front and sides of the
face) upon entry to the patient room or care area.
• Remove eye protection before leaving the patient room or care area.
• Reusable eye protection (e.g., goggles) must be cleaned and disinfected according to manufacturer’s
reprocessing instructions prior to re-use.
• Disposable eye protection should be discarded after use.
• Put on clean, non-sterile gloves upon entry into the patient room or care area.
• Change gloves if they become torn or heavily contaminated.
• Remove and discard gloves when leaving the patient room or care area, and immediately perform
• Put on a clean isolation gown upon entry into the patient room or area.
• Change the gown if it becomes soiled. Remove and discard the gown in a dedicated container for
waste or linen before leaving the patient room or care area. Disposable gowns should be discarded and
cloth gowns should be laundered after each use.
• Gowns should be prioritized for all aerosol-generating procedures and during activities where splashes
and sprays are anticipated.
Patients in the Operatory (Treatment Room)
• Health care personnel (HCP) should strictly follow basic infection control practices between patients
(e.g., hand hygiene, cleaning and disinfecting shared equipment).
• Limit transport and movement of the patient outside of the room
• Consider placing x-ray equipment in patient operatories to reduce the need for patient transport.
• No other team member should enter the room during a procedure and if necessary, should use PPE as
• In operatory, entry and exit should be minimized.
• Once the patient has left the operatory, the room should undergo appropriate cleaning and surface
disinfection before it is returned to routine use
• Special precautions will be taken when performing Aerosol Generating procedures (AGP), in particular,
procedures that are likely to induce coughing are avoided if possible.
Protocols After the Clinical Treatment
• All non-disposable medical equipment used for patient care should be cleaned and disinfected
according to manufacturer’s instructions.
• Ensure that environmental cleaning and disinfection procedures are followed consistently and
• Routine cleaning and disinfection procedures (e.g., using cleaners and water to pre-clean surfaces
prior to applying an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or
objects for appropriate contact times as indicated on the product’s label) are appropriate for SARS-CoV-
2 in healthcare settings, including those patient-care areas in which aerosol-generating procedures are
Safety Measures After the Visit
• Encourage payment by E-Transfer, Pay Pass or credit card over the phone to encourage social
distancing with front desk
• Review of estimates and insurance forms can be carried out via phone call or video conferencing and
sent via mail
• Patients sanitize before leaving
At the End of the Day
We will clean and disinfect the office from top to bottom in preparation for the following day.
We are confident that these guidelines will help to create a safe environment for all of our patients and
team members and hope that you can feel secure in the knowledge that we are doing everything in our
power to provide the safest clinical conditions in order to protect our patients, our team and our
families at Susan Royer DDS.