The following is intended as a further guide for ACSLPA members when determining if they should see clients during the COVID-19 pandemic. The guide is meant to be used in conjunction with the document “Notice to ACSLPA Members in Private Practice – Public Health Restrictions on Businesses and Workplaces” to further support members’ decision-making.

“Non-essential health services are those generally done to protect, promote or maintain the health of an individual but if interrupted would not endanger the life, health and safety of the individual.

Non-essential health services can no longer be provided by regulated health professionals or registered professionals, unless:

A non-essential health service can still be provided at a place of business (i.e., face-to-face) only if the services are deemed urgent or critical by the audiologist or SLP providing that service. A decision must be made on a case-by-case basis, for the specific client situation, at that particular point in time. Only urgent care can be provided to the public (clients) in a face-to-face manner if the service is not included in the essential services list. In most cases, private SLP and audiologist businesses will not have a clear “fit” on the essential services list.

When considering providing face-to-face services, decisions regarding urgency and criticality of the service is required. Services may be continued where there is no face-to-face contact required, regardless of urgency or criticality.

Follow the questions in sequence to equip yourself with the information to make a justified decision regarding ongoing face-to-face services. Decisions to see/not to see a client should be clearly documented. Click the corresponding yes or no button for further information.

Question 1:
Can the client be served in a manner other than face-to-face (using evidence-informed practices)?

Yes
No

Question 2:
Is the service urgent/critical in nature?

Consider:

a) Could interrupting delivery of the product or provision of services immediately endanger an individual’s life, health or safety?

  • Think about other risks. A person’s life, health or safety could be jeopardized if they cannot hear a fire alarm or call 911 because their hearing aids aren’t working

b) If the answer to (a) is “no”, then is the product or service listed on the essential services list available at https://www.alberta.ca/essential-services.aspx?

c) If the answer to (b) is “no’, then is there some other consideration that makes provision of the product or service “urgent”?

  • Think about other risks. Is the person in extreme distress? Is their condition worsening rapidly?

*if the answer to a, b or c is “yes”, then the service would be allowed to be provided under the current public health order (essential and/or urgent).

ACLSPA members must be able to justify the basis for their decision that the product or service was urgent based on the specifics of the situation.

Yes
No

Question 3:
Has the client or accompanying person answered “YES” to any of the questions in the Point of Care Risk Assessment on the right?

Yes
No

Point of Care Risk Assessment

Ask all of the following questions of both the client and the person who will be accompanying them
(if required):

  • Has the client or anyone who lives with or has interacted closely with them returned to Canada from international travel withing the past 14 days?
  • Has the client or anyone who lives with or has interacted closely with them tested positive with COVID-19 in the past 10 days?
  • Is the client or accompanying person currently experiencing any of the following symptoms, even if they are mild?
    • Fever
    • Sore throat
    • Runny nose
    • Cough
    • Fatigue
    • Difficulty breathing
    • Shortness of breath
    • Nasal congestion
  • If the client experienced these symptoms in the recent past, have they been self-isolating for at least 10 days or have their symptoms ended (whichever is longer)?

Steps to Take When Seeing A Client Face-To-Face
1. Arrange an appointment time with the client by phone.
2. Complete as much prework/service by telephone as possible. Inform the client of the requirements for the in-person visit (limits to number of people who can attend with the client, repeat point of care assessment, handwashing upon entry/exit of the clinic, how to gain access to the clinic).
3. Ensure as few staff as possible are in the clinic at the time of the appointment. Consider a plan for working alone safely. Keep clinic doors locked so there can be no access to other individuals.
4. Perform a point of care risk assessment at the time of the appointment (if client/accompanying person answers “yes” to any question, defer to later date with reminder to self-isolate). See Question 3 above.
5. Monitor the client during the appointment. If symptoms are detected, discontinue the service and reschedule.
6. Have client wash their hands (soap and water or alcohol-based hand sanitizer) upon entering the clinic.
7. Maintain a 2-metre physical distance from the client as much as possible. Limit the amount of time you need to be closer to the client to perform the service. Stand to the side of the client where possible.
8. Where appropriate and available, use personal protective equipment (PPE). ACSLPA does not currently recommend any PPE beyond what has been recommended by the Chief Medical Officer of Health and what you would normally wear and/or feel comfortable wearing. More information on PPE at:

Alberta: https://www.alberta.ca/assets/documents/covid-19-healthcare-ppc-guidance.pdf

Public Health Agency of Canada: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals.html

World Health Organization: https://www.who.int/news-room/q-a-detail/q-a-on-infection-prevention-and-control-for-health-care-workers-caring-for-patients-with-suspected-or-confirmed-2019-ncov
9. Review the ACSLPA Advisory Statement on “Infection Prevention Control – Reusable and Single-Use Medical Devices” and the corresponding standard.
10. Clean and disinfect the clinic and any equipment prior to the client’s arrival. Consider developing a checklist for cleaning/disinfecting which includes the signature of the person who cleaned and the time the cleaning/disinfecting was performed.

  • Cleaning and disinfecting are two steps. Clinic surfaces, contact areas and equipment should be cleaned first, then disinfected. The process of cleaning removes any debris while disinfecting is the process of “sanitizing”.
  • All surfaces, especially those that are horizontal and frequently touched, should be cleaned frequently, and at least before and after each client.
  • Any equipment used in the provision of the service must be cleaned and disinfected prior to its next use. This includes bags/suitcases/carts in which equipment is stored or transported. Use single-use items wherever possible.
  • Equipment should be cleaned according to the Manufacturer’s Instructions for Use (MIFU). The MIFU may include information about detergents to use, water type/temperature and any cleaning methods required. Some equipment (including toys) may not have a MIFU. In these cases, practitioners will need to determine the appropriate cleaning and disinfecting protocol.
  • Surfaces that cannot be cleaned should be removed from client areas (e.g., books, magazines, cloth chairs). Surfaces and contact areas that need to be cleaned and disinfected include (but are not be limited to):
      • Desks
      • Keyboards/mice/monitors
      • Worktables/workstations
      • Countertops
      • Shelves
      • Printers/photocopiers
      • Doorknobs/handles
      • Pens (and other shared objects)
      • Light switches
      • Chairs – including armrests, backs and seats
      • Sinks (including faucets), toilets (including flush handle), towel bars
      • Railings
      • Cash machines/pin pads
11. Where possible, consider going cashless, and ensure hand hygiene after exchange of money or items. Avoid sharing communal office equipment/supplies (e.g., pens, phones, tablets).
12. Have client wash their hands upon leaving the clinic.
13. Complete hand hygiene and clean and disinfect surfaces and equipment.