FAQs for clinicians on elective surgery

The advice for personal protective equipment (PPE) use for elective surgery, investigations and procedures is consistent with the Australian Guidelines for the Prevention and Control of Infection in Healthcare and Australian Government Infection Control Expert Group guidance. 

Commission PPE resources relating to COVID-19 are currently being updated to reflect the most recent guidance issued by the Australian Government Infection Control Expert Group.

Health services should develop an organisational-wide Risk Management Strategy to identify, manage and reduce the risk related to the transmission of COVID-19. In particular, this strategy should address the requirements of Action 1.10 of the National Safety and Quality Health Services (NSQHS) Clinical Governance Standard and the requirements of the Preventing and Controlling Infections Standard.

Assessors may review the organisation-wide Risk Management Strategy as evidence, when assessing a health service organisation.

In accordance with the AHPPC Statement on the restoration of elective surgery, the principles for allocation of lists for surgery, investigations and procedures are:

• Equitable access for all patients determined by clinical decision making and safety; this means, prioritisation on the basis of clinical urgency and risk to the health of the patient in the event of further delays
• Preservation and appropriate use of PPE
• Compliance with state, territory and national monitoring requirements in relation to volume of procedures, PPE availability and new COVID-19 cases.

Patients should be screened for clinical and epidemiological risk of COVID-19 based on the current Australian definition of a suspect case.

The definition incorporates travel history, contact with known or suspected cases of COVID-19, and signs and symptoms associated with COVID-19, including fever.

Depending on local rates of community transmission, individual states and territories may recommend testing to manage risks for patients, healthcare workers and health service organisations. The mortality and morbidity rates for patients who have COVID-19 undergoing both elective and emergency surgery are higher than otherwise expected, even when such surgery is relatively minor. Therefore, it is usually safer to postpone elective surgery for someone who is symptomatic or who tests positive for COVID-19. Emergency surgery should not be delayed either because a patient is a COVID-19 case or while waiting for a test result where there is additional risk to the patient's clinical condition.

Patients who, on screening, require further investigation of COVID-19 risk should be referred for COVID-19 testing and further assessment, as appropriate. These patients should only be considered for emergency surgery, investigations or procedures.

Use of PPE in operating suites and procedure rooms should be consistent with Australian Guidelines for the Prevention and Control of Infection in Healthcare 2019.

This means routine operating suite attire: surgical mask, theatre cap, eye protection, gown, and gloves, including for aerosol-generating procedures (AGPs).

Specific guidance relating to COVID-19 has been issued by the Australian Government Infection Control Expert Group (ICEG). The Commission's PPE resources relating to COVID-19 are currently being updated to reflect the most recent ICEG advice.

Yes. Health services should ensure that they meet physical distancing requirements at all times during planning, preparation and post treatment. This applies to all staff, patients and relatives.

In situations where physical distancing is not possible, such as during physical examinations and providing care, staff and/or patients may use a surgical mask to reduce the risk of spread of COVID-19.

The requirements for informed consent apply at all times. These include discussion with the patient about the:

• Rationale for the procedure
• Risks and benefits to them of having the surgery, investigation or procedure at this time
• Actions that will be taken to reduce their risks
• Likely outcomes for them should they not proceed with the surgery, investigation or procedure at the recommended time
• Alternatives to the proposed surgery, investigation or procedure.

The Commission's posters on PPE use are currently being updated to reflect the most recent advice issued by the Australian Government Infection Control Expert Group.