In this section, you will find a range of guidance, learning resources and links to support your practice in responding to the COVID-19 pandemic.  

Please note, this section provides discipline specific information only and more general integrated community information can be found here.

The following topics appear in this section: 

• COVID-19 presentation                                                                                                     

• National clinical guidance 

• Management and prioritisation of community care

• Infection prevention and control 

• Palliative and end of life care 

• Supporting learners in the community 

• Other useful resources 

This section will be constantly developing, so please visit regularly to keep updated. Where possible, we have provided specific links to guidance and sources of information, but due to the constantly evolving landscape, the links may be subject to change and may become broken. To reduce the impact of this we have given links to the webpage.  

Novel Coronavirus (COVID-19) clinical presentations may range from mild to moderate illness to pneumonia or severe acute respiratory infection. The most common symptoms of the Coronavirus are fever, tiredness and a dry persistent cough. However, some people also experience a sore throat, running or blocked nose, muscle aches, stomach upset and/or reduced taste or smell. 

It is worth noting that for some older people living with frailty, their presentation when unwell may be very different to younger people. They may present with declining function, for example falls and/or confusion. 

The following are useful sources of advice for practitioners and public relating to COVID-19: 

• NHS Inform provides the latest Coronavirus (COVID-19) guidance from NHS Scotland and the Scottish Government, including physical distancing measures and advice for infected households.  

• British Geriatrics Society: Coronavirus and older people is a series of resources that provides current advice from experts within the BGS relating to older people and the current COVID-19 pandemic. Of particular relevance is medicines advice for older people, managing delirium and end of life care in older people. 

In this section, you will find essential guidance to support nursing in the community, helping you to keep up to date during this evolving situation.  

Health Protection Scotland 

Health Protection Scotland provides the latest information and guidance, education and resources for health and social care practitioners and can be accessed here. Some of the key guidance is listed below. 

Documents:  

• COVID-19 Guidance for Primary Care 

• Information and guidance for care home settings 

• Information and guidance for social or community care and residential settings   

• Domiciliary care 

Scottish Government  

Scottish Government Coronavirus (COVID 19) provides a suite of resources for health, care and social work and can be accessed here. Some of the key guidance is listed below.

Documents:  

• National Clinical Guidance for Nursing and AHP Community Health Staff during COVID-19 Pandemic

• Clinical guidance for care at home, housing support and sheltered housing 

• Clinical guidance for nursing home and residential care residents - coming soon. 

• Adult support and protection guidance 

Public Health England 

Public Health England provides guidance for healthcare workers, carers and care settings and can be accessed here.  

Clinical Guidelines 

NICE have produced rapid clinical guidelines and evidence summaries for managing symptoms and complications, managing conditions that increase risk and providing services during this pandemic. These can be accessed here. Some of the key guidelines are listed below. 

Documents: 

• COVID 19 – rapid guideline: managing symptoms including end of life in the community

• COVID 19 – rapid guideline: managing suspected or confirmed pneumonia in adults in the community  

• COVID 19 – rapid guideline: community-based care of patients with chronic obstructive pulmonary disease (COPD)   

To support the management and prioritisation of community care, you will be working alongside general practice and secondary care e.g. hospital at home teams, virtual ward and psychiatry to support more care in the community including anticipatory care planning, urgent and end of life care and reducing the number of contacts to those most at risk. In this section we highlight resources that you may find useful to support you. 

Documents: 

• National Clinical Guidance for Nursing and AHP Community Health Staff during COVID-19 Pandemic  Annex 4 contains information to support prioritisation of care in the community.  

• The Scottish Primary Care Hub Triage Guide outlines the community pathway and where the community nurse role and responsibilities fit.  

• NHS England Novel Coronavirus (COVID-19) standard operating procedure: Community health service.  

• Anticipatory Care Planning specific to COVID-19 included is Essential Anticipatory Care Planning Guidance and Template which can be downloaded and provides information on the RED-MAP approach. 

You will likely be providing care to those in the ‘high’ or ‘very high risk’ groups who require essential care. Information and guidance regarding caring for people within the community or residential settings and the use of PPE can be found on the Health Protection Scotland website. 

The four UK countries are adopting the COVID-19 guidance for infection prevention and control in healthcare settings. This official guidance was produced jointly by the Department of Health and Social Care, Public Health Wales, Public Health Agency (Northern Ireland), Health Protection Scotland and Public Health England. 

This UK Government guidance is consistent with the current infection prevention and control advice and guidance that has been issued to and used by NHS Scotland to manage the ongoing response to COVID-19 and can be viewed here.  

     Of note: 

•   Table 2 and table 4 recommended PPE for primary, outpatient, community and social care. 

Aerosol Generating Procedures (AGP) 

There has been a recent update to the guidance for CPR in relation to Aerosol Generating Procedures (AGPs). Chest compressions and defibrillation (as part of resuscitation) are not considered AGPs. This recommendation comes from the COVID-19 IPC guidance and further explanatory notes can be found in section 5.8.1 (PDF version) alongside considerations for risk assessment taking account of RCUK advice. 

CPAP or BiPAP are considered AGPs and home visiting should only be considered where necessary guidance can be found on PPE and how to reduce the risks of visiting in the HPS Primary Care guidance. Certain other procedures/equipment may generate an aerosol from material other than patient secretions but are not considered to represent a significant infectious risk and are not considered AGPs. Procedures in this category include: long term oxygen therapy and nebulisation. 

Personal Protective Equipment (PPE) 

Health Protection Scotland have produced a short video clip showing the correct order for donning and doffing and disposal of personal protective equipment (PPE) for healthcare workers in a primary care setting:

The health, care and support needs of those people at the end of life should be delivered remotely where clinically possible, and as a general principle, the number of health and care professionals entering someone’s home should be kept to an absolute minimum. In your role, you may be required to care for people at the end of life and attend deaths at home. In this section, we highlight the latest guidance and resources to support you in your role. 

Scottish Palliative Care Guidelines have developed temporary guidance related to end of life care during the COVID-19 pandemic. This guidance does not replace the existing palliative care guidance but adds to them with specific pandemic related situations. Contains guidance on end of life care for people with COVID lung disease, symptom management, medicines guidance, anticipatory care planning and links to further palliative and end of life resources.   

Section 12 of the National Clinical Guidance for Nursing and AHP Community Health Staff provides guidance for the palliative and end of life care community services during the  COVID-19 pandemic, which you may find helpful.  

Health Protection Scotland have guidance on attending deaths and death certification during COVID-19. Palliative and end of life care learning resources are available here to support your local training and preparation for your role in Confirmation of Death. 

The Scottish Government have guidance for religious organisations, faith and cultural groups regarding the handling of presumed or confirmed COVID-19 virus in the deceased, specifically completion of required religious or other preparations in advance of burial or cremation, which you may find useful. 

Resources to support care and communication at the time of and after a death can be found in the Death and Bereavement section of the home site. 

The COVID-19 pandemic has meant some changes to the supervision and assessment arrangements for nursing and midwifery students in practice in Scotland to enable them, if they so wish/are able, to support the health and care system during this time of emergency.  

The NMC have introduced emergency programme standards to enable more flexibility to ensure students get appropriate support and supervision in this challenging time. The NMC emergency programme standards for nursing and midwifery education can be accessed here.  

NHS Education for Scotland have developed a range of resources designed to support you to support learners in your clinical area and these can be accessed here. 

Documents: 

• Those supervising and assessing pre registration nursing and midwifery students in community teams in primary and integrated care during the COVID-19 period  

• Team leaders in community teams in primary and integrated care  

• Students on placement in community teams in primary and integrated care  

The Clinical Skills Managed Education Network has developed a number of multi-professional skills bundles for use in any setting with patients with suspected COVID-19. These have been designed to support any healthcare practitioner working in the NHS or Social Care in Scotland, including practitioners returning to the workplace and healthcare students who have been recruited recently. 

These resources are regularly reviewed and updated in line with current best evidence and can be found here:  

Unit A: COVID-19 Helping you in your role - Self-Protection 

Topics covered include: health protection behaviours; hand hygiene; donning and doffing PPE; social distancing in the workplace; implementing self-isolation measures; and psychosocial support and wellbeing. 

Unit B: COVID-19 Helping you in your role - Assessment and Management 

Topics include: demonstrating infection control measures and communication skills; gathering clinical information; undertaking clinical examination; skills linked to investigations and findings; documenting findings using relevant tools and patient management skills using best evidence. 

Unit C: COVID-19 Helping you in your role - Protecting your Workplace 

Topics include: how to safely decontaminate and manage clinical waste; safe manual handling; referral pathway and routes of presentation of COVID-19; and providing guidance for patients and families. 

The COVID-19 Compendium has been devised by Health Protection Scotland and contains links to current national and international policy, guidance and resources on COVID-19 from key organisations.