Guidance on Use of Personal Protective Equipment

Personal Protective Equipment (PPE) is designed to prevent health care workers from acquiring infectious agents from patients in health care settings.  Its proper use is critical to protect both staff and patients.

Scientific data supports the droplet route as the primary mode of transmission of SARS CoV-2 which is the causative agent of COVID-19.  For this reason, droplet precautions as described below is recommended in most situations to care for these patients, especially when supplies of airborne protective equipment are insufficient or threatened.  Aerosol-generating procedures may increase the risk of transmission of this virus and therefore enhanced infection prevention measures (airborne precautions) are recommended for certain patients. 

Incident Command asks that all providers and employees follow these guidelines.  Models of the epidemic curve predict that we may have a surge in patients over the next four to six weeks.  Improper usage of PPE during this critical phase may leave us with shortages of masks, eye protection, and gowns should the worst-case scenarios materialize.

Droplet Precautions: PPE used by the health care worker should be donned prior to going into the patient room and includes the following:

Gloves, gown, regular mask, eye protection (face shield or goggles)

Airborne Precautions: For patients undergoing aerosol generating procedures including intubation, mechanical ventilation, Bipap, nebulized treatments, ventimask, and HHFNC the required PPE include:

Gloves, gown, PAPR or N95 mask with eye protection (face shield or goggles)

Due to limitations on PPE supplies the following protocol applies to the above areas only:

  1. Gloves and gowns are changed upon exit of each patient room.
  2. Surgical masks and N95s are disposed of when visibly contaminated, otherwise are used for the entire shift.  Do not pull mask down below the nose or around neck.
  3. During breaks—the mask is stored in a paper bag for reuse after the break.
  4. Face shields and goggles are used throughout the shift and cleaned at the end of the shift with a sani-wipe and stored in a central place to be available for other staff to use. Masks and eye protection can be worn at the nurses’ station; staff should exercise the utmost care to not contaminate their hands by touching these items.

Employees and providers are not to wear PPE while walking in the hospital or on campus unless as specified above or in the attached document, or they are actively transporting a patient suspected or confirmed of having COVID-19.

Please see this table for more detailed PPE use information.

March 28, 2020