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HOME HEALTH and HOSPICE: PPE

Question: I am seeking guidance on the recommendation for face shields in addition to masks for patient care of a NON-Covid positive or suspected positive patient.  I have heard that the new recommendation is to add a face shield, but cannot seem to find it anywhere.  Do you happen to know if this is an ODH or CDC guideline?

Answer: HCP who enter the room of a patient with suspected or confirmed SARS-CoV-2 infection should adhere to Standard Precautions and use a NIOSH-approved N95 or equivalent or higher-level respirator (or facemask if a respirator is not available), gown, gloves, and eye protection.

When available, respirators (instead of facemasks) are preferred; they should be prioritized for situations where respiratory protection is most important and the care of patients with pathogens requiring Airborne Precautions (e.g., tuberculosis, measles, varicella). Information about the recommended duration of Transmission-Based Precautions is available in the Interim Guidance for Discontinuation of Transmission-Based Precautions and Disposition of Hospitalized Patients with COVID-19.

The following is from CHAP COVID-19 Q&A (last updated November 5, 2020)

Face Shields:

Face shields provide barrier protection to the facial area and related mucous membranes and are considered an alternative to goggles August 11

CDC reaffirms face shields are not meant to function as primary respiratory protection and should be used concurrently with a mask.

  • As an exception, CDC recommends considering the use of a face shield for those who cannot use a mask, understanding that it offers some protection to the patient as well as protection to caregivers
  • CDC advises that although evidence on face shields is limited, not all face shields are equal. The available data suggest that the following face shields may provide better source control than others:
  • Face shields that wrap around the sides of the wearer’s face and extend below the chin are the most effective, as well as considering use of hooded face shields.
  • CDC reminder of precautions when a face shield is used to wash hands before and after removing the face shield and avoid touching eyes, nose and mouth when removing it.
  • Disposable vs. One Time Use Face Shields • Some face shields can only be worn for a single use and disposed of according to manufacturer instructions.
  • Reusable face shields should be cleaned and disinfected after each use according to manufacturer instructions or by following CDC face shield cleaning instructions .
  • Plastic face shields for newborns and infants are NOT recommended. • https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html Aug 7, 2020