Safety & Personal Protective Equipment (PPE)Modified on 5/20/2020 at 02:32pm

Contact the Program of Hospital Epidemiology at 319-356-1606 or 24-hour pager 3158.

Latest guidance and policies from our Program of Hospital Epidemiology.


Chief Medical Officer Theresa Brennan, MD, and the Operations branch of the UI Health Care Hospital Incident Command System (HICS) have reviewed each line of Iowa Governor Kim Reynolds’ order on personal protective equipment (PPE) and has determined that UI Health Care is in compliance with the order.

This site is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. All information is meant for use by health care workers and not the general public. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. No physician-patient relationship is created by this web site or its use. Neither the University of Iowa nor its employees, nor any contributor to this web site, makes any representations or warranties, express or implied, with respect to the information provided herein or to its use.

General safety and infection prevention principles

Best practices

The safety of our staff and patients always comes first. Please take care of yourself and your work spaces as we strive to do our best for each other, our patients, and our community.

In clinical settings:

  • Face shields and medical-grade masks should be worn in clinical settings at all times. View the chart below to view more.
  • Keep arms bare below the elbows in order to avoid sleeve contamination. This means that there should be nothing on your forearms, including wrist jewelry and watches. If you wear a long-sleeved shirt, roll up the sleeves.
  • Neckties, scarves, and long necklaces should not be worn.
  • Tie or clip up long hair.
  • Wipe down your stethoscope after each use.

 Work rooms and commonly shared work spaces:  

  • Wipe down surfaces with disinfectant wipes often.
  • It’s time to declutter. If surfaces are cluttered they are unable to be cleaned.
  • Wipe down shared computer keyboards, phones, door knobs, and other items you frequently touch before using.

Shared food:  

  • Food should not be consumed in areas other than designated break rooms.
  • Limit food sharing. There are potential health risks with communal food sharing, and it is strongly discouraged at this time.

Other best practices:

  • Practice social distancing (6 feet) whenever possible. Consider all opportunities to minimize contact with other employees.
  • Wash your hands often and avoid touching your face.

For staff who wear green scrubs:

  • Green scrubs are not to be worn outside of the hospital. If you currently have green scrubs at home, please bring them back to work as soon as possible so they can be laundered and reused appropriately.

If you work directly with or have face-to-face contact with patients

You should wear your face shield AND a medical-grade face mask at all times.

If you work in a patient-facing area

You should wear your face shield AND a medical-grade face mask at all times.

If you do not work with patients or do not work in a patient-facing area

 OR You should wear your face shield at all times. You may choose to wear your own cloth mask in addition to your face shield if you’d like at this time. Your face shield remains your best source of protection.

Employees arriving at or leaving from work

 OR OR You should make sure that you wear your face shield or a mask as you arrive to and leave from work. If you store your face shield at your desk or workspace during your off hours, wear a mask and put on your face shield as soon as you arrive to your workspace.

UI Health Care patients or visitors

 OR Patients or visitors who arrive with their own face masks can continue to wear their mask. If a patient arrives without a mask, a medical-grade face mask will be provided to them.


View frequently asked questions about face masks and face coverings here
.

In clinical settings:
  • Face shields and medical-grade masks should be worn in clinical settings at all times. View the chart below to view more.
  • Keep arms bare below the elbows in order to avoid sleeve contamination. This means that there should be nothing on your forearms, including wrist jewelry and watches. If you wear a long-sleeved shirt, roll up the sleeves.
  • Neckties, scarves, and long necklaces should not be worn.
  • Tie or clip up long hair.
  • Wipe down your stethoscope after each use.

If you work directly with or have face-to-face contact with patients

You should wear your face shield AND a medical-grade face mask at all times.

If you work in a patient-facing area

You should wear your face shield AND a medical-grade face mask at all times.

If you do not work with patients or do not work in a patient-facing area

 OR You should wear your face shield at all times. You may choose to wear your own cloth mask in addition to your face shield if you’d like at this time. Your face shield remains your best source of protection.

Employees arriving at or leaving from work

 OR OR You should make sure that you wear your face shield or a mask as you arrive to and leave from work. If you store your face shield at your desk or workspace during your off hours, wear a mask and put on your face shield as soon as you arrive to your workspace.

UI Health Care patients or visitors

 OR Patients or visitors who arrive with their own face masks can continue to wear their mask. If a patient arrives without a mask, a medical-grade face mask will be provided to them.
Surface cleaning and disinfection guidance
Updated on 05/07/2020 at 2:52 pm

Virex® II 256 Spray

Download these instructions

For use as a one-step cleaner/disinfectant for environmental surfaces (similar application as the Grey top PDI wipes)

INSTRUCTIONS FOR USE:

  1. Carefully spray Virex® solution away from eyes onto a new disposable
  2. Wet cloth using approximately 12-15 squeezes; cloth should be damp, not

Rationale: When a surface is sprayed then wiped with a dry cloth the disinfectant is wiped away and does not allow the surface to remain wet.

  1. Wipe all hard, non-porous surfaces with damp
  2. All surfaces must be visibly wet and allowed to air

Note: Do not directly spray on electronics.

*DO NOT DISCARD EMPTY SPRAY BOTTLES (Spray bottles will be cleaned and refilled) Virex® II 256 may be used to fill and refill clean, properly labeled containers.

INSTRUCTIONS FOR ORDERING:

  1. Call Stores (6-1784) to request new
    • Virex® Spray Bottle – Reusable (use PS#156332)
    • Wipe Disposable for Virex® Spray (use PS#156334)
  2. Stores will deliver a new supply of Virex® and pick-up empty bottle(s).

Reference:

William A. Rutala, P. M. (n.d.). Frequently Asked Questions. Retrieved from How should readers interpret the recommendation about contact time for disinfectants: http://vtwqt464m234djrhbie88e10- wpengine.netdna-ssl.com/wp-content/uploads/2017/07/FAQ_Contact-time-for-disinfectants- used-on-noncritical-items.pdf

Developed: Program of Hospital Epidemiology and Environmental Services 3/27/2020


Sani-HyPerCideTM Spray

Download these instructions

For use as a one-step cleaner/disinfectant for environmental surfaces

(similar application as the Orange top PDI Bleach wipes)

INSTRUCTIONS FOR USE:

  1. Sani-Hypercide spray is a bleach substitute for environmental cleaning.
  2. Carefully spray Sani-Hypercide solution away from eyes onto a new disposable cloth.
  3. Wet cloth using approximately 12-15 squeezes; cloth should be damp, not dripping.

Rationale: When a surface is sprayed then wiped with a dry cloth the disinfectant is wiped away and does not allow the surface to remain wet.

  1. Wipe all hard, non-porous surfaces with damp cloth.
  2. All surfaces must be visibly wet and allowed to air dry.

Note:

  • Do not directly spray on electronics.
  • Use Sani-Hypercide for environmental cleaning associated with diff and Norovirus infections or when bleach wipes use is specified.

INSTRUCTIONS FOR ORDERING:

  1. Call Stores (6-1784) to request new supply.
  • Sani-HyPerCide Spray Bottle (use PS# 156230)
  • Wipe Disposable for Sani-HyPerCide Spray (use PS#156334)
  1. Stores will deliver a new supply of Sani-HyPerCide.

Reference:

William A. Rutala, P. M. (n.d.). Frequently Asked Questions. Retrieved from How should readers interpret the recommendation about contact time for disinfectants: http://vtwqt464m234djrhbie88e10-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/FAQ_Contact-time-for-disinfectants-used-on-noncritical-items.pdf

Developed: Program of Hospital Epidemiology and Environmental Services 04/09/2020


Oxivir® Ready to Use

Download these instructions

For use as a one-step cleaner/disinfectant for environmental surfaces

(Reserved for Operating Rooms disinfection)

INSTRUCTIONS FOR USE:

  1. Carefully pour Oxivir® solution onto a new disposable cloth.
  2. Wet cloth with disinfectant; cloth should be damp, not dripping.
  3. Wipe all hard, non-porous surfaces with damp cloth.
  4. All surfaces must be visibly wet and allowed to air dry.

Note: Do not directly apply on electronics.

*DO NOT DISCARD EMPTY REFILL BOTTLES (Refill bottles will be cleaned and reused)

Oxivir® may be used to fill and refill clean, properly labeled containers.

*DO NOT POUR SOLUTION IN TUB OR BUCKET FOR MULTIPLE USES

Rationale: Improperly handled disinfectants may be contaminated with organisms that could lead to hospital-acquired infections.

INSTRUCTIONS FOR ORDERING:

  1. Call Stores (6-1784) to request new supply.
  • Oxivir® Ready to Use solution – Reusable (use PS# 139831)
  • Wipe Disposable for Oxivir® Ready to Use solution (use PS#156334)
  1. Stores will deliver a new supply of Oxivir® and pick-up empty bottle(s).

Reference:

William A. Rutala, P. M. (n.d.). Frequently Asked Questions. Retrieved from How should readers interpret the recommendation about contact time for disinfectants: http://vtwqt464m234djrhbie88e10-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/FAQ_Contact-time-for-disinfectants-used-on-noncritical-items.pdf

Keah KC. Et al. Bacterial Contamination of Hospital Disinfectants. http://www.e-mjm.org/1995/v50n4/Hospital_Disinfectants.pdf

Developed: Program of Hospital Epidemiology and Environmental Services 04/29/2020

Showers and hygiene products available for UI Health Care staff
Social distancing

Read more about social distancing here.

Guidance on laundering of scrubs at home
Guidance on green scrubs

For staff who wear green scrubs:

Green scrubs are not to be worn outside of the hospital. If you currently have green scrubs at home, please bring them back to work as soon as possible so they can be laundered and reused appropriately.

General personal protective equipment (PPE) guidance

PPE for treating a suspected or confirmed COVID-19 patient
Updated on 04/24/2020 at 8:51 am

Interim instructions for caring for a patient with COVID-19 (person under investigation* or confirmed)

April 21, 2020

Please send requests for additional guidance to: InfectionPrevention@healthcare.uiowa.edu

Urgent requests: page 3158.

Situation Guidance
Isolation Precautions

PPE* in all clinical settings (Inpatient and Outpatient)

Droplet    +  Contact Precautions  +   Eye Protection

face mask  +      gown and gloves         +   face shield, goggles or mask with fluid shield

Avoid aerosol generating procedures (AGP)*.

If AGPs necessary:

Airborne PPE + Contact Precautions + Eye Protection

  N95 or CAPR  +      gown and gloves        +   face shield, goggles

Wear AGP PPE during the procedure and for 1 hour after procedure completion

Patient transport (procedures or transferring units) Limit transport and movement of the patient outside of the patient room to medically essential purposes.

If procedures or tests are required and not able to be performed in the patient room OR if patient is being transferred to another unit, follow these steps:

  • Notify receiving department/unit of isolation status of patient
  • Wear mask, gown, gloves and eye protection PPE to prepare the patient for transfer (e.g., transfer patient to the wheelchair or cart)
  • Place clean sheet over patient
  • Place a face mask on patient to contain secretions
  • Wipe bed rails/wheelchair handles down with approved disinfectant
  • Transporter wears face mask and face shield.  Clean gloves may be stored in transporter’s pocket.

Receiving personnel should wear PPE for droplet, contact and eye protection (gloves, gown, face mask and eye protection)

After transport, equipment must be cleaned with approved disinfectant

To transport patients who require care during transport (e.g. a critically ill patient) follow the guidance above with the addition of:

  • Persons transporting and caring for the patient wear a surgical face mask (or keep on N95 if one was used for intubation) and eye protection, gown and clean gloves.
  • Other transporters not providing care wear a surgical face mask, eye-protection and do not wear gloves.  This person will clear hallways if needed and open doors, activate elevator buttons, etc.
  • Under no circumstances should anyone wearing gloves touch door handles, doors, elevator buttons, etc.

 

Food and Nutrition Nursing will take food trays into patient room and also remove them from patient room. No special handling of food tray necessary.
Environmental infection control

Inpatients

Daily cleaning:

  • Will be performed with the assistance of EVS

Terminal cleaning (after discharge):

  • Room does NOT need to sit vacant for 1 hour unless an AGP was performed within the last hour.
  • No AGP within last hour EVS staff to clean wearing the following PPE:  gown, gloves, mask and eye protection
  • If AGP within last hour – the room needs to sit vacant for 1 hour after patient discharge. EVS staff to clean wearing the following PPE:  gown, gloves, mask and eye protection.

Procedural Areas (not Operating Room)

  • Room does NOT need to sit vacant for 1 hour unless an AGP was performed within the last hour.
  • No AGP within last hour – Staff to follow normal process and clean all surfaces. Wear the following PPE: gown, gloves, mask and eye protection.
  • If AGP within last hour – the room needs to sit vacant for 1 hour after patient discharge. Staff to follow normal process and clean all surfaces. Wear the following PPE: gown, gloves, mask and eye protection.

Outpatients

  • Room does NOT need to sit vacant for 1 hour unless an AGP was performed within the last hour.
  • No AGP within last hour – Clinic staff to clean all surfaces and equipment touched wearing the following PPE: gown, gloves, mask and eye protection.
  • If AGP within last hour – the room needs to sit vacant for 1 hour after patient discharge. Clinic staff to clean wearing the following PPE:  gown, gloves, mask and eye protection.

*Definitions

  • COVID-19 person under investigation: a person that is going to be or has been tested for COVID-19 and is awaiting results.
  • Droplet precautions PPE: face mask
  • Contact precautions PPE: gown + gloves
  • Airborne PPE: N95 or CAPR
  • Eye protection: face shield, goggles or mask with fluid shield
  • Aerosol generating procedures:
    • nebulized medication administration
    • manual ventilation before intubation
    • endotracheal intubation
    • extubation
    • BiPAP/CPAP
    • high-frequency oscillating ventilation
    • open suctioning
    • sputum induction
    • bronchoscopy
    • CPR
    • autopsy

 

 

 

 

Discontinuation of Isolation Precautions for Patients with COVID-19
Updated on 05/07/2020 at 2:46 pm
Anesthesia guidelines
Updated on 05/12/2020 at 11:21 am
Resuming use of gowns in all instances of contact precautions
Updated on 05/22/2020 at 9:39 am

Effective immediately, gowns should be worn by faculty and staff in treating all patients in contact precautions. This guidance reverses the previous temporary guidance put into place to conserve our supply of gowns for staff treating patients with confirmed or suspected COVID-19. This reversal resumes normal contact precaution guidance.

The Program of Hospital Epidemiology also strongly recommends a continued focus on hand hygiene before and after all patient contact. As always, gowns should be worn if a splash or spray of blood or body fluids is anticipated.

Please contact Epidemiology (319-356-1606) for any questions.

PPE training

Training for all faculty and staff with patient contact

As part of University of Iowa Health Care’s ongoing efforts to protect the health of our community, we want you to be fully prepared should you care for patients with symptoms of COVID-19. We recognize that many of you have already had PPE training. This provides an additional opportunity to reinforce your knowledge with current video examples.

To help contain the 2019 Novel Coronavirus (COVID-19), as well as ongoing flu instances, all employees with patient contact are required to complete these refresher trainings for use of personal protective equipment (PPE). The training courses are available online as compliance issues through Employee Self-Service and need to be completed by March 31.

For areas with a high potential to take suspected or confirmed COVID-19 patients, staff should complete the course as soon as possible. It will take approximately 10-20 minutes to complete.

For those UI employees who wish to take the training—but are not required—please note that it’s available through My Training in Employee Self-Service.

Download a PPE donning and doffing flyer here.

PPE conservation

UI Health Care is implementing centralized strategies to optimize the supply of our personal protective equipment (PPE) and reviewing potential clinical contingency plans.

Securing PPE/ensuring the highest level conservation

Effective immediately, we are following maximum conservation protocols for all critical personal protective equipment (PPE) and testing supplies. Although we presently have enough supplies, our supply chain remains vulnerable and availability changes daily. With everyone’s help, we can do this effectively while maintaining safety for our faculty and staff.

Our Supply Chain/Materials Management department is now centralizing the management of these supplies to ensure conservation and proper use.

Although we presently have enough supplies, our supply chain remains vulnerable and availability changes daily. To continue to keep people safe, we are implementing strategies to optimize the supply of our personal protective equipment (PPE) and are focused on clinical contingency planning.

Health care team members caring for patients in isolation precautions should only include the minimum number of individuals necessary for ensuring proper patient care. Additionally, rounding teams should only have the attending and one house officer enter the rooms of patients in isolation precautions.

Aerosol-generating procedure (AGP) guidance for confirmed or suspected patients with COVID-19

Aerosol-generating procedure (AGP) guidance for confirmed or suspected patients with COVID-19

Aerosol-generating procedure (AGP) guidance for patients with COVID-19

May 11, 2020

Aerosol-generating procedures (AGPs) are procedures performed on patients that are more likely to generate higher concentrations of infectious respiratory aerosols than coughing, sneezing, talking, or breathing. AGPs should be avoided if possible in patients with suspected or confirmed COVID-19.

Aerosol-generating procedures

Procedures commonly recognized as aerosol-generating:

  • Open suctioning of airway secretions*
  • Sputum induction
  • Cardiopulmonary resuscitation (CPR)
  • Endotracheal intubation and extubation
  • Manual ventilation
  • Nebulized medication administration
  • Non-invasive positive pressure ventilation (e.g., BiPAP, CPAP)
  • Bronchoscopy
  • High-frequency oscillating ventilation
  • Disconnection of ventilator circuit to replace Filters/Heat Moisture Exchangers

Procedures that are not believed to generate aerosols:

  • Coughing through mouth or tracheostomy
  • Oral cares
  • Swabs of OP, NP, or nares
  • Endotracheal cuff leak
  • NJ (nasojejunal)/NG (nasogastric) tube placement
  • Metered dose inhaler (MDI) with spacer
  • MDI-drug delivery into a ventilator circuit
  • Heated High Flow nasal cannula – adults, peds, neonate
  • Uncuffed ETTs (peds/neo)

Personal Protective Equipment (PPE) by patient type:

  • Asymptomatic patients or patients without respiratory symptoms —> medical mask + face shield + gloves per standard precautions
  • Patients with suspected or confirmed COVID-19 (not receiving an AGP) —> medical mask + gown and gloves + face shield
  • Patients with suspected or confirmed COVID-19 (during AGP procedure and for 1 hour after procedure completion) —> N95 or CAPR + gown and gloves + face shield

*May be referred to as deep suctioning beyond oral suctioning. 

 For additional details on PPE selection and isolation precautions, see link

 References:

  • Alhazzani, et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19).
  • Cheng V, Wong S-C, Chen J, Yip C, Chuang V, Tsang O, et al. Escalating infection control response to the rapidly evolving epidemiology of the Coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong. Infect Control Hosp Epidemiol. 2020 Mar 5 [Epub ahead of print].
  • Loeb, M. et al. SARS among critical care nurses, Toronto. Emerg. Infect. Dis. 10, 251–255 (2004)
  • Raboud, J. et al. Risk factors for SARS transmission from patients requiring intubation: a multicentre investigation in Toronto, Canada. PLoS One 5, e10717 (2010)
  • Prevention, C. f. (2020, May 4). Healthcare Infection Prevention and Control FAQs for COVID-19. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-faq.html
  • Pichi, Barbara, et al. “CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management.” Oral Oncology 105 (2020): 104682.
  • Raboud, J. et al. Risk factors for SARS transmission from patients requiring intubation: a multicentre investigation in Toronto, Canada. PLoS One 5, e10717 (2010)
  • Tran, K.; Cimon, K.; Severn, M.; Pessoa-Silva, C.L.; Conly, J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: A systematic review. PLoS ONE 2012, 7.
  • World Health Organization (https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations)
  • World Health Organization. Infection prevention and control during health care for probable or confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. (2019)

Face shields

Face shields for all UI Health Care employees

Face shields are provided for all UI Health Care employees.

Why we’re providing face shields for all, not just those with patient contact

  1. Our Program of Hospital Epidemiology believes that face shields are the best way to keep our teams protected from the spread of COVID-19.
  2. A face shield covers the eyes, nose, and mouth, as well as helps you from touching your face. We know that COVID-19 is spread by droplets, such as from a cough or sneeze, so using face shields helps protect us from these infectious droplets.
  3. Previously, faculty and staff with patient care contact were provided face shields. We’re expanding this to provide shields to all employees to help reduce the risk of asymptomatic spread, as well as protect our team members from COVID-19.

The purpose is to protect your eyes, nose, and mouth from infectious droplets.

How to properly clean face shields and CAPR Disposable Lens Cuffs (DLC)

Face shields should be cleaned after each use. 

PPE Reprocessing Instructions
CAPR disposable lens cuff 
  1. Obtain a clean horizontal surface for disinfecting reusables (Process begins with removal of PPE from face in anteroom or hallway)
  2. Hand hygiene
  3. While wearing gloves, carefully wipe the insidefollowed by the outside of the lens using an approved cleaner/disinfectant
  4. Check chin cuff integrity and inspect for damage; if damaged dispose
  5. Fully air dry
  6. Clean/disinfect the horizontal surface with approved cleaner/disinfectant
  7. Remove gloves and perform hand hygiene
  8. Place in envelope* labeled with healthcare worker’s name
  9. Hand Hygiene

Note: Re-used lens cuffs are to be re-used by a single wearer

Face shields and goggles
  1. Obtain a clean horizontal surface for disinfecting reusables (Process begins with removal of PPE from face in anteroom or hallway)
  2. Hand hygiene
  3. Don gloves
  4. Carefully wipe the inside, followed by the outside of the face shield or goggles using an approved cleaner/disinfectant
  5. Inspect for damage; if damaged dispose
  6. Fully air dry
  7. Clean/disinfect the horizontal surface with approved cleaner/disinfectant
  8. Remove gloves and perform hand hygiene
  9. Place in clean location labeled with health care worker’s name. Smaller face shields/goggles may be stored in an envelope*
  10. Hand Hygiene

 

*Envelope: PS#156140

Definitions:

DLC: Disposable lens cuff

CAPR: Controlled Air Purifying Respirator

How to correctly remove a face shield

We have already had multiple reports of face shields breaking. This has occurred when trying to remove it by pushing upward on the bottom of the clear shield.

To remove the face shield without damaging it, loosen the knob that sits over the back of your head, and lift the face shield off with a straight upward motion of the headpiece (not the clear shield).

Guidance for avoiding neck pain with face shield use

View frequently asked questions about face shields here.

Guidance on face masks and face coverings

For staff: What type of mask you should wear with your face shield and when
Updated on 05/07/2020 at 10:14 am

NOTE: Personal protective equipment (PPE) guidance for the care of COVID-19 patients and persons under investigation (PUIs) is unchanged, and can be found here.

The following guidance is subject to change based upon the availability of medical-grade masks. We will closely monitor the supply of these masks and may need to convert to cloth masks for all employees and patients if we reach a critical shortage or are rapidly depleting the supply of these masks during the COVID-19 surge. We strongly encourage you to conserve these masks.

For employees who work directly with or have face-to-face contact with patients OR who work in patient-facing areas

Employees who have face-to-face patient contact (within six feet) or who work in patient-facing areas should use medical-grade face masks in addition to their face shields. These medical-grade masks will be made available in the clinical areas.

The mask should be worn underneath your face shield. Your face shield protects your eyes, protects the mask from contamination, and helps prevent touching of the face and repeated adjustments of the mask. A single mask should be worn all day, and in certain circumstances can be worn more than one day. Discard the mask only when soiled, damaged, or hard to breathe through.

Medical-grade masks will be available within clinics or on your unit. If you interact with patients but are within a service that is not assigned to one specific unit, such as Respiratory Therapy, Food and Nutrition Services, etc., please work with your manager.

For employees who do not have face-to-face patient contact

Employees who do not have face-to-face patient contact may choose to wear their own cloth face masks under face shields. You should wear your face shield at all times. You may choose to wear your own cloth mask in addition to your face shield if you’d like at this time. Your face shield remains your best source of protection.

It’s also important to note that face shields are your primary protection against droplet and contact spread and should continue to be worn at all times, as they have several advantages over masks, such as protection for the eyes, nose, and mouth; protection of your mask against contamination; and prevention of touching of the face. They can also be cleaned, disinfected, and reused, so will continue to provide protection if critical mask shortages continue.

If you work directly with or have face-to-face contact with patients

You should wear your face shield AND a medical-grade face mask at all times.

If you work in a patient-facing area

 

You should wear your face shield AND a medical-grade face mask at all times.

If you do not work with patients or do not work in a patient-facing area

 OR 

You should wear your face shield at all times. You may choose to wear your own cloth mask in addition to your face shield if you’d like at this time. Your face shield remains your best source of protection.

Employees arriving at or leaving from work

 OR OR 

You should make sure that you wear your face shield or a mask as you arrive to and leave from work. If you store your face shield at your desk or workspace during your off hours, wear a mask and put on your face shield as soon as you arrive to your workspace.

UI Health Care patients or visitors

 OR 

Patients or visitors who arrive with their own face masks can continue to wear their mask. If a patient arrives without a mask, a medical-grade face mask will be provided to them.


View frequently asked questions about face masks and face coverings here
.

Face coverings to be worn at all times
Updated on 06/01/2020 at 4:00 pm

All UI Health Care employees, students, learners, volunteers, and contractors in our facilities must wear face coverings at all times while in our facilities unless they are alone in a private office.

What does covering your face at all times mean?

Face shields are required to be worn at all times by all employees, students, learners, volunteers, and contractors. Your face shield is your first line of defense.

In addition, employees must wear a face covering when entering or exiting a UI Health Care facility. Employees may wear their face shield and/or a medical-grade or cloth mask as they enter and exit. If an employee does not have a covering, one will be provided.

Remember, your face shield is yours to use during the COVID-19 pandemic. This means you can take your shield home with you and wear it in the community, like on the CAMBUS and at the grocery store.

Other specific guidelines apply based on your role and where you work.

  • In patient-facing clinical areas: Face shield and a medical-grade mask.
  • In shared work spaces: A face covering with preference for face shield but medical mask may be acceptable if face shield is a barrier to their work (e.g., making phone calls, seeing the computer screen).
  • In hallways outside of clinical areas throughout the day: A face shield is required.
  • In an office space, alone: No face covering required, but a shield should be at the ready in case someone walks in, or if you leave your office.

Here to help you succeed

  • If you store your face shield at your workstation, masks will be available at our entrances for those who do not have their own to wear.
  • Your supervisor will give you reminders and tips on how to stay safe with face coverings.

Holding ourselves accountable

We can only be successful at safety if we each take it to heart and hold ourselves and each other accountable every day, every time. Let’s support each other. Here are a few ideas:

  • If a colleague has their shield up or forgets to wear it, encourage them to take immediate steps to be safe.
  • When having huddles, practice social distancing with your shield on, and avoid walking in pairs.

The simple act of wearing your face shield at all times as a UI Health Care employee shows you care about your colleagues and our patients and visitors.

For staff: Guidance on cloth face masks and coverings

Employees who do not have face-to-face patient contact may choose to wear their own cloth face masks under face shields. 

Cloth face masks or coverings are not a substitute for PPE. Face shields should continue to be worn in all encounters.

For patients and visitors
Updated on 06/01/2020 at 4:00 pm

In clinic areas, patients and visitors who present without a mask are to be given a mask to wear, either a cloth or medical-grade. Patients unable to wear a face mask for medical reasons will be provided a face shield. Face masks should not be worn by children age two or younger.

In inpatient areas, all patients, regardless of COVID-19 infection status, are to wear a mask* when they leave their room (e.g., during transport, for procedures, walks, therapies). When the mask is not in use, it should be stored at their bedside in a clean, dry place and can be re-used as needed.

*There may be some patients who cannot wear due to intolerance, clinical reason (e.g., intubated), or children under the age of 2 years.

View frequently asked questions about face masks and face coverings here.

N95 respirators

Information for employees fitted to an 1870+ N95 respirator
Updated on 05/18/2020 at 1:25 pm

Action required

If you were fit tested for an N95 respirator before April 1, 2020, and are currently fitted to a 3M 1870+ N95 respirator, you are required to be re-fitted. You are required to complete this process by Monday, June 8, 2020.

If you are fitted to an alternate mask, you do not need to be refitted and should only wear the mask you are fitted to in order to appropriately protect yourself.

If you are unsure on how to check what size respirator you are fit to, you can view instructions here.

As a reminder, N95 respirators should only be worn during aerosol generating procedures for patients who are under investigation for or confirmed to have COVID-19, or at all times for patients who are on airborne precautions for a non-COVID-19 diagnosis.

You can view more guidance on personal protective equipment (PPE) here.

Why we are conducting re-fits for this model of N95 respirator

This 3M 1870+ N95 respirator is currently the assigned mask for many staff. Most individuals who are fitted to this size can easily convert to an alternate mask. To help conserve our equipment and make the best use of our current supplies, staff currently fit to this model must be re-fitted to an alternate by Monday, June 8.

How to complete your N95 re-fit

During clinic hours of Monday through Friday, 7 a.m. to 5 p.m., just-in-time mask fitting may be obtained in the University Employee Health Clinic 1097-1 Boyd Tower (Elevator A, Level 1) on a walk-in basis. (The last mask fitting of the day starts at 4:30 p.m.)

Just-in-time N95 respirator fittings
Updated on 05/18/2020 at 1:25 pm

To help us conserve and meet the needs of those who use N95 respirators for patient care, we have just-in-time mask fittings available 24/7.

During clinic hours of Monday through Friday, 7 a.m. to 5 p.m., just-in-time mask fitting may be obtained in the University Employee Health Clinic 1097-1 Boyd Tower (Elevator A, Level 1) on a walk-in basis. (The last mask fitting of the day starts at 4:30 p.m.)

During off hours, please contact the adult House Operations Manager (HOM) at pager 3917.

How to find the size of your N95 Respirator
Updated on 05/18/2020 at 1:25 pm
N95 respirators decontamination guidance
Updated on 03/30/2020 at 12:00 am

University of Iowa Hospitals & Clinics

Ionized Hydrogen Peroxide (iHP) Decontamination Procedure – N95 Respirators

*Important Note: users of N95 respirators must not wear lipstick or other makeup when wearing an N95 respirator as it will contaminate the inside of the respirator, rendering it unable to be decontaminated by this process.

Health Care Provider (HCP) Instructions:

  • HCP obtains new fit-tested N95 respirator from secure storage location in their unit/department.
  • Using a black permanent marker, (Sharpie), HCP writes their first initial, last name, unit name/location, and date of first use on the outside/bottom edge of the N95 avoiding the top nose/bridge area and central filtration area.
  • HCP dons the respirator per the usual procedure ensuring the integrity of the respirator and proper fit.
  • HCP uses the respirator following the institution’s extended use guidelines.

HCP Doffing:

  • Remove the N95 respirator following appropriate doffing guidelines (be sure to use clean hands and not touch the front of the respirator; handle it only by the elastic straps).
  • Place the used N95 respirator in a brown paper bag ensuring that the bag is correctly labeled with the HCPs full name, unit name/location in which to return it. (Infection Control Note: brown paper bag must be used due to moisture build up during use that must be allowed to evaporate).
  • Place the brown paper bag in the designated “dirty N95” drop off location within the unit/department.
  • Note: if the HCP is a “float” staff member and will not return to the same unit/department for their next shift, mark the N95 and paper bag with the added word “FLOAT” in bold letters and include the request locations for pick up.
  • Place brown bag in “dirty” biohazard bin.

HCP Reuse of Decontaminated N95s

  • At the start of your next shift, the HCP will present to the clean storage area in the unit/department to pick up their decontaminated N95, assuring that their name is on the N95 contained within the new white paper bag before taking it.

(Note: if the HCP is “float” staff, they should present to the clean pickup area that was provided on the brown paper bag).

  • The HCP will notice a tally mark in a different color that has been added to the front/bottom edge of their N95 respirator by the Decontamination Technician after it was processed. This is to track the number of times a particular N95 has gone through the decontamination process.  N95 respirators will be available for five uses, initial use and four decontamination cycles and use.
  • The HCP should inspect the N95 prior to donning to assess for any obvious damage, failure of the elastic straps, etc. If damage is found, notify the unit/department supervisory staff before obtaining a new N95.
  • The HCP dons the respirator per usual procedure ensuring the integrity of the respirator and proper fit.
  • HCP uses the respirator following the institution extended use guidelines.
  • If the HCP finds that there is no decontaminated N95 available with their name on it, they will notify their unit/department supervisor. Situations that may result in no decontamination of N95s are:
    • The Decontamination Technician will inspect N95 respirators for residual lipstick/makeup contamination on the inside surfaces prior to processing them. If contamination is found, the N95 will be discarded, the unit/department leadership will be notified and a log entry will be made.
    • If obvious damage/defects are noted on any N95 submitted for decontamination, it will be discarded by the Decontamination Technician, the unit/department leadership will be notified and a log entry will be made.

Final: 03.30.20

Videos: Donning and doffing

COVID-19 PPE

COVID-19 with N95

COVID-19 with CAPR

Your face shield is your safety shield

Social distancing: We stand together, safely

Download flyers: Preventing the spread of COVID-19

Social distancing—General
Waiting in line—Social distancing
Waiting room changes—Social distancing

The signs below can be placed in waiting rooms or on individual items of furniture to help patients maintain a safe distance from others.

Waiting room changes

Seat unavailable

Hand hygiene reminders
Updated on 05/07/2020 at 4:06 pm
Protect yourself and others
Wash your hands often
Water fountains and personal containers
Updated on 05/20/2020 at 3:58 pm