COVID-19 Document Library

Based on supply shortages of chemotherapy-tested exam gloves, OESO and IP have evaluated and approved a number of alternative gloves that meet our high standards. This handout shows the options that are currently or may soon be distributed to help you identify these approved chemogloves and for which drugs they are appropriate. Please note: The Halyard Skybreeze nitrile exam glove is expected to replace Cardinal exam gloves as the new standard. Updated 08.10.22.

This document provides guidance for masking and addresses questions regarding double masking. Below is the content of the document. Uploaded: 1.29.21 

Renewed discussions regarding the potential benefit of double masking on source control and prevention of COVID-19 transmission have prompted many questions about whether changes will be made to the current DUHS masking policy.  Eleven months of experience has demonstrated that the healthcare setting is a well-controlled environment with robust infection prevention protocols in place that help limit the transmission of COVID-19. The healthcare setting is distinctly different than a community setting without these strict controls in place and much of our workforce is now vaccinated.  Furthermore, masks used in healthcare settings are also assessed for filtration efficacy and meet regulatory standards before distribution.  

Unfortunately, no well-designed studies have been conducted to scientifically answer the question “are two masks better at preventing COVID-transmission than one?” One study demonstrates the impact of wearing a well-fitting mask to improve source control and how wearing an overlying mask may improve overall mask fit.¹ Logically, having additional layers of barrier protection over the nose and mouth would reduce particle dispersion. 

With the now broadly circulating B1.1.7 (UK) variant and concern over the B1.351 (S. African) variant in the U.S., many are looking for ways to augment the infection prevention strategies in place – double masking is one such strategy. As we strive to continuously update our COVID-19 guidance to keep in step with the scientific community, we updated masking guidance language as follows. We will continue to closely monitor COVID-19 infections among team members and, should we see any concerning trends or signals, will reevaluate our recommendations below:

Double masking is optional for patients, visitors, and Duke team members at this time. However, we do encourage team members to make simple mask modifications to improve fit, and thereby improve source control. More tips to make your mask fit better are available on the Infection Prevention webpage.

• For patients and visitors: Patients and visitors will be offered a Duke-issued medical mask when entering the healthcare space. If the patient or visitor is wearing their own mask, they may place the Duke-issued mask over the top of their mask if they choose. Patients and visitors may wear their own masks as long as they adequately cover the mouth and nose and have ties or earloops. Patients and visitors may not wear neck gaiters or bandanas. Patients and visitors may not wear any mask with an exhalation valve. Simple mask modifications can be made to help improve fit, if needed. Review a full list of our patient and visitor masking guidelines.
• For Duke team members: Duke team members are still required to wear a Duke-issued medical mask in the healthcare setting. Should team members choose to wear a second mask, they may place a Duke-issued mask over the top of their own mask. Simple mask modifications can be made to help improve fit, if needed. Wearing the Duke-issued medical mask as the outer layer provides a fluid-resistant barrier. We continue to recommend eye protection during patient care activities. Review a full list of our team member masking guidelines.

Mask modifications:

There are many options to make your mask fit better if it is too loose.

• This video demonstrates one way to make your mask tighter.
• A second option is to simply twist the straps of your Duke-issued mask before you put it on so that the elastic is in a crisscross.
• Another option is to use a plastic clip to pull the straps tighter behind your head.

References:

Mueller et al. Matter 2020 Sep 2;3(3):950-962.

This document illustrates seal check instructions for the 3M 1870 Plus N95 respirator. While this guide was made for the 3M brand of N95 respirators, the same principles of fit testing apply to other types of respirators. Uploaded 05.26.21.

This document illustrates seal check instructions for the Halyard N95 respirator. While this guide was made for the Halyard brand of N95 respirators, the same principles of fit testing apply to other types of respirators. Uploaded 05.26.21.

In response to the COVID-19 pandemic and to fulfill the Office of Safety and Health Administration’s (OSHA) Emergency Temporary Standard (ETS) requirements, Duke Health has developed a COVID-19 Safety Plan to be used in addition to previously implemented policies, training, recordkeeping, and reporting. This document includes policies and procedures to minimize the risk of transmission of COVID-19, in accordance with OSHA’s COVID-19 ETS for Healthcare. Uploaded 8.11.21. 

This document illustrates seal check instructions for the 3M 9205+ N95 non-surgical respirator. Uploaded 01.06.22.

This document includes a grid and FAQs about the use and reuse of different N95 respirators, which differs based on how and where the N95 is being used. Uploaded 01.16.22.

Required N95 Use for COVID-19 and Other Airborne Pathogens

• If you are wearing an N95 respirator while caring for patients with suspected or confirmed COVID-19 infection (or otherwise on Airborne or Special Airborne Contact Isolation), the respirator should be used for the entire shift and discarded at the end of the shift unless visibly soiled, damaged, or fails seal check.  

Optional N95 Use

• If you choose to wear an N95 respirator for added respiratory protection in place of an ear loop mask, the N95 may be reused for up to 5 shifts; discard it after 5 shifts or sooner if visibly soiled, damaged, or fails seal check.
• If you are working in the procedural and peri-op environment, the only change to your current allotment and rotation plan is to wait 5 days between uses rather than 3. Additional detail can be found here.

COVID-related PPE requirements for visitors 1.14.22. Uploaded 1.16.22

This document summarizes DUHS recommendations and FAQ for required PPE for team members caring for COVID+ patients. It also anwers some FAQs about patients and visitors in or entering isolation precaution rooms. Uploaded 03.21.22

The attached document contains information from the Centers for Disease Control and Prevention (CDC) regarding healthcare workers caring for asymptomatic patients in areas of moderate to high community transmission wear eye protection in addition to face masks. Effective 1.13.22 Updated 03.21.22

This document illustrates N95 seal check instructions for the following N95 non-surgical respirators: 3M 8210/8110S (without a valve) and 3M 8511 (with a valve). Updated 01.07.22

This document was mailed to all Duke Health employees as a reference for when to wear a face covering in the community and in our facilities. It was provided in a package to all employees along with cloth masks and hand sanitizer. Uploaded 07.10.20

This document includes guidelines for Duke Raleigh Hospital EVS team members on cleaning procedures for inpatient rooms during the COVID-19 response. Uploaded 7.22.20

This document provides a checklist for Duke Raleigh Hospital EVS team members on the cleaning procedures for inpatient rooms during the COVID-19 response. Uploaded 7.22.20

DUHS has deployed multiple models of N95s. This document outlines which N95 respirators can be used for COVID care or voluntary use. It also links to seal check instructions for each model and summarizes extended use and reuse guidance. Updated 01.16.22.

This document illustrates N95 seal check instructions for healthcare workers. While this guide was made for the 3M brand of N95 respirators, the same principles of fit testing apply to other types of respirators. Uploaded 03.30.20

This document provides important clarifications on the extended use, re-use, and disinfection of PAPR hoods for all healthcare workers providing care to patients with known or suspected COVID-19 infection. Updated 04.14.20

This updated infographic provides concise and simplified recommendations for what PPE healthcare workers should wear during the COVID-19 response. This also includes reasonable accommodations for patient/provider masking compliance. Updated 1.28.22.

This document provides instructions for our universal masking initiative at our hospital and clinic sites. It also includes answers to questions from colleagues and patients. Updated 06.02.20

This document is for healthcare workers responsible for transporting patients on special airborne contact precautions and includes information about the transport of vented patients. Updated 04.09.20

This document for managers clarifies their responsibilities related to supplies, including PPE, during the COVID-19 pandemic. Uploaded 04.02.20

This document is for healthcare workers and explains DUHS' discontinuation of contact precautions for MRSA and VRE colonization patients. Uploaded 03.18.20