Review this page for more information about the guidelines and resources available to prevent the spread of infection.
Jump to:
General Infection Prevention Information | Universal Masking Guidelines | Visitor Restrictions
General PPE Recommendations | Specific PPE Recommendations | Clinical Guidance
Specialty-Specific Clinical Guidance | Pediatric-Specific Clinical Guidance | Testing Guidance
End-of-Life Care | Maestro Care | Employee Health | Environmental Controls and Cleaning Protocols
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General Infection Prevention Information |
Who to Contact and Contact Information for COVID-19 Questions
This document lists contact information to help quickly answer common questions related to COVID-19. This resource is intended for DUHS team members at Duke University Hospital, Duke Regional Hospital and Duke Raleigh Hospital.
Infection Prevention 101 Education
The document outlines the basic principles behind standard and transmission-based precautions. To understand the “why” behind the PPE recommended for caring for COVID-suspected or confirmed patients, it is helpful to understand how COVID-19 can be transmitted using these definitions and principles.
COVID-19 Infection Prevention Bundle Checklist
The document outlines many of the measures we have implemented at Duke Health to keep our team members safe while continuing to provide high-quality care to our patients.
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Universal Masking Guidelines |
Click the links below to reveal more information about masking at Duke Health facilities. (Updated 03.31.22)
Team members are required to wear a Duke-issued mask while working in a clinical building. Team members are also required to wear a face covering while walking into and out of work and while using public transportation. Acceptable masks should completely cover the nose and mouth. Team members working in any non-clinical/administrative Duke Health buildings where there is no direct patient care are not required to wear a mask while in Tier 2 of re-opening.
We recommend that unvaccinated team members continue to mask in all settings, except when actively eating or drinking. In settings where masks are no longer required, we recommend that team members continue to ask colleagues if they would prefer for them to be masked and that everyone treat one another with kindness and respect.
| Setting | Mask Requirements |
|---|---|
| Clinical Buildings (inpatient and outpatient buildings where patient care is delivered) |
Masks required at all times EXCEPT:
|
| Non-Clinical/Administrative Buildings | Masks not required. Masks optional during meetings with others based on personal preference. |
| Public Transportation (shuttles/buses/vans) |
Masks required at all times. |
All patients who can tolerate masks are required to wear one in common spaces of our campus, hospitals and clinics (e.g., waiting rooms, hallways, cafeterias). Masks should NOT be worn by anyone who has trouble breathing, is unconscious, incapacitated, or otherwise unable to remove the mask without assistance. Universal masking policies do not apply to patients in inpatient behavioral health (emergency and inpatient) care units and children under the age of 2.
It is strongly recommended that all patients and visitors wear a Duke Health-issued earloop mask when inside a Duke Health facility or while in close proximity to other people for an extended period of time. Review this list of FAQs for more information.
- Approved mask types: Earloop masks, surgical masks with ties, N95s and KN95.
- Not approved mask types: Bandanas, neck gaiters, cloth, and personal vented masks/respirators.
- If a patient or visitor does not have an approved mask, they will be provided with an earloop mask to wear either in place of or over top of their personal mask.
Outpatients who are able to tolerate a mask are required to wear them for the duration of their visit to the healthcare facility.
Inpatients will be provided a mask to wear when a healthcare team member enters their room; however, inpatients are not required to wear masks while in their hospital room.
A letter in English and Spanish is available for inpatients to inform them of our current masking guidelines in place.
Visitors are required to wear a mask:
- at all times in common spaces of our campus, hospitals, and clinics
- when any Duke team member enters the patient or exam room
- at all times when visiting a hospitalized patient residing in a shared patient room
It is strongly recommended that all patients and visitors wear a Duke Health-issued earloop mask when inside a Duke Health facility or while in close proximity to other people for an extended period of time. Review this list of FAQs for more information.
- Approved mask types: Earloop masks, surgical masks with ties, N95s and KN95.
- Not approved mask types: Bandanas, neck gaiters, cloth, and personal vented masks/respirators.
- If a patient or visitor does not have an approved mask, they will be provided with an earloop mask to wear either in place of or over top of their personal mask.
Visitors should be encouraged to wear a mask at all times while visiting hospitalized patients to prevent transmission of COVID-19 to the person they are visiting.
We want to have a well-fitting, multilayer mask. There are several ways 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.
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Visitor Restrictions & Guidelines |
Visitor restrictions are in place at all Duke Health facilities to reduce the spread of infection.
- Current full list of visitor restrictions in place
- Inpatient Visitor Restriction Talking Points (TIER 2)
- Pediatric & Birthing Center Visitation Guidelines
- Inpatients in Adult Areas Overnight Visitation Update
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General PPE Recommendations |
DUHS PPE Recommendations for COVID-19 Response and FAQ (03.21.22)
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.
Appropriate PPE During COVID-19 Response (Infographic) (01.28.22)
This infographic provides concise and simplified recommendations for what PPE healthcare workers should wear.
Recommended PPE for Outpatient Management of Asymptomatic Patients (04.01.22)
This document provides recommendations for the required PPE for a variety of visits in outpatient settings with differential risk.
Isolation Cart PPE (Table) (01.27.22)
This table provides streamlined information about the supplies that are needed for providing care for patients with known or suspected COVID-19.
PPE Observer Standard Work (05.05.20)
This chart provides guidance for trained observers standard work to support the clinical staff to ensure the safe practice and use of personal protective equipment while providing care to highly infectious patients.
View our PPE FAQs for answers to your biggest questions.
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Specific PPE Recommendations |
The links below will take you to the most current documents and policies for each PPE topic. The DUHS PPE Recommendations for COVID-19 Response and FAQ summarizes required PPE for team members caring for COVID+ patients.
- Donning and Doffing
- Eye Protection
- Eye protection is REQUIRED for all team members during direct interaction with patients and visitors. Direct interactions include but are not limited to:
- Any face-to face interactions with patients and visitors within six feet for any duration of time
- Entering any patient room or space regardless of isolation precautions
- Entering any patient room on isolation precautions (always follow posted isolation signage for additional PPE requirements)
- *The exception to the requirement to wear eye protection is in the behavioral health (emergency and inpatient) care areas.
- Individual healthcare workers may choose to wear their own eye protection when not providing care to patients on Special Airborne Contact isolation, Droplet, or Droplet/Contact isolation.
- Eye protection is REQUIRED for all team members during direct interaction with patients and visitors. Direct interactions include but are not limited to:
- Face Shields and Surgical Face Masks
- Face shields continue to be REQUIRED for care of patients on Special Airborne Contact isolation, Special Droplet, or Special Droplet/Contact isolation.
- Face shields are the preferred eye protection as they are readily available, provide full coverage of the eyes, and protect the underlying face mask from potential contamination.
- Head Coverings
- N95s
- PAPRs
- PPE Conservation
- Reusable Cloth Gowns
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Clinical Guidance |
View an up-to-date list of COVID-19/SARS-2-CoV symptoms. Symptoms can develop as soon as two days after exposure or in as many as 14 days after exposure. The average time from exposure to symptom onset is five to six days.
View documents on:
- Antithrombotic Therapy
- Dialysis
- Discharge Process & After Visit Summaries (AVS)
- High-risk Populations
- ICU Care
- Limiting Patient Movement
- Respiratory Therapy Guidance
- RRT & Coding
- Special Airborne Contact Precautions Information & Patient Transport
All patients for whom there is clinical suspicion for COVID-19 and who are undergoing testing to rule out COVID-19 will be managed as a Person Under Investigation (PUI). PUI are designated with a “Rule-out COVID-19” infection status. Patients with confirmed COVID-19 or clinically diagnosed COVID-19 infection are designated with a “COVID-19” infection status. All patients with suspected (PUI) or confirmed COVID-19 should be placed on Special Airborne Contact Precautions - Tracheostomy Protocol
In addition to the guidance above, there are several specialty-specific documents that relate to infection prevention protocols. Click the first link to view these specialty-specific documents and the second link to view documents on pediatric clinical guidance and resources for families.
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Specialty-Specific Guidance |
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Pediatric-Specific Guidance |
- Bed Flow
- Clinical Management Guidelines for Pediatric Patients Exposed to or Infected with COVID-19
- DUH Pediatric Cardiac Catheterization Lab Suspected or Confirmed COVID-19 Patients – Emergent Procedures
- Multisystem Inflammatory Syndrome in Children (MIS-C)
- Response to COVID-19 Exposures in Shared Neonatal Ward
- Resources for Families
- Pediatric AVS: Tips to Prevent the Spread of COVID-19 -- English, Spanish, and Arabic
- Guidelines for the Management of Patients Infected with or Exposed to COVID-19 in Ambulatory Pediatric Clinics
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Testing Guidance |
- DUHS COVID-19 Testing Guidance and FAQs (03.24.22)
- This document summarizes the current DUHS testing guidance for COVID-19 across the health system.
- It includes a table of contents with FAQs about the timing of tests, types of tests, repeat testing, rapid antigen tests, patient-reported home and outside facility tests, and antibody testing.
- Hospital-Specific Testing Guidance
- Test Collection Instructions
- Antibody Testing
- Pediatric Testing (Admission Workflow)
- Repeat Testing
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End-of-Life Care |
View documents on end-of-life care and decedent care.
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Maestro Care |
View documents on Maestro Care updates and guidance related to COVID-19.
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Employee Health |
- Guidelines for Healthcare Workers upon Returning Home from Work
- Workspaces & Break Room Guidance
- Exposure Investigation FAQs
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Environmental Controls and Cleaning Protocols |
All patient care equipment should be cleaned using a hospital-approved/EPA-registered disinfectant that is effective against SARS-CoV-2. After use in a COVID room, the equipment will be cleaned using a 2-step method. Listed below are the steps to clean and disinfect equipment, with and without an anteroom.
- With anteroom: Clean equipment in the patient’s room, while fully donned in PPE, and move equipment to anteroom once clean. Doff PPE according the established procedures, perform hand hygiene and don clean gloves. Clean equipment again in the anteroom and then hand or roll equipment to observer/buddy to remove into the hallway.
- Without anteroom: Perform initial cleaning in the patient room and move equipment to hallway once clean. Doff PPE according to the established procedures and exit the room; after performing hand hygiene and donning clean gloves, clean the equipment again in the hallway.
Doff PPE according to the established procedures and exit the room; after performing hand hygiene and donning clean gloves, clean the equipment again in the hallway.