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.
COVID-19 Update and Q&A Session
This presentation provides a short overview of Duke Health’s COVID-19 response. The presentation is led by Dr. Sarah Lewis with Infectious Diseases and Dr. Kristen Said with Employee Health.
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Universal Masking Guidelines |
Click the links below to reveal more information about masking at Duke Health facilities.
All team members are required to wear a Duke-issued mask while working in a clinical space. Team members are also required to wear a face covering while walking into and out of work and while using Duke transportation. Team members working in any Duke Health building where there is not a formal screening process and no direct patient care may wear a cloth mask with ties or earloops. Acceptable cloth masks should completely cover the nose and mouth.
Double masking is optional for Duke team members at this time. Should team members choose to wear a second mask, they may place a Duke-issued mask over the top of their own mask.
- Video: Team Member Masking
- Masking in Common Areas (Flyer)
This flyer provides an important reminder about limiting the number of unmasked individuals who are in close proximity with one another while eating and drinking. - Getting Through the Day with your Mask (Flyer)
This flyer contains tips for staff on how to go about their day with masks on and how to properly remove and store their mask while eating, drinking and going to the restroom.
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 units and children under the age of 2.
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. Double masking is optional for patients at this time. Patients will be offered a Duke-issued medical mask when entering the healthcare space. If the patient is wearing their own mask, they may place the Duke-issued mask over the top of their mask if they choose.
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
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. Double masking is optional for visitors at this time. Visitors will be offered a Duke-issued medical mask when entering the healthcare space. If the visitor is wearing their own mask, they may place the Duke-issued mask over the top of their mask if they choose.
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. View more on masking guidance for patients and visitors.
We want to have a good fitting mask. 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.
For more tips on how to appropriately wear your mask, review this document.
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Visitor Restrictions & Guidelines |
Visitor restrictions are in place at all Duke Health facilities to reduce the spread of infection. View:
- Current full list of visitor restrictions in place
- Updated Visitor Restrictions Effective October 27
- Visitor Restriction Talking Points
- Pediatric & Birthing Center Visitation Guidelines
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General PPE Recommendations |
Appropriate PPE During COVID-19 Response (Infographic)
This infographic provides concise and simplified recommendations for what PPE healthcare workers should wear.
Recommended PPE for Outpatient Management of Asymptomatic Patients
This document provides recommendations for the required PPE for a variety of visits in outpatient settings with differential risk.
Isolation Cart PPE (Table)
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
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 |
- Donning and Doffing
- Eye Protection
- Note: Eye protection is REQUIRED for all healthcare workers providing direct care to a patient who is unmasked.
- 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.
- Face Shields and Surgical Face Masks
- Note: Face shields continue to be REQUIRED for care of patients on Special Airborne Contact isolation, Droplet, or Droplet/Contact isolation.
- Face shields are the preferred eye protection as they provide full coverage of the eyes and also protect the underlying face mask from potential contamination, however, groups may request alternate eye wear.
- Head Coverings
- N95s
- Also, view our Video: Decontamination Process for N95 Respirator
- 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
- 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 |
- Hospital Specific Testing Guidance:
- Test Collection Instructions
- Antibody Testing
- Pediatric Testing (Admission Workflow)
- Periop Testing
- 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
- Employee Screening:
- 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 CoV2. 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.