What are the COVID-19 guidelines for healthcare workers (Healthcare Workers)?

COVID-19 Guidelines for Healthcare Workers

Healthcare workers should use fitted respirator masks (N95, FFP2, or equivalent) with additional PPE (gloves, gown, eye protection) when performing aerosol-generating procedures on COVID-19 patients, and surgical/medical masks with standard PPE for routine care of non-ventilated patients. 1

Personal Protective Equipment Requirements

Aerosol-Generating Procedures

• Respirator masks required: N95, FFP2, or equivalent respirators must be worn during aerosol-generating procedures 1
• Aerosol-generating procedures include:
  • Endotracheal intubation
  • Bronchoscopy
  • Open suctioning
  • Nebulized treatments
  • Manual ventilation before intubation
  • Physical proning of patients
  • Disconnecting patients from ventilators
  • Non-invasive positive pressure ventilation
  • Tracheostomy
  • Cardiopulmonary resuscitation 1
• Additional PPE required: gloves, gown, and eye protection (face shield or safety goggles) 1
• Procedures should be performed in negative pressure rooms 1

Routine Care

• For non-ventilated COVID-19 patients: surgical/medical masks with standard PPE (gloves, gown, eye protection) 1
• For mechanically ventilated patients (closed circuit): surgical/medical masks with standard PPE 1
• Universal masking is recommended for all healthcare workers entering healthcare facilities 1, 2

Infection Control Measures

Workspace Management

• Divide departmental spaces into "risk" and "clean" zones 1
  • Risk zone: imaging rooms, corridors, counters (secondary protection required)
  • Clean zone: reading rooms, offices, meeting rooms (primary protection required)
• Perform aerosol-generating procedures in negative pressure rooms 1
• Ensure adequate isolation rooms and anterooms 3
• Minimize overcrowding and restrict visitors 3

Screening Protocols

• Implement verbal screening and temperature checks at the start of each shift 1
• Screen all patients for fever and respiratory symptoms before entry 1
• Patients with fever (>37.5°C) should be directed to fever clinics and tested for COVID-19 1
• Point-of-care risk assessment should be performed to evaluate the likelihood of SARS-CoV-2 infection 1

Testing Recommendations

• RT-PCR testing is the gold standard for diagnosis of COVID-19 1
• When resources permit, test healthcare workers routinely according to local epidemiological characteristics 1
• Healthcare workers with symptoms should be tested immediately and quarantined until results are available 1

General Preventive Measures

Hand Hygiene

• Clean hands frequently with soap and water for at least 20 seconds 1
• When handwashing isn't available, use alcohol-based hand sanitizer (>60% ethanol or >70% isopropanol) 1
• Perform hand hygiene before and after patient contact, before clean/aseptic procedures, after body fluid exposure, after patient contact, and after touching patient surroundings 2

Social Distancing

• Maintain at least 2 meters distance from others in healthcare settings 1, 2
• Avoid large gatherings or meetings of 10+ people 1
• Implement physical barriers where possible 2

Equipment and Environment

• Regularly disinfect equipment and surfaces (2-3% hydrogen peroxide, 2-5g/l chlorine disinfectant, or 75% alcohol) 1
• Wipe down shared equipment before use 1
• Clean and disinfect mobile phones and personal devices regularly 2

Additional Recommendations

Personal Practices

• Do not go to work if feeling sick, having fever, cough, or shortness of breath 1
• Avoid touching eyes, nose, or mouth with unwashed hands 1
• Cover coughs and sneezes with tissues or elbow 1
• Change work clothes at the workplace before returning home 1
• Drive to work alone when possible (avoid carpooling) 1

Training and Communication

• Ensure clear communication about IPC guidelines 3
• Provide mandatory training on infection control and proper PPE use 3
• Include all staff (including cleaning staff, porters, and support staff) in training 3
• Use multiple communication strategies, including institutional websites and key personnel 4

Common Pitfalls and Caveats

• PPE shortages: During shortages, powered air purifying respirators (PAPRs) can be used by healthcare workers who failed N95 fit testing 1
• Self-contamination: Proper donning and doffing procedures are critical to avoid self-contamination 2
• Guideline confusion: When local guidelines are ambiguous or constantly changing, healthcare workers may feel unsure about proper adherence 3
• Support staff inclusion: Ensure all facility staff, including cleaning and support staff, are included in IPC implementation 3
• Workplace culture: A supportive workplace culture and management support significantly influence adherence to guidelines 3

Healthcare workers are at high risk of COVID-19 exposure, with documented cases of severe illness and death among infected healthcare personnel 1. Strict adherence to these guidelines is essential to protect both healthcare workers and patients during the pandemic.