Combating COVID-19: Best Practices That Clinicians Need to Know

As the number of global cases of coronavirus disease 2019 (COVID-19) rises, it is imperative that healthcare providers stay informed and prepared with the best clinical practices to combat the SARS-CoV-2 virus. Following appropriate guidelines and practicing proper technique will benefit both patients and clinicians and better prevent the further spread of the virus.

It is has been established that the virus mostly spreads from person to person via close contact or respiratory droplets. The Centers for Disease Control and Prevention (CDC) defines close contact with a patient with COVID-19 as being within 6 feet for an extended period of time or having direct contact with the patient’s bodily fluids (ie, sputum, blood, respiratory droplets).¹ When treating patients in such close proximity, it is especially important to use personal protective equipment (PPE), which can help to reduce the risk of acquiring the virus.

PPE and Isolation Precautions

In a podcast interview, Betsey Todd, MPH, RN, a nurse epidemiologist and clinical editor of American Journal of Nursing, noted the importance of proper PPE and how it varies depending on the 4 categories of isolation precautions: standard, contact, droplet, and airborne precautions.²

Unlike standard precaution, contact, droplet, and airborne precautions are all types of transmission precautions, which Ms Todd notes, may be used in combination. While contact precautions include the use of gloves and gowns to treat conditions such as methicillin-resistant Staphylococcus aureus, other conditions such as influenza infections or tuberculosis may require more PPE, such as a face mask or shield (droplet precautions) or an N95 respirator and negative pressure rooms (airborne precautions), respectively.²

When discussing the treatment of patients with suspected or confirmed COVID-19, Ms Todd noted that there is relative certainty that the virus spreads by droplets, which might suggest the need for a mask and face cover. However, she notes that because the virus is still so new, “the CDC recommends for patients that are suspected of having or have confirmed COVID-19, that [health care providers] go ahead and use, not droplet, but airborne precautions, and place the patient in a negative pressure room if available.”

Ms Todd went on to note that “regular surgical-type masks are made for containing droplets from [a clinician’s] own mouth…whereas N95 respirators or other kinds of particular respirators are made to protect what [clinicians are] breathing in.” Therefore, she suggests the use of airborne precaution technique.

Proper PPE would not be as effective if not worn correctly. When wearing a mask, make sure to fit-test by taking a moment to make sure that the mask fits appropriately. Take a few deep breaths to ensure there is no leakage around or near the mask.²

When asked who should be wearing the N95 masks, Ms. Todd replied, “the CDC and World Health Organization are really trying to strongly push back against the idea that everybody should go around wearing any kind of mask… . People think that it will protect them out in public, but the fact is that N95s are not appropriate for wearing long periods of time.”

The World Health Organization noted earlier this month in a news release that the “shortages [in PPE] are leaving doctors, nurses, and other frontline workers dangerously ill-equipped to care for COVID-19 patients, due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns, and aprons.³”

This article originally appeared on Clinical Advisor