Infection Prevention Guidance
Universal Source Control
Universal source control is recommended for all persons entering a healthcare facility.
HCPs should wear medical-grade surgical/procedure facemasks or respirators for universal source control at all times while they are in the healthcare facility. Well-fitting medical-grade facemasks or respirators are strongly preferred for HCP interacting with patients as non-medical face coverings do not offer reliable protection in higher risk clinical settings.
If a surgical facemask is worn, it is important that it fits well. For more information refer to guidance in the CDC Interim Infection Prevention & Control Recommendations. CDC has also created an FAQ addressing use of 2 masks at the same time to improve the fit of facemasks in a healthcare setting.
Extended use of masks and respirators should be based on principles set forth in prior CDC PPE optimization guidance.
Universal Use of PPE For Patient Care
When there are moderate to high rates of COVID-19 in the community, HCP are more likely to encounter asymptomatic or pre-symptomatic patients. For this reason, in addition to standard precautions, the CDC recommends that HCP wear:
- Eye protection in addition to a facemask for any close contact with patients. This is particularly important if the patient cannot be reliably source controlled throughout the visit.
- An N-95 respirator or higher instead of a facemask for any aerosol generating procedures and for surgical procedures that might pose a higher risk for transmission if the patient were to have COVID-19.
See Implement Universal Use of PPE section of CDC Interim Infection Prevention & Control Recommendations
Personal Protective Equipment for Patients with Suspected or Confirmed COVID-19
- CDC Interim Infection Prevention and Control Recommendations for Healthcare Personnel During COVID-19 Pandemic
- The Infectious Diseases Society of America (IDSA) Infection Prevention in Patients with Suspected or Known COVID-19 Guidelines.
NIOSH and Additional Covering Over N95
NIOSH does not recommend nor approve* of the use of an additional covering over an N95 respirator due to concerns regarding potential interference with the respirator fit and function. In addition, it is never recommended to wear a medical facemask or a cloth mask under an N95 respirator as it will interfere with the seal.
* With exception for crisis situation as a last resort to optimize the supply of N95 respirators
Assuring PPE Supplies
Whether your facility currently has adequate PPE supplies or has PPE supply constraints, LAC DPH asks all facilities to review and be familiar with CDC strategies to optimize PPE supplies and current CAL/OSHA Guidance. DPH can provide a short-term supply of PPE to eligible healthcare facilities and providers if their supply is critically low.
Cal/OSHA Interim Guidance on COVID-19 for Health Care Facilities-Severe Respirator Supply Shortages (8-6-20) guidance . CAL/OSHA has updated guidance regarding respirator requirements when caring for patients with suspected or confirmed COVID-19. Initial and annual N95 respiratory fit testing is required for all staff. Extended use of N95 respirators is permitted however re-use over multiple days is not permitted at this time.
CDC Strategies to Optimize the Supply of PPE - see CDC website
DPH PPE Assistance Program: This program can provide a short-term supply of PPE to eligible healthcare facilities and providers if their supply is critically low. Note that this program serves as a bridge and does not supplant the normal supply chain for PPE. Visit http://ph.lacounty.gov/ppe
PPE Coordinator email for general inquiries about PPE supplies
DPHPPECoordinator@ph.lacounty.gov
