Updated March 18 at 8 a.m.

Mask Protocol

Team members are expected to wear a procedural face mask whenever interacting with guests (patients or visitors) or in any public area.

Patients & Visitors
All patients and visitors must wear a face covering over their mouth and nose at all times while in any OrthoNebraska facility. If the patient or visitor does not have a face covering upon arrival they will be provided one. Patients and visitors are allowed to take these masks home following their appointment; however, we advise that they be considered ‘dirty’ and be disposed of after exiting the building.

Employees & Providers
All patient-facing employees and providers in patient care areas must wear a procedural mask, provided by OrthoNebraska, while at any OrthoNebraska facility. For non-patient facing team members, masking is required upon entry into the facility, but is optional once in socially distanced work areas.

Vaccinated employees may remove their mask in conference rooms or support offices when social distancing guidelines can be maintained. Non-vaccinated employees should continue to practice strict masking whenever possible.

In accordance with local mask mandates, all team members should wear a mask in public areas, including hallways, patient care areas, and rest rooms.

N95 Masks
Team members in high-risk situations, including intubation/extubation, have the choice to wear an N95 for asymptomatic surgical patients if you are vaccinated. There are no changes to ED and ENT procedure mask protocol at this time.

 

How, Where & When to Wear a Mask

How do I properly put on a procedural mask?

  1. Perform hand hygiene
  2. Grasp mask
    • Pinch procedure mask at the ear loops or
    • Grasp upper ties on surgical mask
  3. Place over face
    • For procedure mask: Secure ear loops behind the ears. Secure mask.
    • For surgical mask: Secure upper ties first, behind head. End by securing lower ties behind head.
  4. Perform hand hygiene

How do I properly remove a procedural mask?

  1. Perform hand hygiene
  2. Remove mask
    • Remove procedure mask by holding the ear loops. The front is contaminated, so remove slowly and carefully.
    • Remove surgical mask by untying lower ties FIRST. Untie upper ties last. The front is contaminated, so remove slowly and carefully. Ensure ties do not fall into clean interior side of mask.
  3. After removing facemask, visually inspect for contamination, distortion in shape/form. If soiled, torn, or saturated the mask should be discarded.
  4. If the facemask is NOT visibly soiled, torn, or saturated, carefully store on a paper towel exterior side down.
  5. Perform hand hygiene.

Where do I get a mask?
One mask will be provided to each patient-facing team member at the start of each shift. These masks will be available at the above temperature screening check-points.

Can I take the mask home?
Please do not take home the procedural masks. It should be considered part of your uniform and, therefore, disposed of or placed in the reusable bins prior to contact with others outside of the facility. Healthcare workers who are wearing procedural masks may have contaminated their masks by either close contact with patients and/or by touching the mask while at work. In order to avoid potentially carrying those germs home to your families, please do not take the masks home.

What do I do with my procedural mask at the end of a shift?
If the mask is not soiled or damaged, please see the reuse instructions located HERE.

Can we wear homemade, reusable masks?
No. The homemade masks are not as effective as hospital approved procedure masks. OrthoNebraska has enough masks for now for employees to wear the supplied masks.  These contaminate masks should not be brought home. They should be disposed of in the proper containers at the end of each shift.  It is important to not touch the mask after you start wearing it or when you take it off.  And, as always, wash your hands before and after donning a mask.

Reusing Masks

In procedural areas, can a single procedural mask be worn continuously, including across different cases?
Yes, a single mask can be worn across different cases and between cares of different patients. Masks must be changed if they become wet or contaminated during a case. The routine use of face shields will decrease the likelihood of this occurring and is encouraged.

How long can I wear a procedural mask?
A procedural/surgical mask can be reused up to three shifts/days.

What is considered ‘soiled’ or ‘dirty’? What might be a reason for not being able to reuse a mask?
Anything on the mask that would block the UV light from getting to the mask itself would make the mask unable to be reused. This includes makeup smudges and any body fluids. Also, if a mask has lost its ability to hold its shape around the face it should be discarded.

If a patient or visitor was given a mask, do I need to collect it from them before they leave?
No, you do not need to collect masks given to patients or visitors.

N95s

Can I wear an N95 mask?
N95s are available for those at higher risk – for example: individuals who are working with suspected COVID-19 patients or anyone directly involved in an intubation of a patient. CLICK HERE for a short video with information regarding proper fitting.

If I have an N95 at home, can I bring that in and wear it?
Employees may wear an N95 respirator that they have brought from home, at their own risk, while in patient care areas.  They can NOT wear their own respirator when caring for a PUI (person under investigation) or a known COVID-19 positive patient.  In these cases they must wear the N95 approved by the hospital. PLEASE NOTE: OrthoNebraska will not be responsible for decontaminating any personal N95s. 

If I have an N95, how can I best care for it?
Because of limited supply, it is incredibly important to properly store and care for our N95 masks. Below are a few things to keep in mind:

  • After removing the N95 mask, visually inspect it for contamination and/or distortion in shape or form. If the mask is contaminated, wet, creased or bent – the mask should be discarded.
  • If the N95 is not visibly contaminated or distorted, carefully store it to avoid destroying the spare and consistency of the mask. Please DO NOT store them in your personal bags, backpacks, or in a pocket!
  • The N95 should be stored in a well-ventilated container (like a paper bag with handles) with your name and the date clearly labeled on the bag.
  • A disposable N95 can be worn for several hours and multiple shifts if it is not wet or distorted, if it was not touched while delivering patient care and is not involved in an aerosol-generating procedure (per CDC guidelines).

Why are we wearing procedural masks and not N95s?
At this time, COVID-19 appears to be transmitted primarily through large respiratory droplets. Procedure masks help to provide protection against respiratory droplet spread. In addition, although not thought to be a major route of transmission, there are some data to indicate COVID-19 viral shedding in the presymptomatic stage. Wearing procedure masks in a more generalized manner may help to prevent spread from persons with presymptomatic shedding or persons with very mild disease. Finally, wearing a procedure mask very effectively contains respiratory secretions and may prevent an infected provider from spreading the virus to patients or coworkers. In contrast, N95 respirators provide a higher level of filtration and are important in clinical situations where infectious droplets could become aerosolized. This primarily occurs in specific clinical situations such as when a patient is intubated or undergoes bronchoscopy. N95 respirators are difficult to wear for long periods of time and are impractical for generalized use. Also, the supply of N95 respirators is smaller and our supply would not support universal use. We must reserve N95 use for patients with known or suspected COVID-19 and high risk situations.

Visual Guidance

The following images are intended to provide clarification to avoid potential errors in the proper use and re-use of face masks.

Figure 1 – This image demonstrates approved wear of face mask. Facemask is shown secured over nose and mouth.

Figure 2 – This image shows the correct way to store mask when not in use. Notice the exterior of the mask is facing DOWN.

Figure 3 – This image shows the correct way to store a surgical mask when not in use. Notice the exterior of the mask is facing DOWN and ties are placed carefully away from the inside of the mask

Figure 4 – This image demonstrates inappropriate wear of the procedure mask. Procedure mask should not be pulled under mouth

Figure 5 – This image demonstrates inappropriate wear of the procedure mask. Procedure mask should not be pulled under chin

Figure 6 – This image demonstrates inappropriate use of procedure mask. Procedure mask should not be kept on the elbow when not in use

Figure 7 – This image demonstrates inappropriate wear of the surgical mask. Surgical mask should not hang from lower ties

Figure 8 – This image demonstrates the wrong way to place mask when not in use. Notice the exterior of the mask if facing up. This is not correct

Figure 9 – This image demonstrates the wrong way to store surgical mask when not in use. Notice the exterior of the mask if facing up and ties are touching the interior of the mask. This is not correct.

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