The safety of health care workers is critical to our response to the COVID-19 pandemic.

We are diligently and deliberately working to conserve, preserve, extend, manage, monitor and utilize PPE supplies appropriately to ensure the continued availability of these items. The focus is currently on conserving PPE while actively acquiring additional supply through any available avenues.

Updated information from Fraser Health Infection Prevention and Control on COVID-19 is available on Fraser Health Pulse. (Note: internal link - must be signed in to the Fraser Health network to access.)
 
  • How does Fraser Health address any breaches of infection control practices?

    Fraser Health’s Infection Prevention and Control practitioners work to educate staff and clinicians on the proper infection prevention and control practices, including the proper use of personal protective equipment.

    If you see any breaches of infection prevention and control practices, please inform your supervisor. If needed, the site directors and medical directors will follow up to address the situation.

  • Can I wear the same personal protective equipment for a full shift? When should I change my mask? 

    The practice of extended use of PPE during the current pandemic has been reviewed by the BC Centre for Disease Control and the Ministry of Health.

    As long as proper hand hygiene is followed, and the protocols related to the extended use of masks and eye protection are followed, this practice is safe and ensures everyone has access to the protective equipment they require.

    Your mask should be changed prior to leaving the unit or patient care area for breaks (a new one obtained when you return to work) or if it becomes soiled, wet, damp or difficult to breathe through. Gloves and gowns should be changed between all patients. 

  • I am a community health worker for Home Health and was wondering whether I should be wearing PPE? 

    Health workers should be using PPE based on the applicable precautions for the client.This includes wearing eye protection and a procedure mask for all client encounters during this COVID-19 pandemic.

    When caring for patients with respiratory symptoms or those who have known/suspected COVID-19, use additional droplet/contact precautions, which includes performing hand hygiene, donning a gown, a procedure mask, a face shield and gloves. Observe airborne precautions for any aerosol generating procedures by wearing an N95 respirator.

    There is a COVID-19 Donning and Doffing PPE Guidance for Community Programs Providing Community Client Home Services available on Pulse. (e.g., Home Health, Home Support, Mental Health and Substance Use Services) 

  • We have been sent boxes of masks and the box indicates they are expired. Is it okay to use these products?

    Yes, as explained below, it is acceptable to use these procedure/surgical masks or N95s past their shelf life as long as you inspect them prior to use to ensure straps are intact and there are no visible signs of damage.

    As per Health Canada statement Optimizing the use of masks and respirators during the COVID-19 outbreak released on April 6th, 2020, as well as in the Ministry of Health COVID-19: Emergency Prioritization in a Pandemic Personal Protective Equipment (PPE) Allocation Framework.  Health Canada states: “masks can still be used beyond their shelf life to protect health care providers.  Health care providers should check that the straps are intact and there are no visible signs of damage.  There is no specific timeframe beyond the expiry dates for masks at which they would no longer be considered suitable for use.”

  • Why are we not being provided full hazmat suits? 

    The PPE being provided within Fraser Health is consistent with the provincial standards and are based on the standards for COVID-19 from the Public Health Agency of Canada and the BC Centre for Disease Control.

  • How should we be washing our own scrubs/uniforms at home? Will the germs contaminate our washing machines?

    COVID-19 like many other pathogens is killed by use of soap and water. Laundering used uniform/scrubs/other work clothing at home in the regular wash hot water cycle and tumble-dry is acceptable and will kill COVID-19 and will not contaminate your washing machine. 

  • Can scrubs be issued to all health care areas? 

    In addition to the areas that normally receive scrubs, they are being issued to those areas that are caring for positive and suspect COVID-19 patients on the cohort units.

  • What precautions should I take when assessing a patient with respiratory symptoms? 

    By following current Infection Prevention and Control best practices, you will be safe. Regular handwashing, coughing or sneezing into your elbow, and disposing of tissues appropriately are important ways to prevent the spread of respiratory illness.

    • Staff must always do a point of care risk assessment when assessing a patient

    • Ask patients with respiratory symptoms to put on a mask and perform hand hygiene (ABHR)

    • Isolate patients with symptoms of respiratory illness: fever, new or worsening cough, sore throat, nasal congestion, headache, muscle pain or malaise

    • Use Droplet/Contact precautions, including performing hand hygiene, donning a gown, a procedure mask, a face shield and gloves, if within 2 meters of a patient with respiratory symptoms

    • Observe airborne precautions for any aerosol generating procedures (refer to Aerosol Generating Procedures (AGP) in Acute Care SOP - internal link; must be signed in to the Fraser Health network to access). 

    • Be current with N95 fit testing (tested within the last 12 months).

    For more information contact your site Infection Prevention and Control Practitioner. You can also access the IPC section of the Pulse website (internal link; must be signed in to Fraser Health network to access)

  • Which type of procedure mask is appropriate for use when caring for patients on droplet precautions (including COVID-19 patients)?

    Typically all masks used in our healthcare facilities are appropriate for use for droplet precautions.  All rated procedure/surgical masks (ASTM Level 1, 2 and 3) provide sufficient protection for droplet precautions (including COVID-19 patients).  Selection of the most appropriate mask must be based on the risk of blood and body fluid exposure anticipated for the patient care needed.  There is increased fluid resistance with Level 2 and Level 3 masks and these should be used for tasks where higher amounts of fluid exposure and risk of splash are present.

    For example: 

    Procedure/Surgical Mask

    Uses

    Level 1 masks (80mmHg)

    Primagard level 1 masks (80mmHg)

     

    Can resist splash or spray at venous pressure (e.g. for general procedures and respiratory etiquette)

     

    Level 2 masks (120mmHg)

    Primagard level 2 masks (120mmHg)

    Can resist splash or spray at arterial pressure

    Level 3 masks (160mmHg)

    Primagard level 3 masks (160mmHg)

    Have the highest fluid resistance (e.g. used during orthopedic surgery or trauma)

  • Do I need to wear an N95 respirator with all COVID-19 patients?

    As per IPC guidelines noted March 26th, N95 respirators are ONLY required in the following settings:

    • Inside individual Operating Rooms (not in common areas of the ORs)

    • Critical Care Units and the ARH, SMH and RCH HAU Cohort units where suspect or confirmed COVID-19 patients are being managed and aerosol generating procedures are being performed

    • When providing direct patient care to a patient with COVID-19 during an aerosol generating procedure

    Aside from these settings, a N95 respirator is not needed and a surgical/procedure mask and eye protection should be worn in all patient care areas instead. Please reserve N95 respirators for appropriate use to ensure that they are available when we need them.

  • What is the difference between a medical-grade/surgical N95 respirator (3M 1860/1870+) and a commercial-grade N95 respirator (e.g. 3M 8210 or 3M 9210 N95s)?

    Commercial- and medical-grade N95 respirators are of similar structure and design, the main difference between them is that commercial N95 respirators aren’t tested for fluid resistance. All N95s are equally effective at filtering particles and providing protection against airborne infectious disease such as during an aerosol generating procedure.Fluid resistance is necessary for procedures that may generate high-pressure streams of liquid.

    The commercial grade N95 are approved for use in healthcare settings by Health Canada and the Centers for Disease Control and Prevention. If you have been fit-tested to any of the following N95 models (3M 8210 or 3M 9210) and are working in an operative or procedural setting conducting tasks that pose a risk of high pressure fluid splashes or sprays use the N95 in combination with a faceshield. In the event your N95 does become contaminated with blood or body fluid follow standard practice of stepping out of the patient room, doff and replace your N95.

  • What is the difference between a surgical mask or N95 respirator?

    As with other respiratory infections, droplet and contact precautions should be taken, as per established infection, prevention, and control protocols. 

    For the droplet and contact precautions due to novel coronavirus you need a gown, gloves, face shield and a surgical mask.

    For aerosol generating medical procedures, a N95 respirator (in lieu of a surgical mask) should be used.

    Employees need to fit-tested for a N95 respirator. Additionally, a beard or facial hair will affect the fit of a N95 respirator; therefore, decreasing the effectiveness of a N95. Whereas, a surgical mask can be worn with a beard or facial hair. 

  • I interact with a lot of individuals who are coughing and sneezing. Should they wear a mask?

    If you are interacting with an individual who has flu-like symptoms, please ask them to put on a mask and use hand sanitizer. If masks are not available in your immediate area, please ask a clinical staff member, or a triage nurse (in the emergency department), to provide a mask.

  • What is the difference between eye and facial protection?

    All Fraser Health staff, physicians, and contracted staff working in patient care areas are required to wear eye protection. As well, extended use and cleaning processes have been implemented. Eye protection helps prevent staff from touching their eyes and prevents droplet from entering their eyes. 

    Eye protection refers to PPE that protects the eyes, which includes safety glasses, goggles, and face shields. In general, eye protection are used when there is a potential for exposure to hazards involving the eyes (e.g. particulates, laser, BBF splash). Specific eye protection standards may vary depending on the hazard. Face protection refers to PPE that protects the face (including the eyes), such as face shields. These are used if both eyes and face protection are required (e.g. AGP). 

  • Are safety glasses and goggles equivalent? 

    No. 

    Safety glasses allow air in and around the eye area due to small gaps. They are designed to fit firmly but not tightly around the eyes. 

    drawings of safety glasses

    Safety goggles include a strap to secure the goggles over your eyes and fit tightly against the face to form a seal around the eyes. As goggles are larger and heavier, they may affect the fit of N95 respirators when used together. Staff are required to be fit tested with the goggles on to ensure the fit of the N95 respirator is still adequate. 

    sketch of goggles

    Some goggles have an indirect venting system to prevent fogging. These have vents that are angled away from the front lens of the goggles to keep the risk of splashes from entering the goggles low.

    image of safety goggle

  • Should I wear a mask/eye protection during my shift?

    All staff and medical staff who work in patient care areas are to wear a surgical/procedure mask and eye protection (ie., face shield, goggles, or safety glasses) during your shift. 

    The mask can be donned at the beginning of the shift and can be worn throughout the entire shift as long as it is not visibly soiled, damp, damaged or hard to breathe/see through; it does not need to be changed between patients.

  • What are the pros and cons of safety glasses vs goggles vs face shields?

    Safety glasses 

    Goggles

    Face Shields

    Pros

    • Light weight

    • Comfortable to wear

    • Minimal gaps around the eyes

    • Covers majority of the face

    • Fits everyone 

    Cons

    • Gaps around the eyes

    • Does not cover the rest of the face

    • May slide away from the face when bending forward (fit dependent)

    • Limits peripheral vision

    • Heavy and less comfortable

    • Does not cover the rest of the face

    • Require staff to repeat fit-test with the goggles on

    • Gets warm

    • Gap below the chin

  • When should I be using safety glasses, goggles, and/or face shields?

     Safety Goggles

    Goggles

     Face Shields

    When to wear 

    • Everyday use in patient care area 

    • Hazard includes dust or gas

    • AGP (besides intubation) 

    • AGP (including intubation)

    • Everyday use in patient care area

    • Other tasks that may cause more droplet/sprays 

    Additional PPE required

    • Tasks cause glasses to slip
    • Staff must come into close proximity with patient’s breathing zone

    • AGP 

    • Other tasks that may cause more droplet/splash

    • Intubation

    • Other tasks that may cause more droplet/splash

    • N/A


  • Are my safety glasses and goggles up to Fraser Health standards?

    All safety glasses/goggles used within Fraser Health for droplet and other BBF protection must meet one of the following standards:  1) CSA Standard CAN/CSA-Z94.3-07 or Z94.3-15, Eye and Face Protectors, or 2) ANSI Standard ANSI/ISEA Z87.1-2015, Occupational and Educational Personal Eye and Face Protection Devices. In addition, they should fit the user properly (close fitting around the eyes and comfortable), and should be latex free. If your safety glasses/goggles satisfy all the conditions above and are in good conditions, they are up to Fraser Health standards. 

  • I need to perform a task that requires the use of a respirator and have not been fit-tested in the last year. What should I do?

    Do not proceed and notify your supervisor/manager.

  • I am a health care worker and do not know my N95 fit-test status. What should I do?

    Refer to the Fit-Test Report to determine your current status. Your manager will also be able to advise you. (Internal link - opens in new window when signed in to Fraser Health network)

  • I need a fit-test. How do I get fit-tested?  

    You have two options:
    (internal links; you will need to be signed in to Fraser Health's internal network to access)

    1. Attend a drop-in fit-test session. 
    2. Have your department-trained fit-tester (if applicable) complete a fit-test for you.