BCD: Lessons Learned from Infection Control and Response Visits (ICARs) with LTCF: Topic 7

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Healthcare-Associated Infections (HAI) Prevention Program

Infection Control Assessment and Response Visits:
Lessons Learned

Topic 7: Use of Face Shields

In April 2020, the DPH Healthcare-Associated Infections (HAI) Prevention Program began performing telephone-based, COVID-19-focused infection control assessment and response visits (ICARs) with long-term care facilities (LTCFs) around the state.

ICARs are educational discussions that cover a range of infection prevention and control topics that can impact the spread of COVID-19 within a facility. ICARs provide opportunities for questions and discussion, a review of policies and practices, and "just in time" education.

To date, the HAI program and its partners in this effort have conducted more than 250 ICARs.  

This "ICAR Lessons Learned" series of messages will highlight common recommendations and clarifications our team of infection preventionists are making during these calls, as they promote best practices and alignment with CDC and DHS guidance.

Use of Face Shields

Conventional capacity personal protective equipment (PPE) practices are designed to protect the health and safety of health care workers and the people in their care. LTCFs should aim to operate in conventional capacity as long and as often as possible, using contingency and crisis capacity strategies only as needed, and until the facility can return to conventional capacity operations. 

During the COVID-19 pandemic, LTCF staff have utilized face shields as part of their PPE ensemble. During periods of supply shortages, facilities have needed to employ optimization strategies to extend their supply of face shields. More than a year into the COVID-19 pandemic, these strategies and practices may now feel routine; however, it is important that PPE optimization strategies do not become a facility's "new normal."  

Below are reminders and information about the appropriate use of face shields by LTCFs.

  • Check the manufacturer’s instructions for use (IFU) for any face shields being used in the facility to determine whether the product is disposable or reusable. Most face shields are intended to be disposable. In particular, face shields that include foam or elastic components are generally intended for one-time use, as foam and elastic are difficult to clean and disinfect.
  • Ensure reusable face shields are properly cleaned and disinfected per manufacturer IFU after each removal. In particular, be sure to follow manufacturer "contact time" instructions for the product being used.
  • As supply shortages ease, reinforce with staff that conventional capacity practice is to throw away disposable face shields after a single resident encounter.
  • If reusing a disposable face shield as part of an optimization strategy, disinfect the face shield after each removal per CDC guidance and ensure any foam or elastic parts remain intact prior to reuse. 
  • Store new, unused face shields in a designated clean supply area. Store cleaned and disinfected face shields that will be reused in a separate clean area.

As discussed in a recent message from the DHS HAI Prevention Program, universal use of eye protection is still recommended by CDC in areas with moderate to substantial community transmission. LTCFs should consider this, as well as the above points, as they determine the quantity of face shields needed to maintain adequate supplies.  

Note that the recommendations highlighted here do not replace the value of a facility having its own ICAR, or the need to stay current on CDC and DHS guidelines. ICARs are non-regulatory and complement infection control surveys, with a focus on education and infection prevention. 

To request an ICAR for your facility, email the HAI Prevention Program or call 608-267-7711.