Keep Yourself and Your Family Safe
How to protect yourself — including proper use of PPE — and tips for how to protect your family when you return home after your shift.
The American Nurses Association (ANA) supports all nurses responding to COVID-19, caring for infected individuals and impacted communities, and preventing the spread of the coronavirus within their health care facilities, communities, and families.
How to protect Yourself from COVID-19
Everyday measures to protect yourself from the virus include vaccination, frequent hand hygiene, physical distancing when in crowded spaces or large gatherings, and wearing a cloth face mask. To find a vaccination site near you, visit vaccines.gov. If you are at higher risk for severe illness, additional information is found here. If you are health care personnel:
- Adhere to the standards for donning and doffing PPE when caring for COVID-19 patients.
- Avoid touching your N95 respirator, facemask, eye goggles, and face shield if wearing during extended use.
- Wash your hands before donning all PPE. When doffing PPE, wash your hands before doffing your goggles, N95 respirator, and face shield, and again after all PPE is doffed.
- Wash your hands frequently with soap and warm water.
- Doff PPE before breaking for meals and taking trips to the restroom.
- Practice hand hygiene before and after going to the restroom and before eating.
- Eat meals in non-clinical areas.
- Disinfect your cell phone frequently, place your cellphone in a clear sealable bag that serves as a barrier, discard of the bag before going home, disinfect your cell phone before entering your home.
- Change your scrubs and shoes if possible before returning home.
N95 Respirator Fit Testing
Fit testing is still required by OSHA. Fit testing ensures the N95 respirator forms a seal around the mouth and nose. If you have not been fit tested for an N95 respirator, your organization or infection control department must provide “just-in-time” fit testing to ensure the N95 respirator is worn properly. Contact your facility’s occupational health department or infection control personnel for your organization’s fit testing requirements.
Reuse and Decontamination of N95 Respirators
The American Nurses Association continues to advocate aggressively for access to new unused PPE to ensure the ultimate protection of HCP when caring for COVID-19 patients. Read our full statement on the use of decontamination systems here.
As of May 27, 2021, The Food and Drug Administration (FDA) recommends health care personnel and facilities transition away from crisis capacity conservation strategies such as decontaminating disposable respirators for reuse, and the use of non-NIOSH approved disposable respirators such a KN95s. It is recommended that health care facilities increase inventory of available NIOSH-approved respirators including N95s, Elastomeric respirators, including elastomeric respirators without an exhalation valve that can be used in operating rooms, and Powered air-purifying respirators (PAPRs). To read the full list of recommendations, click here. To review strategies for optimizing your N95 supply, click here.
The Use of Cloth Masks
Within the health care setting, ANA maintains that all personnel have access to the highest level of respiratory protection to minimize exposure risk to COVID-19. This includes the use of the N95 respirator (or medical facemask with face shield if the N95 respirator is unavailable), face shield, or goggles for eye protection, gown, and gloves. A cloth mask alone does not provide enough respiratory protection from COVID-19 within a medical setting.
Recently, recommendations for the use of cloth masks by the public changed. Those who are fully vaccinated may resume activities that you did prior to the pandemic without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance. Those who are unvaccinated should continue to wear a cloth face mask covering the nose and mouth when in public, in addition to practicing physical distancing. Layering preventive measures such as vaccination, the use of a cloth mask in conjunction with physical distancing, frequent hand washing, and staying home when sick all help to reduce the spread of COVID-19.
How to Keep Your Family Safe When You go Home After Your Shift
COVID-19 is primarily spread through respiratory droplets from coughs and sneezes and droplets exhaled when talking that land in the mouth, nose, or eyes of someone in close contact. The virus is also contracted by touching the face, eyes, nose, or mouth with your hands that may have the virus on them. Therefore, cleaning hands and wiping down frequently touched objects, such as a cell phone or tablet, that are commonly transported between home and work is an important step to take prior to returning home. The U.S. Environmental Protection Agency (EPA) has developed a list of products suitable for use against COVID-19.
Additional tips include:
- Remove scrubs and shoes worn while providing care before entry into the home. If possible, wear hospital provided scrubs or carry a change of clothes to work including shoes.
- Remove shoes before entering into the home.
- Keep scrubs contained in a disposable bag, wash in hot water with detergent separately from other laundry items. Dispose of the bag in a lined trashcan once emptied into the washer. Wash your hands.
- Disinfect your cellphone frequently while on the unit and again just before leaving. Consider storing your cellphone in a clear sealable bag as a barrier.
- Leave high touch objects that are not essential for home on your unit, such as pens and clipboards used during your shift, disinfect frequently during the course of your shift.
- If using a personal stethoscope, leave on the unit in a locker, and disinfect before and after use with every patient.
- Wash hands with soap and water upon leaving the unit and again upon entry into the home.
It's also important that your family members understand what COVID-19 is, the symptoms, and the importance of preventative measures such as hand hygiene and physical distancing. Encourage your family members to get vaccinated if they are medically eligible.
Guidelines have changed during the course of the pandemic. Those who are fully vaccinated may resume activities they did prior to the pandemic. However, in mixed household of vaccinated and unvaccinated individuals, it is important to consider the risk of those who are unvaccinated or those who are considered vulnerable or at high risk of severe infection or complications from COVID-19 before re-engaging in pre-pandemic activities or forgoing preventive measures such as mask wearing and physical distancing.
If unvaccinated family members live within your home, continue to emphasize the importance of wearing a cloth face mask along with physical distancing, which is remaining a distance of 6 feet between oneself and others. Continued frequent hand hygiene is essential. Wash your hands upon returning home with soap and water for at least 20 seconds. When out in public and soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol content. Avoid touching your face, particularly your mouth, nose, and eyes. Disinfect your cellphone frequently because it is a high touch surface where germs and viruses can live.
Reassignment of Health Care Workers Within a Vulnerable Population
Individuals over the age of 65 and with chronic underlying medical conditions are at increased risk of severe morbidity and mortality as a result of COVID-19. If you fall within this category, have a conversation with your employer about redeployment to support telehealth services, transfer to units without COVID-19 patients, or assignment to non-COVID-19 patients needing care. It is also crucial to have access to the appropriate PPE to minimize the risk of exposure.
What to Do If You Are Pregnant
A statement released by the Association of Women’s Health Obstetric and Neonatal Nursing (AWHONN) upholds “Normal physiologic and immunologic changes of pregnancy increase the pregnant woman’s susceptibility to infections. However, data specific to COVID-19 is limited. Pregnant women, their fetuses, and newborns may be at an increased risk for morbidity and mortality if COVID-19 is contracted during pregnancy.” In accordance with recommendations supported by AWHONN, ANA supports the CDC’s recommendation that health care facilities should consider limiting the exposure of pregnant health care personnel to patients with confirmed or suspected COVID-19 during high-risk procedures especially those with increased risk of aerosolization. If you are pregnant and are health care personnel, it is important to continue your routine prenatal care and inform your prenatal care clinician of your exposure risk at work along with any symptoms (including fever, cough, or difficulty breathing) associated with COVID-19. Vaccination against COVID-19 is strongly encouraged. In fact, two new studies are available confirming the safety and efficacy of mRNA COVID-19 vaccines in pregnant and breastfeeding mothers. To read more about the studies, click here.
Citations for the latest studies on the safety and efficacy of mRNA vaccines in pregnant and breastfeeding mothers are below:
Immunogenicity of COVID-19 mRNA vaccines in pregnant and lactating women. Collier AY, McMahan K, Yu J, Tostanoski LH, Aguayo R, Ansel J, Chandrashekar A, Patel S, Apraku Bondzie E, Sellers D, Barrett J, Sanborn O, Wan H, Chang A, Anioke T, Nkolola J, Bradshaw C, Jacob-Dolan C, Feldman J, Gebre M, Borducchi EN, Liu J, Schmidt AG, Suscovich T, Linde C, Alter G, Hacker MR, Barouch DH. JAMA. 2021 May 13.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in pregnancy: Measures of immunity and placental histopathology. Shanes ED, Otero S, Mithal LB, Mupanomunda CA, Miller ES, Goldstein JA. Obstet Gynecol. 2021 May 11.
Recommendations for Breastfeeding Mothers
Research on the risk of pregnant women and breastfeeding mothers associated with COVID-19 continues. The following guidelines are outlined by the CDC for breastfeeding mothers for the protection and prevention of spreading COVID-19 to their infants:
- Breast milk provides protection against many illnesses and is the best source of nutrition for most infants.
- You, along with your family and health care providers, should decide whether and how to start or continue breastfeeding.
- In limited studies, COVID-19 has not been detected in breast milk; however, we do not know for sure whether mothers with COVID-19 can spread the virus via breast milk.
- If you are sick and choose to direct breastfeed:
- Wear a facemask and wash your hands before each feeding.
- If you are sick and choose to express breast milk:
- Express breast milk to establish and maintain milk supply.
- A dedicated breast pump should be provided.
- Wash hands before touching any pump or bottle parts and before expressing breast milk.
- Follow recommendations for proper pump cleaning after each use, cleaning all parts that come into contact with breast milk.
- If possible, consider having someone who is well, feed the expressed breast milk to the infant.
For additional resources on breastfeeding and pregnancy visit the CDC’s Guidance on Pregnancy and Breastfeeding.
Guidance for Protection When Working in Home Health and Home Hospice Care Settings
- Connect with your patient or patient’s family in advance by telephone, text monitoring system, or video conference prior to home visits for temperature and symptom monitoring.
- If you must visit the home and the patient is suspected or confirmed to have COVID-19, wear the following PPE: Gown, gloves, eye protection (goggles or face shield), N95 filtering facepiece, or respirator (or medical facemask if not available). Always perform hand hygiene before donning PPE and after doffing PPE.
- Don and doff PPE outside of the home, dispose of PPE outside the home in a lined trash receptacle, do not travel with used PPE.
- The Centers for Medicare and Medicaid Services provides guidelines for home health care personnel along with detailed guidelines for home hospice care personnel.
Additional Information on Personal Protective Equipment (PPE)
Following the correct sequence of donning and doffing PPE is essential in the prevention of self-inoculation of COVID-19. Below are several links to review the proper sequence along with vital information related to respirator use.
- Sequence for Putting on Personal Protective Equipment (PPE)
- Three Key Factors Required for a Respirator to be Effective
- Important Steps for Using NIOSH-Approved N95 Filtering Facepiece Respirators
- Frequently Asked Questions about Respirators and their Use
Additional Information on Infection Control
For additional information on infection control measures to take within your facility, visit: the Infection Control and Prevention of our site. You can also learn more about infection control, and find training modules for your staff through ANA’s Project Firstline.