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PPE Essentials Page 10.19.20

PPE Essentials

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Page last updated 10/20/20 at 11:19 AM

PPE Guidance Grids

PPE for Ambulatory Locations
N-95 COVID-19 Negative and Non-PUI
PPE for Inpatient Locations

For videos on general principles, conservation and reuse, and donning and doffing, visit the PPE Instructional Videos page.

N95 Respirator Guidance

Specific guidelines and additional resources can be found on Starport.

N95 respirators should be used in the following scenarios:  

  • Providing care within the patient’s room to a hospitalized PUI or COVID-19 patient, such as those in the inpatient, observation, Emergency Department, and Labor and Delivery settings.  
  • Performing a category 1 or category 2 procedure (AGP or high risk procedure with cough induction with unmasked patient or prolonged close contact with unmasked patient) on any patient, including endoscopy, transesophageal echocardiograms, flexible laryngoscopy, and bronchoscopy.

Safe Extended Use, Reuse, and Decontamination of N95 Respirators and Eye Protection

Specific guidelines and additional resources can be found on Starport.

MedStar Health continues to review and assess Personal Protective Equipment (PPE) conservation practices, which include safe PPE extended use, reuse and decontamination strategies endorsed by national experts. 

In accordance with the Centers for Disease Control and Prevention (CDC), our PPE conservation strategy includes extended use of N95 respirators and eye protection.

Associates and physicians caring for PUIs or COVID-19 positive patients will receive one N95 respirator at the start of each shift. If it becomes visibly soiled or no longer keeps a strong seal, another N95 respirator will be issued.

Eye Protection Flier. Click to view.
PPE Extended Use Job Aids
PPE Extended Reuse Job Aid
PPE Extended Use, Reuse, Cleaning & Storage

Universal Face Mask Guidance

Specific guidance and resources for associates, patients, and visitors related to masking can be found on Starport.

Associates are required to wear procedural face masks in all clinical facilities, including administrative offices in hospitals or ambulatory locations. Cloth masks can only be used by associates working in non-clinical facilities such as White Oak or the MedStar Health Corporate Office.

Face masks are also required in all non clinical areas (offices, lobbies, cafeterias, hallways, restrooms etc.).

Patients are expected to wear face masks, when clinically feasible and appropriate, throughout the duration of their ambulatory or ED visit, and throughout hospitalization while outside of patient rooms.

All approved visitors are expected to bring their own face mask. If they do not have one, a blue cloth face mask developed by Under Armour will be provided. Visitors who wear masks with valves must have them replaced.

Universal Masking in Healthcare Facilities Job Aid

Isolation Gown and Personal Scrub Guidance  

Isolation gowns available in all MedStar Health entities have been reviewed and are appropriate for isolation precautions during the care of COVID-19 patients. Proper use of PPE and Universal Precautions will protect your clothing from contamination, therefore, it is safe to wear your personal scrubs when properly wearing recommended PPE.  

Gown Essentials Grid

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Pre-Operative Testing

Pre-Operative Testing

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Page last updated 8/24/2020 at 12:30 PM

General Information

MedStar Health established a new Pre-operative COVID-19 Testing Call Center to serve as the single point of contact for scheduling and fielding general questions related to pre-procedural testing. The call center helps patients, providers and providers’ offices navigate the complex landscape of pre-operative COVID-19 testing—directing patients to the appropriate location based on their date of surgery, and ensuring that testing is completed in the appropriate timeframe. When referring a patient for testing, providers should continue to enter a referral order in MedConnect. The list of testing locations will now include instructions to contact the call center for scheduling. The MedConnect referral workflow can be found here; testing locations can be found here.

Pre-Operative COVID-19 Testing Call Center

Pre-Operative COVID Testing FAQ

Pre-procedural testing should be completed 72 – 96 hours prior to the procedure. Calculate 72 – 96 hours from the time of the courier pickup to the surgery time. When counting days, count Day 1 as the day of the test, and Day 5 as the day of the surgical procedure.

Refer to the MMG Labcorp COVID Testing Algorithm for detailed guidance on when and where to order pre-procedural testing.

For urgent testing, calculate 48 – 72 hours from the time of the courier pickup to the surgery time. Refer to the MMG Point of Care COVID Testing Algorithm for guidance on when and where to order rapid point of care (POC) testing.

Pre-operative testing timeline

Refer to the Pre-Operative Testing Timeline or click the image below for full details on when to order testing depending on the day of surgery:

Pre-Operative Testing Timeline. Click the image for more information.
Pre operative testing resources

Common Pre-Op Testing Questions

How close to surgery must patients get tested?

  • Testing should be completed >72 hours and <5 days before surgery. Count 72 hours starting from the hour the testing sample is collected. When counting days, count Day 1 as the day of the test, and Day 5 as the day of the surgical procedure. This adherence to protocol is necessary to protect our associates and to conserve PPE.  The only exception to this requirement is a life-threatening emergency procedure.

What if a patient refuses testing?

  • Patients who refuse testing will have their procedure cancelled and will be counselled on the importance of testing for both them and their provider.
  • This patient testing requirement cannot be overridden by the patient’s physician.

What if there are exceptional circumstances for my patient that do not fit the pre-op testing protocol ?

  • Complex patient circumstances that do not fit the standardized protocol will be discussed by the patient’s surgeon and anesthesiologist to determine the optimal testing protocol given the patient’s circumstances.
  • Only the VPMA of the entity can approve proceeding with an urgent/emergent or scheduled case without testing.  Each VPMA will provide a report to us at the end of each week listing the number of testing exceptions and the rationale.

Do patients need to be retested between same day procedures? 

  • No, patients with repetitive procedures in the hospital also do not need to be retested, if they have a negative test within 5 days.

When should I order a rapid test pre-op?

  • Emergency cases do not require testing prior to surgery. Patient care in emergent situations should not be delayed due to testing. Please see the “What PPE should I wear to surgery” section for guidance on appropriate PPE during these cases.
  • All patients are educated about self-quarantining at the time of testing (see Pre-Operative Testing and Self Quarantine Instructions). Patients are responsible for self-quarantining between the time of the test and when they arrive for surgery. However, findings indicate that MedStar Health has had no conversions to COVID-19 positive status for patients who could not or did not quarantine. Therefore, effective July 10, 2020 the updated pre-operative COVID-19 testing protocol no longer includes the second test requirement or the need to cancel elective surgeries for patients who could not or did not quarantine. Reference this Updated! Pre-Operative COVID-19 Testing Protocol memo for more information.

What if rapid turnaround testing with LabCorp is not available?

  • While the standard protocol is to use LabCorp for pre-operative testing, each entity may prioritize some rapid turnaround testing capacity for pre-operative testing, recognizing the inherent trade-offs for patient flow if this strategy is chosen.

When should I retest a COVID positive patient?

  • Patients should not be retested within 90 days of a COVID positive test. Patients can be retested after the 90 day window has passed.

Nasal Swab Collection and Competency

MMG and Urgent Care: Nasal Self Swab Specimen Guidance

Nasal Swab Competency Quiz

Nasal Swab Competency Signoff

Antibody testing

Antibody tests should not influence clinical management of patients (e.g.: antibody test results should not be incorporated into decision making for surgical planning, testing, PPE use, etc.). Currently, the main benefits of antibody testing are epidemiological. This may change over time as we learn more about prevalence of the disease and the best way of interpreting test results. For more information, refer to the Antibody Testing Provider Guide and the Antibody Testing FAQ page.

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Updated Temporary Patient Visitor Restrictions During COVID-19 (v2)

Updated! Temporary Patient Visitor Restrictions During COVID-19

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PPE Essentials Page

May 28, 2020

To protect the safety of our patients and associates, the following guidelines are now part of our MedStar Health temporary patient visitor restrictions for hospital (inpatient) locations.

Updated! Hospital (Inpatient) Locations

  • No visitors are permitted at any hospital location. Exceptions to these restrictions may be approved by hospital Vice President of Medical Affairs (VPMA) and/or Chief Nursing Officer (CNO) in specific circumstances, including two visitors per patient at end-of-life; two parents/caregivers of pediatric patients; one personal visitor or one professional support person in Labor & Delivery (a professional support person is allowed in post-partum units); one visitor per patient undergoing urgent/emergency surgery; one visitor to accompany patient for hospital discharge; one visitor if indicated by patient’s provider to support patient rehabilitation needs.
    • Any visitor who lives in the same household as a COVID-19 positive person is not permitted. Approved visitors will be asked whether they live in the same household as a COVID-19 positive person.
    • Patients with disabilities may designate one support person to accompany, visit and stay with them in the hospital. A support person is defined as someone who is legally authorized to make decisions for the individual with disabilities, a family member, a personal care assistant, or a disability service provider. In this situation, the support person will be permitted to visit even in the instance that the support person is a household contact of the patient. Other reasonable accommodations for individuals with disabilities may be approved by the VPMA and/or CNO, provided the accommodations comply with all infection prevention policies.
  • No visitors under the age of 18 are permitted, unless they are parents of pediatric patients.

As a reminder, all visitors are required to bring and wear their own face mask for the duration of their visit at any/all clinical care locations. If they do not have one, a blue cloth face mask developed by Under Armour will be provided.

Visit the Temporary Restrictions during COVID-19 page for MedStar’s complete updated visitor policies.

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N95 Decontamination Process Video

N95 Decontamination Process Video

N95 Decontamination Process

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Instructions for Adding MSH Covid Screening Tool as a Link to your Smart Phone Home Screen

Instructions for Adding MSH Covid Screening Tool as a Link to your Smart Phone Home Screen

This associate screening tool is currently being piloted at specific MedStar locations, and has not yet been rolled out system-wide. These instructions will show you how to add the link as an icon on your smart phone home screen for easy access.

Click to navigate to:

For iPhone

1. Open the Safari browser on your iPhone. (Chrome will NOT work for iPhone).

2. Enter the associate screening URL address: mi2apps.medstar.net/covidrtw/

3. Select the share icon at the bottom of the screen.

4. Select “Add to Home Screen”

5. Type the desired name for the link that will appear as an icon on your home screen. Select “Add.”

6. The link will appear as an icon on your home screen.


This associate screening link is currently being piloted at specific MedStar locations, and has not yet been rolled out system-wide. These instructions will show you how to add the link as an icon on your smart phone home screen for easy access.

For Android

1. Open the Chrome browser on your Android device (Works for Android NOT iPhone).

2. Enter the associate screening tool URL address: mi2apps.medstar.net/covidrtw/

3. Select the menu icon at the top right of the screen.

4. Select “Add to Home Screen.”

5. Type the desired name for the link that will appear as an icon on your home screen. Select “Add.”

6. The link will appear as an icon on your home screen.

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PPE Instructional Videos

PPE Instructional Videos

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Page last updated 6/11/2020 at 1:48 PM

Visitor Mask Assembly

Under Armour Visitor Mask Assembly Video

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Azithromycin Discharge

Azithromycin Discharge/ Outpatient Prescriptions and Update for Hydroxychloroquine Prescriptions

April 19, 2020

Azithromycin

Washington, D.C., regulations now limit azithromycin prescriptions for ONLY approved ICD-10 diagnoses, including documented COVID-19 positive results, based on the D.C. Health Department letter here.

Place diagnosis in ‘special instructions’ box in MedConnect, as shown. Duration cannot exceed 10 days, and refills are prohibited.

Hydroxychloroquine and Chloroquine

MedStar continues to discourage outpatient use for COVID-19 related treatment or prophylaxis; our outpatient pharmacies will fill prescriptions ONLY for chronic rheumatologic conditions, see reference here.

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Isolation Meal Policy

Isolation Meal Policy

April 13, 2020

To improve the dining experience for our patients and ensure isolation meals served in disposable service-ware remain warm, we would like to partner with Sodexo to implement the use of the warming pellet as a standard for all isolation trays. This process would require the added step of removing the warming pellet from the patient tray prior to the delivery of the meal into the patient’s room. Upon removal, the warming pellet would be simply placed at the bottom or top of the meal delivery cart. This is a critical step to avoid the risk of contamination of the service-ware, since we cannot have the warming pellet sent back to the kitchen for ware washing once it has been in an isolation room.  

In the majority of our hospitals, nursing is presently delivering trays for isolation patients who are on airborne and droplet precautions and would remove the warming pellet before entering the patient room with the meal.  Our tray passers plan to help facilitate this process when meals are delivered to each unit.  

The method of using the warming pellet in conjunction with the disposable service-ware has proven successful in maintaining meal temperature recently during downtime procedures for new dishwasher installations at both MGUH and MWHC.

The method of using the warming pellet in conjunction with the disposable service-ware has proven successful in maintaining meal temperature recently during downtime procedures for new dishwasher installations at both MGUH and MWHC. Pictured below is an example of use of the warming pellet in conjunction with the disposable service-ware.

Pellet removal from patient tray prior to delivery
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Proning Videos

Proning Videos

Proning with MaxiSlide

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Supine to Prone
Prone to Supine

Proning with Liko Roll Lift

Supine to Prone
Prone to Supine

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How to Don an N95 Respirator

How to Don an N95 Respirator

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