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Coronavirus (COVID-19): extended use of face masks and face coverings in hospitals, primary care and wider community healthcare

Guidance for staff within acute hospitals, community hospitals, primary care and wider community healthcare, together with advice for visitors, including those attending for an appointment.

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Specific guidance for hospitals

FRSMs are strongly recommended to be made available to and worn by all hospital inpatients (unless exempt) across all pathways, where it can be tolerated and does not compromise clinical care (e.g. when receiving oxygen therapy or when in labour). This also applies to patients who are being transferred or transported to hospital. Staff are encouraged to engage in a discussion with patients as early as possible in the admission process to promote the importance of using facemask and adhering to other COVID-19 control measures. Posters to support this can be found here.

In hospital, if a patient declines to wear a FRSM or is unable to tolerate one, the discussion and refusal to wear a FRSM should be noted in their patient/ medical records, each time. First and foremost, it helps ensure that a conversation takes place between the clinician and patient about the importance of wearing a FRSM. Secondly, in the event that there is transmission within a ward, it is helpful as part of outbreak investigation to understand which controls were in place, including mask wearing.

It is recognised that it will be impractical for individuals to wear FRSM at all times and these will have to be removed for reasons such as eating, drinking, sleeping or showering. Individuals should be provided with a new replacement FRSM to put on after such activities where removal is required.

This is particularly important when patients are moving outwith their immediate bed space, including when moving around a multi-occupancy room, a ward, department and/or hospital and when transferring between wards, departments and/or hospitals. However, patients should be strongly encouraged to also wear face masks when in bed as much as possible. Even when patients are in single rooms, they are strongly encouraged to wear a mask whenever anyone enters their room, i.e. including when receiving direct care or receiving visitors.

In cases where patients feel they can’t tolerate wearing a FRSM, the option of wearing a face covering should be available to them.

If someone is not wearing a face covering when they enter your workplace, it’s likely because they’ve forgotten to put it on. Employees should assess whether they feel comfortable and confident to approach patients, and if they do, they can say ‘we ask you to wear a face covering in this space/building unless you have an existing medical condition which prevents this.’ A range of posters and communication materials to support staff are available.

It is recognised that some patients may require respite from wearing a FRSM for long periods of time. They should be encouraged to put on a new FRSM after a reasonable period of respite time. This should be decided on an individual case-by-case basis.

In longer stay areas, such as secure care mental health settings, there may be security reasons for patients’ faces to be seen at all times.

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