Protecting vulnerable populations, particularly long-term care residents and staff, from viruses and infections is critical. The COVID-19 pandemic shed light on the fact that not only is there a need for an increased supply of personal protective equipment (PPE), but there is also a need for enhancing PPE designs and features.
For residents and staff alike, face coverings will continue to be one of the most important preventive safety measures recommended to resume normal daily activities and interactions, especially between guests and their loved ones.
What type of face covering is best? Are masks enough or could face shields make more sense? Administrators should evaluate based on the following factors: design, effectiveness and comfort. Manufacturing availability and quality are also very important, yet often overlooked, factors to consider.
Design
Researchers from the University of Iowa and the Iowa City VA Healthcare System published a view in JAMA that face shields should be considered as part of the strategy to reduce community transmission. In order for face shields to offer optimal protection, they stated that “the shield should extend below the chin anteriorly, to the ears laterally, and there should be no exposed gap between the forehead and the shield’s headpiece.”
With this design, the researchers noted, a face shield can also prevent the wearer from touching their face, reducing the potential for autoinoculation. When made with high-quality material, face shields are designed to be reused and easily sanitized.
Finally, speaking is less muffled than with a cloth mask, and communication is easier because the shields are clear. This is especially important for residents who may be coping with hearing loss challenges. In fact, the American Speech-Language-Hearing Association (ASHA) suggests using a clear face covering to aid in communication so that people can read lips and see facial expressions. A face shield may also be more comfortable for people who wear hearing aids or cochlear implants.
Effectiveness
While as of this writing there have not been any randomized clinical studies to verify the effectiveness of face shields, a simulation study conducted by researchers at the National Institute for Occupational Safety and Health found that a healthcare worker wearing a face shield within 18 inches of a coughing patient could reduce inhalational exposure by 96% immediately after a cough. These findings were published in the Journal of Occupational and Environmental Hygiene.
Comfort
As face coverings become standard for any social interaction, comfort for all-day wear is also a key factor. Any face covering will not work if it is worn incorrectly — or not at all. As an example, the TrueHero Extreme Coverage Face Shield is made of medical-grade PETG so it is not only extremely durable but is also lightweight and appropriate for all-day wear. Hook-and-loop straps provide a secure fit and infinite adjustability, while closed-cell foam padding lines the forehead for additional protection and comfort.
Manufacturing availability and quality
By now everyone is aware of reports on the shortage of PPE, including face masks, for healthcare providers during the pandemic. Cover stories showed workers improvising with “homemade” equipment or dousing their disposable face masks with hand sanitizer to get by. News reports discussed extensive markups and faulty, unusable products that were made overseas, with each country (and state for that matter) scrambling to get their own. Many companies and organizations jumped in to help — from fashion designers to 3D printmakers to car manufacturers. These were noble efforts and important in a pinch, but now is the time to take another look at how to prepare for not only the remainder of the COVID-19 pandemic (however long it may be), but also for moving forward.
Consider face shield suppliers that are headquartered in the United States and, more importantly, fully manufacture in the United States to ensure quality and consistency of their product. Also look for a company that can supply the volume needed without significant delays.
The aftermath of any crisis provides opportunity. Adapting new and improved standards throughout long-term care facilities for resident and staff protection will provide a better experience for all, in ways that will outlast the pandemic.
Jay Baker is CEO of Jamestown Plastics Inc., an ISO-certified company that has been in business since 1958. It has decades of expertise in plastics manufacturing for some of the top medical device and consumer companies in the world.
