When Healthcare Workers Go Home: Sanitary Practices to Keep Everyone Safe
By Debra Wood, RN, contributor
Nurses and physicians on the front lines of patient care—especially those treating patients who are confirmed to have COVID-19—are concerned about the possibility of bringing the coronavirus home to their families. What steps can healthcare professionals take to avoid transmissions at home?
Scientists and medical professionals are still learning about the virus, so little evidence exists to determine best practices for avoiding transmitting the virus to family members.
Even so, experts have several suggestions for minimizing the risk.
Coming home: Tips to avoid possible transmission
“Keep a number of gloves in your coat pocket/handbag for wearing when you leave your work area,” said Sandra Russo, PhD, RN, director of the nursing program at Touro College in New York. “You need to wear gloves if taking a train or bus to travel to and from home or work.”
Leave hand sanitizer in the car and use it before touching anything else.
“Make an area by your door to place your shoes upon entering from work,” Russo advised. “Immediately, change out of your clothing from work, shower and shampoo your hair. Only after showering should you touch your loved ones.”
Russo added that children may need to be told to keep a distance until after the shower.
Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP, at the Baylor School of Nursing in Waco, Texas, also recommended stripping down in the garage and then showering.
Connie Steed, MSN, RN, CIC, FAPIC, president of the Association for Professionals in Infection Control and Epidemiology (APIC), reported the virus survives longer on solid surfaces than porous surfaces, such as uniforms. She reinforced that actions taken really depend on the clinician’s comfort level.
Steed suggested nurses take a set of clothes to the job in a plastic bag and change into those clean clothes before leaving the care facility. Put work clothes in a bag and then drop those into the washing machine upon arrival home.
“This virus is easily killed and does not survive long with washing,” Steed said.
Some clinicians are setting up home decontamination areas in their garage or entry to the house, reported Cindy Weston, DNP, RN, CCRN, CNS-CC, FNP-BC, assistant professor and associate dean for clinical and outreach affairs at Texas A&M College of Nursing in Bryan. She suggested that work clothing should be taken “directly to the laundry, placed in the washing machine without shaking to minimize aerosolization of any organisms and laundered as appropriate.”
The Centers for Disease Control and Prevention (CDC) recommends laundering scrubs or uniforms according to manufacturer’s instructions, in the warmest water setting, and drying in the dryer. Shoes designated for work only should stay outside the home, per the CDC.
“Perform hand washing as often as possible and remember to not touch your face,” Russo said.
Wash hands with soap and water for 20 seconds or use hand sanitizer if available and hands are not visibly dirty.
“Be very mindful of touching your face, especially the ‘T’ area—eyes, nose, mouth,” said Paula Zweig-Cohn, RN, director of infection control at Mount Sinai South Nassau in Oceanside, New York. “These are frequently the entry points for the virus to enter the body.”
Zweig-Cohen also suggests self-monitoring for COVID-19, advising nurses to take their temperature twice daily and watch for respiratory symptoms.
“Stay home from work if sick,” Zweig-Cohn said.
Some choosing temporary isolation from family
Out of extreme caution, some healthcare workers caring for COVID-19 patients are sleeping in a guest room or garage and isolating themselves from their families. Others are staying in hotels or a friend’s house, such as Christian Rose, MD, at Stanford University in Palo Alto, California, who wrote about staying with a fellow physician in The New England Journal of Medicine. Kyle McBride, RN, of Kissimmee, Florida, told WESH TV he has sent his family to live with relatives.
“Some healthcare professionals are choosing isolation from their families and children during the COVID-19 pandemic, as they serve on the front lines of care, in particular if they have family members or children who have immune-compromised conditions or are in high-risk categories,” Weston said.
Keeping your home clean
The CDC recommends cleaning frequently touched surfaces with soap and water, followed by a disinfectant, while wearing disposable gloves.
These high-touch surfaces include:
- Tables and countertops
- Doorknobs and handles
- Light switches
- Phones and keyboards
- Toilets, faucets, sinks, etc.
The Environmental Protection Agency has also provided an extensive list of disinfectants that can be used against SARS-CoV-2, which is the virus that causes COVID-19. The list includes many common household products, plus instructions on the length of contact time the surface be visibly wet.
Weston agrees home surfaces and floors should be cleaned regularly.
The kitchen and bathroom should be cleaned every four hours, Steed recommended.
Staying home when not at work
Like other Americans, nurses and healthcare professionals should shelter in place when not at work. Limit time in grocery stores and take advantage of deliveries. Stay six feet away from others and wear a mask, according to new guidance from the CDC, since asymptomatic people with the virus can spread it to others.
Limit trips to the store to once weekly, clean the shopping cart with a wipe or hand sanitizer, do not use your phone in the store and avoid touching your face. Wash hands after shopping or receiving deliveries and dispose of all packaging, recommended Hopkins Medicine.
“Using commonsense things about the home is important,” Steed said. “Hand hygiene is key.”
Resources:
CDC: COVID-19 Resources for Healthcare Professionals
Find more resources and learn how AMN Healthcare is supporting clinicians and facilities during the COVID-19 emergency response.