Improving protection from bioaerosol exposure during postoperative patient interaction in the COVID-19 era, a quality improvement study

PURPOSE: During patient transport from operating room to post-operative recovery area, anesthesia staff are at increased risk of particle aerosolization from patients despite wearing face shields. Current single-use face shields do not provide anesthesia staff from adequate protection from bioaerosolized particles expired during a patient's cough, particularly during transfer from the operating room to the post-anesthesia recovery unit. In this study, we compare the efficacy of single-use face shield currently available at our institution to a newly designed face shield that provides better protection while still maintaining cost-effectiveness and the ease-of-use of a disposable device. MATERIALS AND METHODS: A patient actor, simulated movements from a patient post-procedure, during transport from operating room to postoperative recovery area. Patterns of exposure of bioaerosolized particles produced from a cough between different face shields was evaluated using fluorescein dye. MAIN RESULTS: More extensive coverage of the lower face, as provided by the Enhanced Protection Face Shield, offers improved droplet protection from bioaerosolized particles emitted from a cough. CONCLUSIONS: Transfer from the operating room to the post-operative recovery unit is a hands-on process and involves managing multiple aspects of patient care physically. Current single-use face shields are convenient and cost-effective, but do not provide adequate protection from droplet aerosolization by patients during transfer. Other masks that provide adequate coverage are costly and are not designed to be single-use. A single-use disposable face shield that offers improved coverage of the lower face provides improved protection for anesthesia staff while maintaining cost-effectiveness, ease-of-use, and infection control.