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cdc.gov/coronavirus
Management of Visitors to Healthcare Facilities
in the Context of COVID-19: Non-US Healthcare Settings
Document can be found at:
https://www.cdc.gov/coronavirus/2019-
ncov/hcp/non-us-settings/hcf-visitors.html
Outline
 COVID-19 background
 Importance of visitor management
 Limiting visitors to healthcare facilities
 Considerations during community transmission of COVID-19
 Visitor management when visiting patients with COVID-19 is essential
COVID-19 Background
 Caused by a newly emergent coronavirus, SARS-CoV-2
 Leads to respiratory tract infection, including pneumonia
 Transmitted mainly between people who are in close
contact with one another via respiratory droplets (e.g.,
sneezing, coughing, or talking)
 Transmission via contaminated surfaces can also occur
 May be transmitted by individuals who are infected but
have no symptoms
Importance of Visitor Management
 Healthcare facilities should minimize the risk of SARS-CoV-2 transmission to
visitors of patients with suspected or confirmed COVID-19
 The risk of visitors introducing SARS-CoV-2 into
healthcare facilities increases as community
transmission becomes widespread
 Facilities should establish policies and procedures
for managing, screening, educating, and training
all visitors
Limiting Visitors to Healthcare Facilities
Limit All Visitors During the COVID-19 Pandemic
If visitors are allowed into the facility:
 Instruct visitors with symptoms of acute respiratory
illness (e.g., fever, cough or shortness of breath) to leave
the facility
 Encourage visitors to be aware of signs and symptoms of
acute respiratory illness
 Follow national policies regarding the use of medical
masks or face covers by healthy visitors*
*WHO advice on the use of masks in the context of COVID-19 is available here: https://www.who.int/publications-detail/advice-on-the-use-of-
masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak
Inform Visitors about Symptoms
 Place visual alerts at facility entrances and
other strategic areas
 Signs should:
– include signs and symptoms of COVID-19
– instruct visitors not to enter the facility if
they have respiratory symptoms
– instruct visitors whom to notify if they have
respiratory symptoms
Restrict Visits to High-risk Patients
 Visitors should not visit patients who are at high risk for severe illness from
COVID-19, such as:
– older adults
– people who live in a nursing home or long-term care facility
– people of any age with underlying medical conditions
Educate Visitors
 Educate all visitors who are allowed to visit and help care for
patients on:
– signs and symptoms of COVID-19, including
instructions on whom to notify if they develop symptoms
– appropriate hand hygiene practices
– respiratory hygiene and cough etiquette
Use Administrative Controls
Designate an entrance for visitors
Apply alternatives for direct interaction
between visitors and patients
 Example: telephone or internet connection for
video or audio calls
Facilities should:
Considerations during Community
Transmission of COVID-19
Considerations during Community Transmission of
COVID-19
 Community transmission is present when there are multiple people with
confirmed COVID-19 infections that are not linked to transmission chains or other
people with confirmed infections
 Restrict visitor access to healthcare facilities
 Allow only visitors essential to providing patient care
– Essential visitors help provide patient care and/or care for pediatric patients
 Consider requiring all essential visitors to wear a medical mask or face cover
(e.g., homemade mask), according to national policies, to prevent anyone who is
infected but does not have symptoms from spreading COVID-19 in the facility
Visitor Screening
 Establish thresholds to determine when active screening of
all visitors will be initiated
 During active screening, assess all visitors before they enter
the healthcare facility for symptoms of acute respiratory
illness consistent with COVID-19
 If a visitor has symptoms, do NOT allow them to enter the
facility
Managing Visitors who are Essential to the
Care of Patients with COVID-19
Visitors Essential for the Care of Patients with COVID-19
 Schedule visits to allow enough time for screening, education, and training
of visitors
 Assess visitors to determine risks to their health
– Discourage visitors who are at high risk for severe illness from COVID-
19 (e.g., older adults or those of any age with underlying medical
conditions)
 Limit the number of essential visitors to one visitor per patient
Educate and Limit the Movement of Essential Visitors
 Provide visitors with education on:
– appropriate personal protective equipment (PPE) use
– hand hygiene
– limiting surfaces touched
– social distancing
– restricted movement within the facility
 Visitors should only visit the patient they are caring for
and avoid going to other locations in the facility
 Visitors should NOT be present during aerosol generating
procedures or during collection of respiratory specimens
Personal Protective Equipment (PPE) for Visitors
Essential for the Care of Patients with COVID-19
 Protects visitors from COVID-19
 Have a trained healthcare worker train visitors on PPE use, including:
– correct donning and doffing of PPE
– appropriate hand hygiene
– appropriate disposal of PPE
 Ensure the availability of adequate supplies of PPE and
hand hygiene stations
 Do not allow sharing of PPE among family members of a patient with
COVID-19
 Follow PPE contingency plans if a visitor is essential and PPE is not
available
Additional Considerations
 Ensure that essential visitors understand the potential risks associated with
helping to provide care to patients with COVID-19, especially if visitors are:
– at high risk for serious illness from COVID-19
– primary caregivers and have extended contact with patients (e.g.,
parents or guardians of children)
 Active screening should be considered for essential visitors with potential
exposure to SARS-CoV-2 due to a breach in infection prevention and control
protocol
For more information, contact CDC
1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348 www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the
official position of the Centers for Disease Control and Prevention.

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22_VisitorManagement_ITF_CLEARED_4.20.2020.pptx

  • 1. cdc.gov/coronavirus Management of Visitors to Healthcare Facilities in the Context of COVID-19: Non-US Healthcare Settings Document can be found at: https://www.cdc.gov/coronavirus/2019- ncov/hcp/non-us-settings/hcf-visitors.html
  • 2. Outline  COVID-19 background  Importance of visitor management  Limiting visitors to healthcare facilities  Considerations during community transmission of COVID-19  Visitor management when visiting patients with COVID-19 is essential
  • 3. COVID-19 Background  Caused by a newly emergent coronavirus, SARS-CoV-2  Leads to respiratory tract infection, including pneumonia  Transmitted mainly between people who are in close contact with one another via respiratory droplets (e.g., sneezing, coughing, or talking)  Transmission via contaminated surfaces can also occur  May be transmitted by individuals who are infected but have no symptoms
  • 4. Importance of Visitor Management  Healthcare facilities should minimize the risk of SARS-CoV-2 transmission to visitors of patients with suspected or confirmed COVID-19  The risk of visitors introducing SARS-CoV-2 into healthcare facilities increases as community transmission becomes widespread  Facilities should establish policies and procedures for managing, screening, educating, and training all visitors
  • 5. Limiting Visitors to Healthcare Facilities
  • 6. Limit All Visitors During the COVID-19 Pandemic If visitors are allowed into the facility:  Instruct visitors with symptoms of acute respiratory illness (e.g., fever, cough or shortness of breath) to leave the facility  Encourage visitors to be aware of signs and symptoms of acute respiratory illness  Follow national policies regarding the use of medical masks or face covers by healthy visitors* *WHO advice on the use of masks in the context of COVID-19 is available here: https://www.who.int/publications-detail/advice-on-the-use-of- masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak
  • 7. Inform Visitors about Symptoms  Place visual alerts at facility entrances and other strategic areas  Signs should: – include signs and symptoms of COVID-19 – instruct visitors not to enter the facility if they have respiratory symptoms – instruct visitors whom to notify if they have respiratory symptoms
  • 8. Restrict Visits to High-risk Patients  Visitors should not visit patients who are at high risk for severe illness from COVID-19, such as: – older adults – people who live in a nursing home or long-term care facility – people of any age with underlying medical conditions
  • 9. Educate Visitors  Educate all visitors who are allowed to visit and help care for patients on: – signs and symptoms of COVID-19, including instructions on whom to notify if they develop symptoms – appropriate hand hygiene practices – respiratory hygiene and cough etiquette
  • 10. Use Administrative Controls Designate an entrance for visitors Apply alternatives for direct interaction between visitors and patients  Example: telephone or internet connection for video or audio calls Facilities should:
  • 12. Considerations during Community Transmission of COVID-19  Community transmission is present when there are multiple people with confirmed COVID-19 infections that are not linked to transmission chains or other people with confirmed infections  Restrict visitor access to healthcare facilities  Allow only visitors essential to providing patient care – Essential visitors help provide patient care and/or care for pediatric patients  Consider requiring all essential visitors to wear a medical mask or face cover (e.g., homemade mask), according to national policies, to prevent anyone who is infected but does not have symptoms from spreading COVID-19 in the facility
  • 13. Visitor Screening  Establish thresholds to determine when active screening of all visitors will be initiated  During active screening, assess all visitors before they enter the healthcare facility for symptoms of acute respiratory illness consistent with COVID-19  If a visitor has symptoms, do NOT allow them to enter the facility
  • 14. Managing Visitors who are Essential to the Care of Patients with COVID-19
  • 15. Visitors Essential for the Care of Patients with COVID-19  Schedule visits to allow enough time for screening, education, and training of visitors  Assess visitors to determine risks to their health – Discourage visitors who are at high risk for severe illness from COVID- 19 (e.g., older adults or those of any age with underlying medical conditions)  Limit the number of essential visitors to one visitor per patient
  • 16. Educate and Limit the Movement of Essential Visitors  Provide visitors with education on: – appropriate personal protective equipment (PPE) use – hand hygiene – limiting surfaces touched – social distancing – restricted movement within the facility  Visitors should only visit the patient they are caring for and avoid going to other locations in the facility  Visitors should NOT be present during aerosol generating procedures or during collection of respiratory specimens
  • 17. Personal Protective Equipment (PPE) for Visitors Essential for the Care of Patients with COVID-19  Protects visitors from COVID-19  Have a trained healthcare worker train visitors on PPE use, including: – correct donning and doffing of PPE – appropriate hand hygiene – appropriate disposal of PPE  Ensure the availability of adequate supplies of PPE and hand hygiene stations  Do not allow sharing of PPE among family members of a patient with COVID-19  Follow PPE contingency plans if a visitor is essential and PPE is not available
  • 18. Additional Considerations  Ensure that essential visitors understand the potential risks associated with helping to provide care to patients with COVID-19, especially if visitors are: – at high risk for serious illness from COVID-19 – primary caregivers and have extended contact with patients (e.g., parents or guardians of children)  Active screening should be considered for essential visitors with potential exposure to SARS-CoV-2 due to a breach in infection prevention and control protocol
  • 19. For more information, contact CDC 1-800-CDC-INFO (232-4636) TTY: 1-888-232-6348 www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Editor's Notes

  1. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html
  2. - Performing hand hygiene by washing hands for at least 20 seconds or by using an alcohol-based hand rub with at least 60% ethanol or 70% isopropanol. Facilities should provide adequate supplies for visitors to perform hand hygiene.  - Following respiratory hygiene and cough etiquette precautions in the event an individual develops respiratory symptoms while visiting the facility. Facilities should provide adequate supplies for visitors to perform respiratory hygiene and should instruct visitors with cough or other respiratory symptoms to leave the facility and seek care if needed.  
  3. Sometimes visiting COVID-19 patients is essential, such as pediatric patients and/or for basic patient care and feeding.