September 23, 2020By Dawn Patton Mangine

Need to Know: Safety Protocols to Return to In-Person Clinical Simulation Learning

With vaccine trials happening to create immunity to the coronavirus, getting back to in-person learning may be closer than it seemed this past summer. At the same time, educators and students can’t completely rely on a vaccine, of course. Not everyone may be able to be vaccinated, and there may be people who decline vaccination. Since reducing the rate of infection to zero is not possible, other safety measures should be implemented in order to reduce the risk of COVID-19 transmission among students. These measures will help prevent the transmission of other viruses, as well, such as cold and flu. Here, Pocket Nurse‘s Dawn Mangine shared today’s article highlighting the necessary safety protocols clinical simulation champions need to know for returning to in-person learning.

CDC Recommendations

The Center for Disease Control and Prevention (CDC) highlights key aspects of back-to-school and back-to-work planning. Families, educators, and students can all do their part to minimize transmission by complying with the following guidelines.

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  • Consistent and proper use of personal protective equipment (PPE) throughout the day
  • Educating students, faculty, and staff about personal protective practices, including hand washing, mask wearing, and disinfecting surfaces
  • Separation of students during instruction and while moving throughout buildings and on campus
  • Cooperating with local health authority contact-tracing plans in the event of a positive COVID-19 case
  • Establishing a screening system to identify infected individuals

Mask Up

COVID-19, like many other viruses, is transmitted in airborne droplets; thus, containing these droplets is essential. Nurses, EMTs, doctors, and other healthcare workers have long taken precautions that include mask wearing to reduce the spread of infectious diseases and viruses. Amid the current pandemic, everyone from preschoolers to hair stylists to educators are dealing with the reality of wearing masks for a large part of the day.

The CDC recommends face coverings as a method of slowing the spread of COVID-19. “The spread of COVID-19 can be reduced when cloth face coverings are used along with other preventative measures, including social distancing, frequent handwashing, and cleaning and disinfecting frequently touched surfaces.”

Several types of masks are available; as long as they properly cover the nose and mouth, and fit under the chin where applicable, they are effective in preventing airborne transmission.

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  1. Cloth masks: Often used by the public sector in non-healthcare settings. They are washable and reusable, and they often can be homemade, leading to increased availability.
  2. Surgical masks: Can protect against airborne droplets, including saliva or secretions from a person’s upper respiratory track. They filter out large particles and are disposable.
  3. Respirator masks (such as N95 masks): These masks protect against large and small particles that are airborne, including infectious agents and droplets.
  4. See-through masks: This is a type of cloth mask that features a clear PET window. It is especially useful in settings where non-verbal communication and lip reading may be necessary.
  5. Face shields: Face shields protect against spray and splatter, but not against airborne infectious agents. The CDC does not recommend face shields as a substitute for cloth face coverings.

Wearers should wash their hands before donning a mask and avoid touching the mask once it is on. Masks and face coverings that are reusable should be washed or disinfected as often as needed. (PET windows and face shields can be disinfected with alcohol wipes.)

Cleaning and Disinfecting

Cleaning and disinfecting are not synonymous. Cleaning is the act of removing dirt, germs, and impurities from the surface – it doesn’t kill germs. Disinfecting is the act of using chemical agents registered by the Environmental Protection Agency (EPA) to kill germs and viruses on the surface of materials.

Disinfectants that are effective for killing viruses similar to coronavirus (SARS-CoV-2) on hard, non-porous surfaces are isopropyl alcohol, quaternary ammonium, sodium hypochlorite (the main component of bleach), and hydrogen peroxide. Users can find concentrated disinfectants that can be diluted in water, ready-to-use solutions, and wipes.

For disinfecting with bleach, the CDC recommends 1000 parts per million in solution (or 1/3 cup bleach to one gallon of water). Most isopropyl alcohol-based products are 70 to 75 percent alcohol in 30 or 25 percent water. The water ensures that the alcohol doesn’t evaporate off of surfaces too quickly.

To clean and disinfect manikins, task trainers, and other equipment, Nick Brauer, Vice President of SimGHOSTS and Simulation Specialist at University of Tennessee Health Science Center, directs users to look at the user manuals for guidelines first. In general, directions are to surface clean manikins and equipment with mild soap and water then an alcohol-based disinfectant wipe. Manikins, task trainers, and other equipment that is porous or mechanical should not be submerged.

Setting Boundaries

Along with establishing appropriate physical distancing protocols (experts suggest at least six feet between people), setting up physical barriers is recommended to protect staff in high-traffic areas, as well as students at their desks. Plexiglass partitions reduce airflow between people as well as protecting against upper respiratory expulsions like coughs and sneezes. These dividers can usually be disinfected using alcohol-based wipes.

Hot Topic

Along with a dry cough, sore throat, and shortness of breath, fever is an indication of COVID-19. Although many people who get the virus are contagious before they are symptomatic, taking temperatures is one way to screen for possible illness. Workplaces and educational institutions encourage staff, students, and employees to take temperatures at home, and if they are running a fever over 100.4 to stay home.

However, some institutions are also installing thermal imaging devices onsite to take more temperatures much quicker. With thermal imaging, non-contact cameras use sensors to detect so-called “hot zones:” infrared energy (heat) emitted from an individual. The system converts the energy into an electronic signal, which is then converted into visible thermal video images that are analyzed by a monitoring center in real-time to assess risk.

While thermal imaging cannot diagnose someone with a virus, these systems can help isolate potential risks. People with Elevated Body Temperature (EBT) can be asked to step aside, and then further screened for a virus or infection.

Using thermal imaging systems is quicker than infrared and digital thermometers, so installing them in places with moderate to high traffic can be advantageous.


Reopening responsibly and safely is a matter of understanding and following infection control protocols, as well as having the PPE and safety equipment to reduce transmission. With vaccines and the right tools, proper handwashing, and physical distancing, institutions can prevent viruses from impacting our way of life.

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