This guidance informs mask use of all employees, volunteers and contractors of healthcare facilities, and patient/clients and visitors of healthcare settings.
Healthcare providers can make their own requirements for healthcare workers and patients. However, visitors of patients are required to wear a medical mask at a minimum while onsite. Those with mask exemptions should follow the local facility policy.
As the national situation changes the guidance will be reviewed and updated. Local requirements may be added, based on current epidemiology and other factors (for example, facility-based outbreak, staff resourcing).
Health care settings include:
- primary and community care (eg, general practice)
- iwi and Pacific healthcare providers
- pharmacies – other than those located within supermarkets
- urgent care services (eg, after-hours clinics and accident and emergency)
- disability support services
- residential care (aged and disability-related)
- diagnostic services (eg, diagnostic laboratories, collection rooms, radiology services)
- oral health services
- allied health services which may include but are not limited to:
- occupational therapy
- acupuncture treatment
- audiology services
- chiropractic treatment.
A clinical zone is considered:
- an area where a healthcare worker is providing care, assessment, expertise or therapy to a patient/client
- a public facing area within a clinical zone including waiting areas, reception areas, and transit areas between clinical zones
- patient/resident rooms where care is being delivered in home-based or residential care settings.
Healthcare workers in all healthcare settings
In general, healthcare workers are recommended to wear a medical mask as a minimum when working in a patient or public-facing role and/or in a clinical zone or a public facing area.
This includes both clinical and non-clinical support workers if they are working in a clinical zone or public facing area of a healthcare facility.
Healthcare workers are required to wear a P2/N95 particulate respirator (P2/N95) when providing care to patients/clients/residents with confirmed or clinically suspected COVID-19 infection or when working in a COVID-19 treatment or assessment zone.
To reduce COVID-19 transmission, healthcare workers are recommended to wear a P2/N95 when:
- having close face-to face contact with all patients during oropharyngeal or eye procedures, including dental, ENT, ophthalmology, upper GI endoscopy and intubation.
- having close contact with undifferentiated patients / where there is higher risk or unknown risk e.g. Emergency Departments, Birthing Units, staff performing initial screening of admissions and assessments and in primary and urgent care.
- undertaking respiratory tract swabbing.
- when the healthcare worker has been advised or identify that they are clinically vulnerable.
A healthcare worker may to choose to wear a P2/N95 at times when a medical mask would be sufficient.
Fit testing/ fit checking a P2/N95
Fit testing is a procedure through either a qualitative or quantitative test to ‘match’ the right P2/N95 with the wearers face shape to ensure maximum protection.
Fit testing is strongly recommended for all healthcare workers who wear a P2/N95 at least once, and then repeated if any major changes to face shape occur or if available products change. Health and Safety recommendations regarding frequency of fit testing requirements are subject to review.
Fit checking /user seal check is a ‘quick check’ method used by the wearer to ensure the respirator is properly positioned on their face and there is a tight seal between the respirator and face. A fit check/user seal check must be done every time a P2/N95 is put on.
In situations where fit testing has not yet been carried out and a P2/N95 respirator is recommended for use, refer to our interim guidance.
Note: Facial hair that encroaches on the edge of a respirator will reduce the effectiveness of the seal. It is recommended that healthcare workers discuss further with their Occupational Health or Infection Prevention and Control team for additional advice.
Patients in hospital settings
Minimum recommendations for patients in hospital settings:
- Patients/clients are recommended to wear a medical mask while attending acute assessment units, outpatient services, day procedures, outpatient investigations. Patients/clients with mask exemptions should follow the local facility policy.
- Hospital inpatients’ use of masks is guided by local hospital policy and should include clinical assessment of the need for transmission-based precautions, and a patient’s ability to tolerate a mask and where and when it may be required (refer to PPE in acute healthcare guidance).
Patients/clients in community healthcare settings (except residents in aged or residential care)
Patients/clients receiving care at community-based healthcare settings are recommended to wear a medical mask. Patients/clients with mask exemptions should follow the local facility policy.
Aged and other residential care residents are not required to wear a mask. However, in some situations such as when receiving close care, residents may choose to wear a mask.
Whānau/visitors/support people/kaitiaki in all healthcare settings
Whānau, visitors, support people and kaitiaki of patients are required to wear a medical mask at a minimum while onsite. Those with mask exemptions should follow the local facility policy.
Non-clinical zones are the areas which are not patient/client/public facing within the healthcare settings* listed. These include administrative areas and offices, workspaces, dispensaries, laboratories, meeting rooms and other shared spaces, provided these do not form part of a clinical zone.
Healthcare workers working in non-clinical zones
Healthcare workers working in non-clinical zones are not required to wear a medical mask at all times, however mask wearing is strongly encouraged in shared spaces. Any local requirements should be followed. People should remain respectful of colleagues.
Posters are available to facilitate use of masks in health care settings.
They are available for download from the Unite Against COVID-19 Resource Toolkit.
Face mask album – Unite against COVID-19 Resource Toolkit.
Further detailed advice on the use of personal protective equipment in health care:
- PPE guidance for primary and community health and disability care workers
- COVID-19: Advice for community allied health, scientific and technical providers