“…32 Implementation interventions: The implementation of specific PPE protocols and operating procedures as part of a multidimensional HF policy developed with the involvement of HWs was recommended. 19,23,42,51 In a pandemic context a distinct response plan is especially needed. 64 Besides standard universal masking adoption in the whole HF for respiratory diseases like COVID-19, 91 critical policy elements would include (1)robust regular training and qualifications as a requirement to provide care of patients requiring additional transmission-based precautions 39,71,75,77 ; periodic fit testing and appropriate mask sizing 22,44,49,51,57,72,73,75,77,87,91 ; (2)PPE compliance monitoring by checking expiration date, proper stock management, and ensuring the adherence to PPE manufacturer instructions 51,55 ; (3)PPE provision as per the level of risk in 3 different zones (eg, high, medium or low risk) 23,75 ; use of additional PPE like powered air purifying respirators (PAPRs) 75 in all areas allocated for aerosol-generating procedures; (4)donning and doffing area designations and establishment of standard PPE ensemble and illustrations of step-by-step instructions for safe donning and doffing ensuring separation of clean PPE from contaminated items, preferably in negativepressure rooms with mirrors.…”