Healthcare personnel masking: current practices and gaps in standardized thresholds.

OBJECTIVE

To characterize institutional masking policies for healthcare personnel (HCP) and identify factors informing masking decisions in the post-COVID-19 pandemic era.

DESIGN

Cross-sectional, survey-based study.

SETTING

Healthcare institutions participating in the Society for Healthcare Epidemiology of America (SHEA) and Association for Professionals in Infection Control and Epidemiology (APIC) Research Networks.

PARTICIPANTS

One representative per institution, including infection preventionists, hospital epidemiologists, or healthcare administrators, knowledgeable about organizational masking policies.

METHODS

A structured, web-based survey was distributed through the SHEA/APIC Research Networks. Survey domains included institutional characteristics, masking strategies outside of transmission-based precautions, epidemiologic and operational factors influencing masking decisions, and mask types required. Responses were collected anonymously via REDCap over a six-week period and analyzed descriptively.

RESULTS

A total of 172 unique healthcare institutions completed the survey (41% response rate, n = 172/425). Most respondents were infection preventionists (65%) or hospital epidemiologists (25%). The most common masking approach was a seasonal or situational risk-based strategy (57%), while 7% of institutions reported no formal masking policy. Among institutions using seasonal or situational masking, decisions were most frequently informed by outbreaks or clusters (37%), public health guidance (33%), and HCP illness/absenteeism (27%). Most institutions reported no fixed epidemiologic thresholds for masking decisions. When masking was required, surgical masks were most commonly used (98%).

CONCLUSIONS

Masking policies and decision-making criteria vary widely across healthcare institutions, reflecting a lack of standardized operational guidance. These findings underscore the need for consensus-based, data-driven frameworks to support consistent, transparent, and evidence-informed masking policies in healthcare settings.