Can visitors be 'forced' to wear PPE?

[Double-Helix, BSN, RN]

We recently had a patient with an influenza requiring droplet isolation. Visitors (the parents) flatly refused to wear a face mask in the room, despite frequent education. The parent did sanitize their hands before entering/leaving the room but did leave several times to use the bathroom and get something to eat. Our nurse manager attempted to address it with the parents as well, but to no avail, and the parents actually ended up getting very upset.

With the JC expected to come to our unit any day, this raised the question on our unit- Can visitors be forced to wear PPE when visiting patients with infectious disease? Especially the parents of a minor child. What would be the steps to take to enforce this? Call security and have the parents escorted from the hospital?

[SwansonRN]

I have gotten attitude when I ask people to wear PPE "you don't understand that's my cousin, I don't need to wear that" but they have always complied after I explain that it's not just to protect themselves, but the rest of the hospital. I don't think you can force them, but you can be very firm.

[Twinmom06, ASN, APN]

I've been told (whether its true or not)...that if they're living in the house they're exposed anyway so sitting in the hospital room poses no additional risk to the patient...now as for the rest of the hospital and exposure, again if they're living with the patient, the clothes they wear into the hospital have been in that same house...so they're not going to wear PPE in and out of the hospital...

again - I'm a student but I do work as an aide, and in most cases we don't push the PPE with visitors that already live with the patient

[Nurse_]

I have a tuberculosis patient and the family refuses to wear PPE. I informed them about the importance, but they still refused. I documented it and let my charge nurse know.

We cannot force anyone to wear PPE, just like we cannot force someone to take their meds. We can only strongly suggest things but nothing more.

[classicdame, MSN, EdD]

I do not htink we have a legal right to force anyone unless there is a declared state of emergency or some such by the local health department. Back to rule #3 in nursing.

Air goes in and out

blood goes round and round

cannot fix stupid

[rumwynnieRN]

It's the flu -- they're mentality is what someone else, "I was already exposed." I think I'd be more worried if they had acinetorbacter, and they weren't wearing PPE. Otherwise, eh. You did your job, document like someone else said, and if joint commission shows up, it's in the patient's chart.

[StNeotser, ASN, RN]

I suppose in a perfect world your hospital could just not admit visitors who don't want to abide by the rules but we all know how that goes..................once they scream and have a hissy fit they're allowed to do as they please.

[blondy2061h, MSN, RN]

I'm beginning to think I work at the only hospital in the world that doesn't have visitors wear PPE.

[Ruby Vee, BSN]

​Visiting is a privelege, not a right. If you don't abide by the rules, the privelege is revoked and if you refuse to leave, the nice men in the grey uniforms will help you find the exit.

[Bruce_Wayne, ASN, RN]

For flu/droplets as long as you stay a few feet away from the patient, practice good hand hygiene, and don't touch your eyes and mouth I think you're reasonably safe. Not totally safe but safer than if they don't do those things.

I once had a TB patient walking all up and down the hallway with his n-95 over his mouth but not his nose and he acted insulted or ignorant when confronted. It was frustrating because when he feigned ignorance he was lying and when he got insulted it's so self centered thinking that your desire to parooze the halls is worth infecting an entire hallway of already sick people.

[SleeepyRN]

My former supervisor would not allow families to visit in the resident:s room if they refused PPE

[MattNurse, MSN, RN]

Yes you can force for certain instances, the instance that comes to mind is neutropenic patients, I make them put on a mask when they are sick and wash their hands before entering the room. We have signs outside the door that says a patient must check in with the nurse before entering. You would probably want to check with your infection control office at the hospital. I wouldn't wear a mask if I were visiting family with the flu, I never get the flu w/ vaccinations and like others said you need to be within 4 feet and touching your face.