Nearly 70% of the PSWs and nurses who responded to an online survey told us that wearing a face shield makes it harder to provide safe, quality care because their facial protective equipment (FPE) including face shield, fogs up. Additionally, over 50% reported difficulty seeing when they wear goggles. Fogging of FPE is particularly common for homecare providers while assisting their clients with showers and during other high-exertion activities that increase body temperature and sweating. While environmental solutions like leaving a door or window while showering a client are helpful solutions, they are not always practical.

Based on findings from the pilot study, Determinants of nurse’s and personal support worker’s adherence to facial protective equipment in a community setting during the COVID-19 pandemic, utilizing materials that reduce visibility issues while wearing FPE would also decrease personal barriers to FPE use in homecare.

There is a clear need for solutions to reduce fogging of face shields and googles, to enable care providers to see clearly while using this vital infection prevention equipment.

14 products with anti-fogging potential were identified through online community forums and consultation with athletes who have experience with face shield fogging. Treatment products ranged from common household items like shampoo and dish soap to car glass cleaners and specialized anti-fogging solutions. These products were evaluated for their effectiveness in preventing fogging of a face-shield through two phases of testing:

• Laboratory-style testing on face shields in a hot, humid shower environment was performed to identify the most promising solutions.
• Field-testing of the 3 best-performing solutions was performed by 10 providers – 8 PSWs and 2 Nurses, who tested each solution on their face shield and/or goggles while providing client care.

The 3 solutions that worked the best to reduce fogging during laboratory-style tests were Live Clean Baby Shampoo, Dawn Dish Soap, and Aveeno Body Wash.

Field-testing by PSWs and Nurses found that Live Clean Baby Shampoo and DAWN Dish Soap performed the best – both were easy to apply and helped to reduce fogging and condensation on the face shield or goggles for about 2-4 clients.

This research is changing practice at our organization. Starter kits containing instruction cards, product samples and microfibre cloths for product application and drying of face shields/goggles are being distributed to all VHA service providers with their Personal Protective Equipment.