Use of Adhesive Tape to Facilitate Optimal Mask Positioning and Use in the Emergency Department: A Randomized Controlled Trial.

Pettit, Nicholas; Zaidi, Ali; O'Neill, Brian; Doehring, Marla

STUDY HYPOTHESIS We hypothesize that placing a piece of surgical tape at the bridge of the nose over the mask will improve proper mask use among emergency department patients by creating a physical deterrent to mask removal. METHODS This study was an open-label single-center randomized controlled trial of a simple intervention to improve mask use performed at Eskenazi Hospital between April 2020 and October 2020. We permitted participants to either use their own mask or the surgical/cloth mask that we provided. We then randomized the participants to either the control group (no tape over the mask/nose) or to the intervention group (tape placed over the face mask at the bridge of the nose). The primary outcome of this study was the frequency at which participants correctly wore their masks upon reevaluation at 60 minutes. A subgroup analysis based on the mask type compared adherence in those with a hospital-provided mask versus in those with a patient-supplied mask. RESULTS We enrolled 123 participants in this trial. At 60 minutes, 100% of the intervention group participants were correctly wearing their masks versus 69% of control participants (absolute risk reduction, 31%; 95% CI, 19% to 43%; number needed to treat=3.2 patients). Subjects who were observed wearing their masks incorrectly exhibited some combination of either their mask removed or their nose and/or mouth exposed. Hospital-provided masks were not more likely to be worn correctly (odds ratio, 3.4; 95% CI, 0.9 to 12.3). CONCLUSION Applying a piece of tape to a mask on the bridge of the nose affords a simple, low-cost, and low-risk solution that resulted in 100% of patients wearing their masks correctly at a 60-minute reevaluation.