With the current personal protective equipment (PPE) shortage and possible continued shortage, agencies should develop strategies for PPE use and options for re-use when needed. Each type of PPE should be categorized in three ways: Plan A (Best Case Option), Plan B (Back-Up Plan), and Plan C (Worst Case Scenario). This is seen when clinicians properly triage patients and only use N95 respirator masks for patients under investigation (PUI) or diagnosed with COVID-19. Developing these strategies now will help the agency use current PPE supplies sparingly yet appropriately in preparation for potential further PPE shortages.
A PPE Conservation Strategy for Face Masks
Plan A: Since COVID-19 is a respiratory virus, N95 respirators are the preferred mask for use while caring for a patient diagnosed with COVID-19 to prevent transmission, as recommended by the Centers for Disease Control and Prevention (CDC).
Plan B: While supplies of N95 masks remain scarce, plans can be created to re-use N95 masks if they are not visibly soiled, are removed properly and stored in a paper or other breathable bag for ideally 72 hours to thoroughly dry after use, along with additional considerations.
Plan C: Another strategy to lengthen the life of an N95 mask is to wear a face shield or homemade mask over the N95 respirator to prolong its use. If N95 masks are not accessible, other mask options may need to be used, such as homemade or donated masks (although they may increase the risk of being infected with COVID-19).
PPE Use After a Home Visit
While PPE usage is important, high risk of COVID-19 exposure happens during removal of PPE, so re-educating staff on proper donning and doffing (removal) of PPE is vital to control transmission. PPE should be removed and disposed of OUTSIDE of the home with hand hygiene performed immediately after removal. Caregivers should bring their own trash bags to dispose of PPE, which should be treated as household waste unless it contains blood or body fluids. The CDC has recommended protocols for donning and doffing of PPE with careful handwashing with soap and water, or hand sanitizers if running water is not accessible.
Hand Sanitizer Is PPE, Too
It is important to note that not all hand sanitizers are created equal. Active ingredients differ in types of hand sanitizer. The CDC recommends using hand sanitizer with at least 60% alcohol. There are alcohol-free hand sanitizers that have other active ingredients, such as benzalkonium chloride, which have not been found to kill the virus causing COVID-19. Many agencies buy large-sized containers of hand sanitizer for clinicians and caregivers to refill small bottles to carry with them on visits. The proper procedure for refilling bottles is to empty, wash, dry and refill (with the appropriate OSHA-approved label). Be sure to also check expiration dates and storage. Storing hand sanitizer bottles in cars or areas that get above 90 degrees can warp plastic bottles and cause small cracks in the plastic, possibly lessening the efficacy of the alcohol to kill pathogens.
The current pandemic has stretched our healthcare system’s PPE usage past its limit. Agencies will need to adjust policies and procedures to accommodate decreasing supplies of PPE and keep their caregivers and patients safe during this increasingly uncertain time.
Caring Brands International is offering possible PPE assistance to those in the home healthcare industry. Click here for more information.