Stewardship of Personal Protective Equipment (PPE) During a Pandemic

Abstract

BackgroundThe use of PPE is fundamental in protecting healthcare workers (HCWs) from being exposed to SARS-CoV2. The pandemic caused global PPE shortages forcing institutions to address appropriate utilization and conservation. Initial efforts to limit PPE distribution to avoid misuse and frequent changes in public health guidance created confusion and apprehension amongst HCWs.MethodsInfection Prevention and Control (IP&C) implemented a PPE stewardship initiative, consisting of daily rounds on patients positive or suspected of COVID-19. Principles included: 1.) supporting HCWs caring for these patients, 2.) assure implementation of infection prevention principles for a safe environment, 3.) advise on appropriate PPE and isolation precautions with respect to patient acuity, and 4.) promote best practices aligning with the most up-to-date guidance.Rounds addressed questions and concerns regarding PPE availability and utilization. We partnered with Nursing and Respiratory Therapy to alleviate demands on IP &C. The "PPE Spotters" team, monitored and optimized PPE utilization, supply, and distribution; provided training on donning/doffing, PAPR use, PPE reuse; and provided general support to HCWs for questions.ResultsWe measured number of isolation days of confirmed or suspected patients with COVID-19 and the numbers of N95 masks distributed to units during the 4-week period before (18.2 mask per isolation day) and the 8-week period after (3.0 masks per isolation day) the PPE Spotter team was formed. Our PPE stewardship efforts successfully limited N95 misuse as community COVID-19 burden increased.ConclusionsThis multi-disciplinary resource, particularly during periods of evolving PPE guidance and supply chain insecurity, was vital. Additionally, it expanded the pool of staff to advocate for HCW safety and IP&C principles.All HCWs can benefit from learning about this novel model that can be adapted to any institution and various scenarios. We recently adopted this model to support staff in psychiatry with an influx of patient volumes and their needs.