Managing Personal Protective Equipment in Health Care Settings

A recent overview of personal protective equipment (PPE) in health care settings, including evidence on the efficacy of N95 masks and the importance of including health care worker perspectives on use of PPE, was published in the Canadian Medical Association Journal.¹

Current guidelines for PPE in the general care of patients with coronavirus disease 2019 (COVID-19) in acute care facilities recommend gloves, an isolation gown, eye protection, and a medical mask or N95 respirator. However, many health care workers fear that due to policy or lack of supply, they may be left exposed to transmission events of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).²

“Answering questions such as how aerosols are generated, how limited supply of PPE can be managed, how care can be organized to optimize PPE use, and how health care worker perspectives can be integrated into organizational decisions are central to protecting health care workers from COVID-19 and future pandemic pathogens," said Jeanna Parsons Leigh, MD, in a press release.¹

The study authors went further to analyze the use of N95 masks compared with medical masks in preventing viral respiratory infections, suggesting ways to manage the limited supply of masks and other PPE. According to the journal, evidence shows that medical masks were no different from N95 respirators for preventing viral respiratory infections as a component of the PPE during routine clinical care.²

According to the study authors, paying particular attention to training health care workers in the correct methods of putting on and taking off PPE is crucial. Further, involving health care workers in developing strategies for PPE use as well as clear communication is important for ensuring front-line workers have confidence and use PPE effectively.¹

"Individuals and organizations may interpret the literature differently, and may arrive at different conclusions as to which PPE is appropriate for a given context for a novel virus,” the study authors wrote. “A breakdown in trust and communication can lead to conflict, anxiety and worker absences."¹

REFERENCES

• Managing personal protective equipment in health care settings. EurekAlert! https://www.eurekalert.org/pub_releases/2020-06/cmaj-mpp062420.php. Published June 25, 2020. Accessed July 1, 2020.
• Ng-Kamstra J, Stelfox HT, Fiest K, et al. Perspectives on personal protective equipment in acute-care facilities during the COVID-19 pandemic. CMAJ 2020. doi: 10.1503/cmaj.200575.