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The reuse and reprocessing of personal protective equipment (PPE) “must be a last-resort temporary measure”, according to new guidance from infection prevention experts.
They have drawn up a checklist of “actions and practical strategies” that can be used by infection prevention and control teams to inform local risk assessments to manage acute shortages of PPE.
The joint paper, titled Strategies for managing acute shortages of personal protective equipment, has been published by the Infection Prevention Society (IPS) and the Central Sterilising Club (CSC).
“We have undertaken this piece of work to give practical guidance to our members, many of whom are facing critical shortages of PPE”
They said the document had been developed to guide infection prevention and control teams “in light of the current acute shortages of PPE” due to the coronovirus pandemic.
Nursing staff in hospitals, care homes and other health and social care settings have faced ongoing, and high profile, shortages of PPE over recent weeks, as they attempt to tackle the Covid-19 crisis.
Several surveys have indicated the scale of the shortage, with a shortage of gowns a particular problem. Media reports have suggested some parts of England were on the brink of running out.
Public Health England recently told clinicians to consider reusing masks, gowns and visors marked single use or seeking alternative kit when treating Covid-19 patients if stock runs dangerously low.
Moves to reuse PPE sparked criticism and safety concerns, with both the IPS and the Royal College of Nursing saying they had not been consulted on the PHE guidance.
In their paper, the IPS and CSC said: “Reuse and reprocessing of PPE must be a last-resort temporary measure that is implemented for a limited time period to enable stocks to be replenished.”
The paper provided infection prevention and control teams with a “checklist of actions and practical strategies that can be used to inform local risk assessments to manage shortages of PPE”, they said.
It stated that the reuse of gowns or other PPE should only be considered as a “last resort because of the increased risks of contamination during re-donning and is not recommended”.
“Gowns should be protected during use with plastic aprons to minimise contamination and should not be reused if damaged, soiled or wet,” the guidance added.
Using reusable gowns was “one way of assuring supplies of PPE”, said the guidance, noting that ward-based systems were needed to ensure they were placed in laundry bags and not thrown away.
“Reuse and reprocessing of PPE must be a last-resort temporary measure”
Whether single-use gowns could be laundered depended on the quality of the disposable garment and should not be attempted if the gown was “damaged or visibly soiled”.
Likewise, the guidance warned that reprocessing single use respirators was “not recommended and should only be considered when the supply of new respirators is inadequate”.
“Respirators are considered to be for single-person use and would need to be returned to the original user,” added the guidelines from the IPS and CSC.
However, it warned that the reuse of respirators during a shift was not recommended, with the guidance suggesting that this was case even as a last resort.
“Systems that would enable the same mask or respirator to be reused by one member of staff would be very difficult to achieve safely and would probably not be feasible to continue for more than a single shift,” it said.
As an alternative to FRSM or FFP3 reuse, the guidance said: “It would be preferable to use FFP2 (N95) respirators rather than attempt to retain and reuse.”
The joint paper also covered a range of other strategies to conserve PPE, such as making system changes to minimise the number of staff entering areas provided for COVID-19 patients.
The IPS represents 2,000 members working in the field of infection prevention and control, including many nurses, while the CSC is the UK’s original decontamination forum and was founded in 1960.
IPS President Pat Cattini said: “We have undertaken this piece of work to give practical guidance to our members, many of whom are facing critical shortages of PPE for managing COVID-19 patients.
“This advice has been prepared to help them navigate safe and effective strategies to manage the issues they face and provide healthcare workers with the protection they need.”
She added: “IPS members are at the forefront of trying to ensure healthcare workers have the equipment they need and that they know how to use it correctly.”