PPE Reuse and Storage – Protecting Healthcare Workers
Event Type
Discussion Panel
TimeThursday, April 1511:00am - 12:00pm EDT
LocationEducation and Simulation
DescriptionThe number of victims from coronavirus disease 2019 (COVID-19) has been growing exponentially with more than 101 million positive cases reported across 188 countries, and over 2 million fatalities. Under-resourced and overwhelmed health systems have been unable to cope, putting extreme pressure on health care workers (HCW), with many making the ultimate sacrifice and paying with their lives. During COVID-19, the World Health Organization (WHO) found that in Europe and the Americas, health care workers, who represent 3% of the global population, made up 14% of reported COVID-19 cases. The heavy toll of this pandemic on the health care workers has led to dramatically high mental and physical health illnesses. According to Amnesty International, more than 3000 HCWs have died, and the WHO puts the number of infected HCWs at 1,500, 000. The figures likely represent significant underreporting, and the disease burden is expected to continue to grow.

Outbreaks take a tremendous toll on HCWs in the best of circumstances, but when HCWs are asked to perform their life-saving work without adequate preparation or resources, the results can be disastrous. The high demand for personal protective equipment during the novel coronavirus outbreak has prompted the need to develop strategies to conserve supply. Access to the very equipment used to protect our HCW has been limited, leaving HCW vulnerable to infection. Now, nearly a year into the pandemic, personal protective equipment (PPE) is still being rationed and health care facilities across the country have moved to re-using PPE to help conserve limited resources.

Little however is known regarding the safety or efficacy of decontamination interventions allowing for PPE reuse. There are no current guidelines for HCW on best practices for PPE Reuse or how to store PPE and limit fomite exposure while not in use. Historically, most healthcare providers are exposed to a contagion during the doffing process. This was in a pre-pandemic era, when “single-use” PPE was utilized and then immediately discarded. However, as a result of the current demands for PPE and the resultant shortages, very little research has been done on the risks of reusing potentially contaminated PPE.

We will report on our study results which employed a 3-part approach: (1) hierarchical task analysis (HTA) of the PPE doffing process based on the CDC PPE guidelines with a particular attention on mask reutilization; (2) Human factors-informed failure modes and effects analysis (FMEA); and (3) video review of learner performance and adherence to the CDC PPE guidelines in the donning and doffing of PPE. We will identify failure mode(s), assign priority risk scores, identify contributing factors and consequences, and identify risk mitigation strategies.

This study will use a florescent dye applied to the outer surface of a N95 to represent contamination. The fomite transfer that occurs to the workstation and participant as a result of mask reuse will be evaluated under a black light. In addition, it will also evaluate different methods of storing N95 mask in between uses in order to limit the amount of fomite transfer. Simulated conditions will be similar to what is expected to occur during a typical shift in the acute care setting. In between patient encounters, participants will don and doff their PPE under video surveillance to evaluate for variations that occur among different HCW. The aim of this study data will support methods of N95 mask storage and reuse techniques that can lead to safer PPE usage.

This panel will lay out the problems our health workforce currently faces and recommends urgent research and policy actions that governments, health systems, and funders must take to address them. The panel will discuss and review recommendations that fall into four main categories: infection prevention and control, health workforce training, socioeconomic and legal support, continuous monitoring and improvement and data collection. Without the health workforce, there would be no health care system and we will not curb this or future pandemics.