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Virginia Health Care Association | Virginia Center for Assisted Living

Act Now to Conserve PPE

Act Now to Conserve PPE

CDC issued guidance on March 18 on the use of masks, gowns and face shields including suggestions on what to do if in crises shortages and when your supplies are exhausted. In order to significantly conserve masks and gowns, nursing homes and assisted living communities need to implement significant conservation steps now by reviewing the CDC’s crises capacity strategies. We strongly urge you to adopt these strategies to extend availability of your remaining PPE until such time as production and supply improves or we can obtain masks and gowns from other health care sectors and manufacturing.

The CDC recommendations continue to protect from droplet exposure, which is how COVID-19 and most other respiratory viruses are spread. We believe these recommendations help preserve PPE supply given the dire shortage.  

Highlights from the new CDC guidance on PPE use are below.  

Mask Summary 

  • Implement extended use of facemasks which allows the wearing the same facemask for repeated close contact encounters with several different patients, without removing the facemask between patient encounters.   
  • Restrict facemasks to use by health care professionals (HCP), rather than patients for source control. Have patients with symptoms of respiratory infection use tissues or other barriers to cover their mouth and nose. 
  • Implement limited re-use of facemasks, which is the practice of using the same facemask by one HCP for multiple encounters with different patients but removing it after each encounter. Discarded if soiled, damaged, or hard to breathe through. 
  • Prioritize facemasks for selected activities, such as: 
    • For provision of essential surgeries and procedures 
    • During care activities where splashes and sprays are anticipated 
    • During activities where prolonged face-to-face or close contact with a potentially infectious patient is unavoidable 
    • For performing aerosol generating procedures, if respirators  

Gowns Summary 

  • Shift gown use towards cloth isolation gowns 
  • Consider the use of coveralls  
  • Extended use of isolation gowns (disposable or cloth), such that the same gown is worn by the same HCP when interacting with more than one patient known to be infected with the same infectious disease when these patients housed in the same location (i.e., COVID-19 patients residing in an isolation cohort). This can be considered only if there are no additional co-infectious diagnoses transmitted by contact (such as Clostridium difficile) among patients. If the gown becomes visibly soiled, it must be removed and discarded as per usual practices. 
  • Re-use of cloth isolation gowns among multiple patients in a patient cohort area without laundering in between.  
  • Prioritization of gowns for the following activities: 
    • During care activities where splashes and sprays are anticipated, which typically includes aerosol generating procedures 
    • During the high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of healthcare providers, such as: dressing, bathing/showering, transferring, providing hygiene, changing linens, changing briefs or assisting with toileting, device care or use, wound care 
    • When No Gowns Are Available consider pieces of clothing as a last resort, preferably with  long sleeves and closures (snaps, buttons) that can be fastened and secured, particularly for care of COVID-19 patients as single use. Other options include:  
      • Disposable laboratory coats 
      • Reusable (washable) patient gowns 
      • Reusable (washable) laboratory coats 
      • Disposable aprons 
      • Combinations of pieces of clothing can be considered for activities that may involve body fluids and when there are no gowns available: 
        • Long sleeve aprons in combination with long sleeve patient gowns or laboratory coats 
        • Open back gowns with long sleeve patient gowns or laboratory coats 
        • Sleeve covers in combination with aprons and long sleeve patient gowns or laboratory coats 

Reusable patient gowns and lab coats can be safely laundered according to routine procedures   

Eye Protection Summary  

  • Implement extended use of eye protection is the practice of wearing the same eye protection dedicated to one HCP for repeated close contact encounters with several different patients, without removing eye protection between patient encounters including for disposable and reusable devices.  
    • Eye protection should be removed and reprocessed if it becomes visibly soiled or difficult to see through.   
    • If HCP touches or adjusts their eye protection, they must immediately perform hand hygiene. 
  • Prioritize eye protection for selected activities such as: during care activities where splashes and sprays are anticipated, which typically includes aerosol generating procedures or prolonged face-to-face or close contact with a potentially infectious patient is unavoidable 
  • Consider using safety glasses (e.g., trauma glasses) that have extensions to cover the side of the eyes. 
  • Designate convalescent HCP for provision of care to known or suspected COVID-19 patients.
  • Selected options for reprocessing and clean eye protection are provided.