Healthcare Facilities Implement PPE Crisis Standards of Care

A survey of over 1,000 infection preventionists found that most healthcare facilities are implementing crisis standards of care when it comes to using personal protective equipment during the ongoing COVID-19 pandemic, including respirators and masks.

About 73 percent of respondents said their facilities have implemented PPE crisis standards of care for respirators. Meanwhile, approximately 69 percent said the standards are in place for masks and 76 percent for face shields or eye protection, according to the survey conducted by the Association for Professionals in Infection Control and Epidemiology (APIC).

In many cases, this means healthcare personnel are reusing PPE or extending the life of the supplies, which are usually meant for single use, APIC stated.

Most respondents said they are allowed to use respirators (39 percent) and masks (57 percent) as many times as possible before getting a fresh supply. And for many infection preventionists, that can be about five days for both supplies, respectively.

“It is disheartening to see our healthcare system strained and implementing PPE crisis standards of care more than eight months into the pandemic,” said Connie Steed, MSN, RN, CIC, FAPIC, 2020 APIC president. “Many of us on the frontlines are waiting for the other shoe to drop.”

COVID-19 cases continue to rise in the US, with officials recording a total of 1.4 million new cases and nearly 16,000 deaths this week, according to the COVID-19 Tracking Project run by The Atlantic.

The numbers make it the worst week yet for COVID-19, researchers stated.

Making matters worse for providers is the upcoming flu season, which the CDC expects to hospitalize 400,000 people this year.

Most infection preventionists (79 percent) are already concerned about how medical supply shortages will impact the current influenza season, the APIC survey showed.

In fact, the majority of responding infection preventionists are more concerned about the impact supply shortages will have on the current season compared to previous years because of the COVID-19 pandemic.

Hospitals and other healthcare facilities seemingly have an adequate supply of most PPE and cleaning supplies right now, with a majority of survey respondents saying they have plenty or at least a sufficient supply of all key supplies, including masks, face shields, hand soap, and injection supplies.

This is in stark contrast to a previous APIC survey from March 2020 that found nearly half of facilities were out of or nearly out of respirators, while a significant number of facilities were also running out of other critical devices used to protect healthcare personnel from infectious diseases.

However, providers are currently most likely to be without or running low on many of the supplies needed to handle a surge of COVID-19 patients, including cloth gowns, respirators, isolation gowns, and cleaning or disinfectant.

Supplies of these items could get worse again as hospitals across the country brace to meet bed capacity because of rising COVID-19 cases. About 72 percent of infection preventionists are worried about their facility reaching capacity.

In turn, about half of infection preventionists are concerned about their facility’s ability to provide safe care (54 percent) and protect healthcare personnel (51 percent) during the flu season and pandemic.

Healthcare-associated infections have already increased because of the pandemic. Nearly 28 percent of respondents reported increases in central line-associated bloodstream infections (CLABSI), 21 percent in catheter-associated urinary tract infections (CAUTI), and 18 percent in ventilator-associated pneumonia (VAPs) or ventilator-associated events (VAEs).

“With the upcoming flu season, we implore people to do what they can to keep safe, protect our healthcare personnel, and lessen the strain on our healthcare system: wear a mask, get your flu shot, wash your hands, and maintain social distancing from others to slow the spread of COVID-19,” Steed stated.