Infection Control

How much PPE is enough during a pandemic?

Briefings on Infection Control, June 1, 2009

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Emergency management directors and IPs are aware of the importance of personal protective equipment (PPE) during a catastrophic event. But due to the unexpected nature of a pandemic, directors are unsure how much PPE is enough to survive a surge of patients. A study published in the January 2009 Journal of Hospital Infection observed a British hospital simulating the height of a flu pandemic in one of its acute medical wards. The 29-bed ward was staffed by 14 trained nurses, five healthcare assistants, and four domestic staff members. During this 24-hour exercise, staff members adhered to the procedures outlined in the United Kingdom?s pandemic influenza IC guidelines, which call for workers to wear gloves, a plastic apron or gown, and a surgical mask when working within three feet of a patient. The study concluded that although the World Health Organization recommendations on the likely use of FF3 respirators was excessive, staff members did use more gloves and surgical masks than expected, including 650 surgical masks, 1,200 pairs of gloves, and 750 disposable aprons. Many staff members noted they lacked confidence using PPE while following procedures. Basic tasks took longer, and the facility also generated significantly more waste. Is there a number? It is difficult to plan for the uncertainty of a pandemic flu outbreak. Each hospital plays a different role in its community and therefore has unique PPE requirements, says Tom Huser, MS, CHSP, safety coordinator of emergency management and hazardous materials at Clarian Health in Indianapolis. ?There?s no real number,? Huser says. ?It depends on the facility, the facility?s size, location, and population served. If you are a small hospital in the suburbs or rural areas, you may be the only game in town, but the entire population served is probably going to be smaller than a square mile around an urban hospital.? Clarian is fortunate to receive funding from the office of the Assistant Secretary for Preparedness and Response, which the hospital has used to stockpile materials, Huser says. He estimates Clarian has 710,000 pairs of gloves and 5,000 pairs of eye protection locked away in a separate location.

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