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PPE Management Strategies for Latest COVID-19 Surge

Publish Date: December 9, 2020

When COVID-19 first became a global pandemic last Spring, the sudden increased demand for personal protective equipment (PPE) led to significant shortages across healthcare settings. Perioperative nurse leaders faced the reality of not having enough gowns, face masks, powered air-purifying respirators, N95 respirators, eye protection, and gowns to help protect their staff members from becoming exposed to COVID-19.

This fall as COVID-19 continues to resurge, Periop Today asked perioperative nurse leaders working in an acute care hospital, an ambulatory surgery center, and an academic institution how they are coordinating their PPE inventory to be better prepared. Here are their responses:

Kristy Simmons, MSN, RN, CNOR

Kristy Simmons, MSN, RN, CNOR, Pediatric Team Leader and ANCC Magnet Champion Chair
Woman’s Hospital in Baton Rouge, Louisiana

Brandy Miller, MHA, MSN, RN, CNOR

Brandy Miller, MHA, MSN, RN, CNOR, Director of Surgical Services
The Surgery Center, Fort Wayne, Indiana

Carla Brannen

Carla Brannen, MAM, BSN, RN, Assistant Administrator of Perioperative Services
University of Washington Medical Center in Seattle, Washington


Are you prepared with your PPE supplies for a COVID-19 resurgence?

Simmons: We do feel prepared; however, it is an ongoing concern that we work on every day. Clinical folks have worked very closely and collaboratively with supply chain, infection prevention, and regulatory folks since March to ensure preparedness.

What are you doing differently (stock, supply chain, reuse, etc.) in terms of PPE since pre-COVID?  

Simmons: We have a lot of creative solutions in place to ensure the safety of our patients and care team members. We have to procure supplies outside of our usual vendor relationships and it has been both costly and labor intensive. Our clinical teams have been very flexible and adaptable to the product variations and creative product usage. For example, we have used plastic sleeves to create boot covers when boot covers are not available. We are currently supporting limited reuse and reprocessing of N-95 masks. 

What's your outlook for keeping up with patient care in terms of PPE? 

Simmons: Our outlook is cautiously optimistic as none of us knows what lies ahead. Our supply chain processes, and our trial and substitution processes are working well to meet our needs. We remain conservative in terms of PPE usage and feel confident that our team is on board with this. 

Are you prepared with your PPE supplies for a COVID-19 resurgence? 

Miller: Our ASC currently has one month of PPE supplies to support our current and fourth quarter projected caseloads. Beyond that, we would be challenged to stay open; additionally, we have the risk of corporate allocating our supplies elsewhere in the health system. 

What are you doing differently (stock, supply chain, reuse, etc.) in terms of PPE since pre-COVID? 

Miller: We have increased our PAR levels [minimum inventory required to meet projected demand] and we are now ordering whatever we can get that is allocated to us from our supplier, even if there does not seem to be an immediate use/need  within the next two weeks.

We have also moved to a greater variety of PPE brands (some are of lesser quality), depending on what can be obtained and what is available. We are reusing some items (with the same person, not sharing among team members) that we would have never reused in the past, such as masks, and hair bouffants. We are being more discriminate in what PPE we are using, and we are holding one another accountable with our PPE usage.

What's your outlook for keeping up with patient care in terms of PPE? 

Miller: I feel it is important to maintain a positive position as possible, while making sure to be realistically prepared and investigating as many back-up resources as possible.

Are you prepared with your PPE supplies for a COVID-19 resurgence? 

Brannen: As of today, we are appropriately stocked with PPE supplies for our patients, staff and providers. 

What are you doing differently (stock, supply chain, reuse, etc.)  in terms of PPE since pre-COVID?

Brannen: There is more awareness of using PPE to its fullest extent when possible and there is more discussion around conservation of items such as hats, beard coverings, shoe covers, and masks. For example, we might ask, “Do you need shoe covers if your shoes are dedicated to OR and you are not at the sterile field?” or “Are you putting on a hat and then throwing away when you could save it (when not contaminated)?”  We are tracking our PPE inventory through daily reports from supply chain on issues or substitutions and there is more communication to providers on supply issues and substitutes. We are also engaging regular conversation in all procedural areas regarding PPE use and conservation tactics.

What's your outlook for keeping up with patient care in terms of PPE? 

Brannen: As we don’t know how many patients we will see with this next wave; we are being judicious in our use of PPE. We work daily with supply chain and infection prevention to determine quantities and if substitutes for our usual supply are appropriate.

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