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What Types of PPE Should Be Available to Nursing Home Employees?

Are you wondering what type of PPEs should be available to nursing home employees? If YES, here are 5 PPEs nursing home employees need.

A large percentage of nursing homes in the United States are dealing with unbearable shortage of masks, gowns and other items they need to protect residents, workers and the broader community from COVID-19. And so many months into or after this pandemic, the shortages have actually become much worse.

At any given time, about 1.3 million people with long-term medical issues or short-term rehabilitation needs are residing in the nation’s 15,000 nursing homes. In addition, a good number of them are at risk, according to an analysis of government data by U.S. PIRG Education Fund and Frontier Group.

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As of late August 2020, 226,495 residents in 2,981 nursing homes nationwide were at risk since the homes had dangerously low supplies of one or more types of personal protective equipment (PPE) such as N95 masks or gowns, according to data submitted to the federal government.

It entails that 20 percent of nursing homes in late August 2020 had a less-than-one-week supply of one or more types of PPE, which represents a massive shortage by industry standards.

Have it in mind that these shortages actually became more severe as the summer went on, with three times as many nursing homes noting that they were completely out of masks, gowns, and eye protection in late August, compared with mid-July.

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According to reports, Forty-six percent of all nursing homes nationwide reported they didn’t have a one-week supply of at least one type of PPE at some point from May through August 2020.

In the United States, a one-week supply is considered the minimum acceptable. If a home has an outbreak, it can burn through its limited supply in a day or two. In addition, a home may have no knowledge of when its next shipment of PPE may arrive.

Homes with less than one week’s supply often ration, forcing workers to re-use PPE or go without. Ideally, it is not entirely surprising that while nursing homes contain less than one-half of 1 percent of the U.S. population, they have produced 3 percent of the nation’s COVID-19 cases and 27 percent of deaths.

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Experts note that nursing homes have been hit harder in part because the living space is tighter, residents are there around the clock, and people in nursing homes and rehabilitation facilities are generally older and in poorer health than the overall population.

Certainly, the PPE shortages have made difficult situations even worse and Workers in these homes are also expected to change their PPE before every new patient to avoid potentially transferring the coronavirus from one patient to another.

Demand for PPE is coming from every sector of the economy, not just health care. The world supply chain was strained.

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It’s particularly necessary that nursing home workers get PPE not only to protect residents and themselves but to limit the wider spread of the virus among family members when they return home from work or anyone they might come into contact with in public places.

Types of PPE That Should Be Available to Employees of a Nursing Home

  1. Gowns

A clean, non-sterile gown is required for protecting skin and preventing soiling of clothing during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. In a nursing home, most patient interactions do not require the use of a gown, but they are always a needed item when caring for patients under contact isolation precautions for an infectious disease.

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It is imperative that you select a gown that is appropriate for the activity and amount of fluid likely to be encountered. Remove a soiled gown as promptly as possible and wash hands to avoid transferring microorganisms to other patients or environments.

  1. Gloves

Disposable gloves are made from a wide range of polymers such as latex, nitrile rubber, polyvinyl chloride (PVC, or more commonly referred to as vinyl), and neoprene.

They are available as unpowdered or powdered. Both non-sterile and sterile gloves are used by healthcare providers (HCPs) when delivering care to patients. Note that Latex and nitrile mold to the hand and offer superior protection against pathogens.

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Nitrile gloves tend to be preferred over vinyl for tasks that require a high degree of dexterity. Vinyl gloves are acceptable when the risk of exposure to pathogens is lower, and a high degree of dexterity is unnecessary.

  1. Face and Eye Protection

Protective goggles, and face shields, and safety glasses provide a barrier to infectious substances. They are more or less used in conjunction with other personal protective equipment such as gloves, gowns, respirators, and facemasks.

Note that the type of face and eye protection chosen is dependent on the specific task and potential for exposure. Personal knowledge of potential exposure is critical for making an informed decision about the right face and eye protection.

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However, note that Eyeglasses prescribed for vision correction and contact lenses are not considered eye protection. For complete and proper protection, it’s also necessary to evaluate the combination of protection recommended for the specific work situation.

For instance, some facemasks may not work with various goggles or shields. The same way a full-face respirator may provide adequate protection without additional components of PPE.

  1. Face Masks

Facemasks are known to offer barriers to infectious materials and are more or less used with other PPE such as gowns and gloves.

When worn correctly, face masks and eye protection offer adequate protection for the mouth, nose, and eyes during procedures where there is a potential for droplets or splashing of blood or body fluids. Note that Procedure facemasks are flat/pleated and affix to the head with ear loops. They are used for any non-sterile procedure.

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Surgical masks come in two basic types: one that is affixed to the head with two ties conforms to the face with the aid of a flexible adjustment for the bridge of the nose and may be flat/pleated or duck-billed in shape. Meanwhile, the second type of surgical mask has two elastic loops, one for each ear.

Have it in mind that both have a flexible nose piece that is adjusted by pinching at the bridge of the nose. Both are loose fitting and provide one-way protection as they capture particles or droplets from the wearer and protect patients and operative sites.

  1. Respirators

Presently, OSHA standards mandate that respirators are used for airborne transmission-based precautions; these minimally filter 95 percent of 0.3 µm-size particles. Respirators are also leveraged for case-specific aerosolizing procedures where airborne particulates create a high risk of infection for the HCP.

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Note that the N95 is exceptionally durable, has a soft and comfortable inner surface, an adjustable nosepiece, and secure head straps to provide a proper fit. A person using an N95/HEPA respirator is expected to be fit-tested before use.

Check with agency policy about respirator use for infection control. If the respirator has full facemasks, this also protects the eyes and face in addition to the respiratory tract.

In a nursing home, disposable single-use items are preferred. Self-awareness and self-protection are vital and following appropriate precautions and safe use of PPE is necessary to avoid self-inoculation while working around patients with severe transmissible illnesses.

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Safe removal of PPE is imperative, as the WHO noted that approximately 30 percent of infections of healthcare workers were due to poor practices while removing PPE.