Mask Respirator

In essence, infection prevention and control isn’t just one measure, like personal protective equipment (PPE), but all of these layers. Each layer is imperfect but plays a critical role in reducing risk.

What’s the matter with Kansas? Well, for one thing, counties could choose whether to follow state health department guidelines on masking. COVID-19 case-count differences between counties that did and those that didn’t is striking.

Faced with greater than three times the number of cases as the last surge, along with exponential growth with no end in sight, there is little hope healthcare workers can safely treat patients without a drastic change in policy and a more productive and secure supply line.

Investigators claim that their device can decontaminate N95s and surgical masks in the time it would take an infection preventionist to wash her hands.

If you are an infection preventionist and are not currently involved in product review, now may be a great time to reach out to your supply chain team to explain the perspective you can bring to the table and ask to be involved.

Ashish Diwanji: “The personal protective equipment made and sold in the US has to abide by the standards set up by NIOSH …. The PPE made and sold from China do adhere to the Chinese standards, but their standards are different than ours.”

Sharon Ward-Fore, MS, MT(ASCP), CIC: “I’m hoping that healthcare facilities will find the value in their infection preventionists and understand how important a role they play as far as training on PPE and disinfectants, and in hand hygiene, being kind of a boots on the ground people on the floor to see things firsthand.”

Fauci: “While results of phase 3 trials for multiple candidate vaccines are on the near horizon, ‘low-tech’ tools to prevent the spread of SARS-CoV-2 are essential, and it must be emphasized that these interventions will still be needed after a vaccine is initially available.”

It can be helpful for infection preventionists to still provide quick COVID-19 rounds in units and high-risk areas like emergency departments and urgent care clinics. These can be as simple as 30-minute reviews of personal protective equipment, isolation precautions, and communication pathways.

As these healthcare worker serology studies are designed and performed, we need more insight beyond just PPE use and symptoms, but also internal and external exposures.

If you see something, say something. Let coworkers know when they may have breached infection control practices such as forgetting to wash their hands, not wearing PPE properly, or missed opportunities to clean a high-touch surfaces.

Especially in healthcare settings, when infection preventionists need to explain protocols and guidelines to their fellow healthcare workers and patients, something can always be lost in translation if much of the face remains hidden.

Linda Spaulding: “We [infection preventionists] have listening sessions with staff and we talked to them about proper mask wearing 24/7. We can do a listening session and we still have people sitting there with a mask under their nose, while we’re telling them not to. You have to continuously stress this among healthcare workers, be it whatever department.”

Neck gaiters weren’t the only face coverings tested: in all 14 were analyzed, from N95s (unsurprisingly judged to be the most effective in containing COVID-19 spread) to bandanas (not much more effective then neck gaiters, according to the study).

Film healthcare workers as they don and doff N95s, show that video to participants (explaining where they got it right, and where they got it wrong), and then have the participants don and doff again with more input from trainers.

Many factors make the isolation precautions for diseases like COVID-19 more complex than typical droplet or airborne definitions.

Maureen Spencer, RN, M.Ed.: “The World Health Organization did come out and said that they support the concept that this is droplet and airborne. And what that does is it changes our approach for infection prevention.”

It will also be necessary to again train other professionals the way IPs have historically trained them about infection prevention, because a lot of the old rules had to be set aside when COVID-19 surged.

We have much work to do in terms of risk communication and awareness. This is a good example of how quickly exposures can happen in the workplace when we focus only on employee-to-customer interactions or healthcare worker-to-patient interactions.

The filtering face piece respirators will be manufactured at General Motor’s facility in Warren, Mich. The company had to revamp its manufacturing process to accommodate making the respirators, creating four separate assemble stations.

Harry Peled, MD: “I think for administrators and infection control people, the attitude has to be there is enough evidence that the wearing of N95s should be official. The claim that we’re going to wait for perfect evidence is just not tenable. We don’t do that for anything else in medicine.”

Investigators argue in the Annals of Internal Medicine that all healthcare workers in inpatient settings caring for COVID-19 patients should be equipped with N95s.

Healthcare workers are particularly susceptible to maskne because they tend to wear their masks for extended periods.

N95 decontamination must meet 3 criteria. It needs to: inactivate the pathogen, it can’t damage or degrade the N95 in any way, and it should not introduce an additional hazard to the healthcare worker.

Just-in-time (JIT) fit testing allows a healthcare organization to offer evaluation, training, and fitting of HCPs during rapid intervals, as needed, based on specific patient care assignments. 

Decontaminated respirators should only be resorted to when unused devices are not available, but that happened a lot in the last few months.

The wearing of cloth masks doesn’t mean that employees should stop following social distancing guidelines. In fact, social distancing guidelines must be followed at all times.

Viral droplets from a sneeze can even travel 23 to 27 feet.

One hospital has asked workers to consider shaving their beards.

Face shields are durable and can be cleaned and reused repeatedly, thereby eliminating the problem of shortages.