About
This page offers a series of strategies or options to conserve supplies of all personal protective equipment (PPE) in healthcare settings when there is limited supply due to increased use and demand (e.g., as may occur during an infectious disease pandemic or epidemic) or supply chain disruption.
Conventional capacity strategies
Engineering Controls
Engineering controls reduce exposures for healthcare personnel (HCP) by placing a barrier between the hazard and the HCP. Engineering controls can be very effective as part of a suite of strategies to protect HCP without placing primary responsibility of implementation on them (i.e., they function without HCP having to take an action).
Use of physical barriers
Barriers such as glass or plastic windows can be an effective solution for reducing some exposures among HCP to potentially infectious patients. This approach can be effective in reception areas (e.g., intake desk at emergency department, triage station, information booth, pharmacy drop-off and pick-up windows) where patients may first report upon arrival to a healthcare facility. Other examples include the use of curtains between patients in shared areas and closed suctioning systems for airway suctioning for intubated patients.
Administrative Controls
Administrative controls are employer-dictated work practices and policies that reduce or prevent hazardous exposures. Their effectiveness depends on employer commitment and HCP acceptance and consistent use of the strategies.
Identify patients with signs or symptoms of infection
Develop mechanisms to screen patients for acute respiratory and febrile illness and exposure risks prior to their healthcare visits, such as through the appointment reminder system. Postpone and reschedule those with signs and symptoms or exposures presenting for non-acute visits.
Telemedicine
Nurse advice lines and telemedicine can screen and manage patients with acute respiratory or febrile illness without the need for a face-to-face visit. Promoting the use of these technologies and referral networks can help triage persons to the appropriate level of care, potentially reducing the influx of patients to healthcare facilities and reserving personal protective equipment (PPE) for when it is needed.
Bundle patient care activities
Bundling care activities, when safe to do so, can minimize room entries and PPE use. For example, perform multiple care activities during one single encounter, rather than multiple separate encounters throughout the day.
Encourage the use of technology to minimize in-person interactions with a patient, when appropriate
Video or call applications on cell phones or tablets allow HCP and visitors to interact with a patient without utilizing PPE supplies. HCP should only use this approach on a limited basis (e.g., when verifying insurance information), and should not use this approach when in-person care is needed.
Encouraging visitation to take place via communication technologies may save PPE supplies. However, restrictions on in-person visitation to patients can be detrimental to a patient's emotional health and well-being and should generally only be considered as a crisis strategy.
Contingency capacity strategies
Administrative Controls
Decrease length of hospital stay for medically stable patients with an infectious diagnosis for whom PPE use is recommended during their care
If patients cannot be discharged to home for social rather than medical reasons, public health officials might need to identify alternative non-hospital housing where those patients can convalesce.
Selectively cancel elective and non-urgent procedures and appointments for which PPE is typically used by HCP
Shift HCP who work in these areas to support other patient care activities in the facility. Facilities need to ensure these HCP received appropriate orientation and training to work in areas that are new to them.
Limit HCP entering the patient care area to those providing direct patient care
Having HCP who provide direct patient care assume the job duties of HCP not providing direct patient care (e.g., food delivery, environmental services duties), and bundling these duties with other care activities may preserve PPE supplies. If HCP take on new job duties, they should be educated and trained to perform their new duties correctly, as well as provided sufficient time to perform the additional tasks.
Crisis capacity strategies
Administrative Controls
Cancel all elective and non-urgent procedures and appointments for which PPE is typically used by HCP
Shift HCP who work in these areas to support other patient care activities in the facility. Facilities need to ensure these HCP received appropriate orientation and training to work in areas that are new to them.