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 CDC Offers Guidance on Conserving Personal Protective Equipment

The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) on Wednesday urged long term and post-acute care providers to follow just-released guidance from the Centers for Disease Control and Prevention (CDC) to conserve and extend the life of vital supplies like masks and gowns during the COVID-19 pandemic.

The association said it understands many nursing centers and assisted living communities are running low on Personal Protective Equipment (PPE).

“Therefore, we urge you to adopt these new guidelines from CDC as soon as possible and for some, that may mean coming up with more creative ways to use or make your own PPE,” AHCA/NCAL said.

In the government guidance, CDC advised providers to do the following when using masks:

--Implement extended use of facemasks, which allows the wearer to keep using the same facemask for repeated close-contact encounters with several different patients, without removing the facemask between patient encounters.

--Restrict facemasks to use by health care personnel (HCP), rather than patients for source control. Have patients with symptoms of respiratory infection use tissues or other barriers to cover their mouth and nose.

--Implement limited re-use of facemasks, which is the practice of using the same facemask by one HCP for multiple encounters with different patients but removing it after each encounter. Discarded if soiled, damaged, or hard to breathe through.

--Prioritize facemasks for selected activities, such as for provision of essential surgeries and procedures, during care activities where splashes and sprays are anticipated, during activities where prolonged face-to-face or close contact with a potentially infectious patient is unavoidable, and for performing aerosol-generating procedures.

For gowns, CDC advised providers to:

 --Shift gown use toward cloth isolation gowns.

--Consider the use of coveralls.

--Extended use of isolation gowns (disposable or cloth), such that the same gown is worn by the same HCP when interacting with more than one patient known to be infected with the same infectious disease when these patients are housed in the same location (that is, COVID-19 patients residing in an isolation cohort).

This can be considered only if there are no additional co-infectious diagnoses transmitted by contact (such as Clostridium difficile) among patients. If the gown becomes visibly soiled, it must be removed and discarded as per usual practices.

--Re-use of cloth isolation gowns among multiple patients in a patient cohort area without laundering in between.

--Prioritization of gowns for the following activities: during care activities where splashes and sprays are anticipated, which typically include aerosol-generating procedures, during the high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of HCPs, such as: dressing, bathing/showering, transferring, providing hygiene, changing linens, changing briefs or assisting with toileting, device care or use, wound care.

--And, when no gowns are available consider pieces of clothing as a last resort, preferably with long sleeves and closures (snaps, buttons) that can be fastened and secured, particularly for care of COVID-19 patients as single use.

--Other options include: disposable laboratory coats, reusable (washable) patient gowns, reusable (washable) laboratory coats, disposable aprons, and combinations of pieces of clothing can be considered for activities that may involve body fluids and when there are no gowns available like long-sleeved aprons in combination with long sleeved patient gowns or laboratory coats.

CDC said in the area of eye protection, providers should:

--Implement extended use of eye protection is the practice of wearing the same eye protection dedicated to one HCP for repeated close contact encounters with several different patients, without removing eye protection between patient encounters including for disposable and reusable devices.

--Eye protection should be removed and reprocessed if it becomes visibly soiled or difficult to see through.

--If HCP touches or adjusts their eye protection they must immediately perform hand hygiene.

--Prioritize eye protection for selected activities such as: during care activities where splashes and sprays are anticipated, which typically include aerosol-generating procedures or prolonged face-to-face or close contact with a potentially infectious patient is unavoidable.

--Consider using safety glasses (for example, trauma glasses) that have extensions to cover the side of the eyes.

--Designate convalescent HCP for provision of care to known or suspected COVID-19 patients.

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