CDC updates on strategies to optimize supply of PPE and equipment during shortages
To help healthcare facilities plan and optimize the use of personal protective equipment (PPE) in response to COVID-19, the Centers for Disease Control and Prevention (CDC) has developed a Personal Protective Equipment (PPE) Burn Rate Calculator.
While there are no commonly accepted measurements or triggers to distinguish surge capacity from daily patient care capacity, surge capacity is a useful framework to approach a decreased supply of PPE during the COVID-19 response. Three general strata have been used to describe surge capacity and can be used to prioritize measures to conserve PPE supplies along the continuum of care.
The summary of N95 strategies includes:
Eye Protection
Isolation Gowns
Gloves
Facemasks
N95 Respirators
Powered Air Purifying Respirators
Elastomeric Respirators
Ventilators
Conventional capacity: measures consisting of engineering, administrative, and PPE controls that should already be implemented in general infection prevention and control plans in healthcare settings.
Contingency capacity: measures that may be used temporarily during periods of anticipated PPE shortages. Contingency capacity strategies should only be implemented after considering and implementing conventional capacity strategies. While current supply may meet the facility’s current or anticipated utilization rate, there may be uncertainty if future supply will be adequate and therefore, contingency capacity strategies may be needed.
Crisis capacity: strategies that are not commensurate with U.S. standards of care but may need to be considered during periods of known PPE shortages. Crisis capacity strategies should only be implemented after considering and implementing conventional and contingency capacity strategies. Facilities can consider crisis capacity strategies when the supply is not able to meet the facility’s current or anticipated utilization rate.
The CDC’s optimization strategies for PPE offer a continuum of options for use when PPE supplies are stressed, running low, or absent. Contingency and then crisis capacity measures augment conventional capacity measures and are meant to be considered and implemented sequentially. As PPE availability returns to normal, healthcare facilities should promptly resume standard practices, including:
Decisions to implement contingency and crisis strategies are based on these assumptions:
Facilities understand their current PPE inventory and supply chain
Facilities understand their PPE utilization rate
Facilities are in communication with local healthcare coalitions and federal, state, and local public health partners (e.g., public health emergency preparedness and response staff) to identify additional supplies
Facilities have already implemented conventional capacity measures
Facilities have provided HCP with required education and training, including having them demonstrate competency with donning and doffing, with any PPE ensemble that is used to perform job responsibilities, such as provision of patient care
HCP and facilities—along with their healthcare coalitions, local and state health departments, and local and state partners—should work together to develop strategies that identify and extend PPE supplies, so that recommended PPE will be available when needed most. When using PPE optimization strategies, training on PPE use, including proper donning and doffing procedures, must be provided to HCP before they carry out patient care activities.
