Personal Protective Equipment: An Ongoing Challenge

By Phenelle Segal, RN, CIC, FAPIC, Founder, ICCS

The pandemic is an ongoing fluid situation, and guidance as well as practice is constantly changing. ICCS recognizes that clients are often confused as a lot of information is delivered to them at the state and federal level. It is difficult to keep up with the updates. As we continue working with many clients that enlisted our services at the beginning of the public health emergency, we are noticing frustration with use of personal protective equipment (PPE). Employers are experiencing a new "round of PPE fatigue," especially after vaccination and mainly with respect to eyewear protection.

Guidance is provided by the Occupational Health and Safety Administration (OSHA) and the Centers for Disease Control and Prevention (CDC) and is often ambiguous. Employers and employees feel the use of some PPE is costly and may be unnecessary. ICCS understands that PPE fatigue is reality. We work with our clients to analyze the guidance and apply it as best as possible. While we may all have our personal opinions about what’s necessary and what isn’t, we need to focus on the fact that PPE fatigue should be considered while at the same time understanding and following the requirements. PPE use is dependent on the specific healthcare setting, services provided, activities, state requirements, and OSHA and CDC guidelines.   

It is important for employers to ensure that they have access to state and federal updates and adhere to them. An example includes OSHA’s COVID-19 healthcare emergency temporary standard (ETS). Employers will be fined if there is a complaint and OSHA finds a violation of the standards. The fines can be very heavy, but they are avoidable.

ICCS encourages clients to reach out if guidance or standards are confusing and employees have concerns or pushback is occurring. Compliance is most often dependent on understanding the reason behind the guidance and standards.

ICCS Infection Prevention & Control Newsletter: September 2021

This issue covers some of the most significant news from September. Topics include COVID's impact on the ASC industry and HAIs, a Joint Commission advisory on preventing non-ventilator hospital-acquired pneumonia, temperature and humidity requirements for sterile supplies, vaccination guidance for pregnant individuals, and federal funding for infection prevention and control.

* * *

How COVID Changed the Ambulatory Surgery Center Infection Prevention Landscape — This column by ICCS Founder and President Phenelle Segal, RN, CIC, FAPIC, discusses how the pandemic has affected ASC infection prevention and control.

The Impact of COVID-19 on Healthcare-Associated Infections in 2020 — A CDC analysis comparing infection rates before and during pandemic revealed a significant increase in healthcare-associated infections in 2020. As Phenelle stated, "Concerns about COVID-19 negatively impacting HAI prevention strategies and decades of progress is now a reality. We must be reminded that it is incumbent on us as infection preventionists to stress the critical need for infection prevention practices to return to pre-pandemic times, despite the ongoing serious challenges COVID-19 has created. Ongoing education, monitoring, and feedback is critical to patient safety."

Quick Safety 61: Preventing Non-Ventilator Hospital-Acquired Pneumonia — The Joint Commission issued an advisory on preventing non-ventilator hospital-acquired pneumonia.

Temperature and Humidity Requirements for Sterile Supplies — The Joint Commission published an FAQ concerning the hot topic of the storage of sterile supplies, and more specifically temperature and humidity requirements.

FDA Authorizes Booster Dose of Pfizer-BioNTech COVID-19 Vaccine for Certain Populations — The FDA amended the emergency use authorization for the Pfizer-BioNTech COVID-19 Vaccine to allow for use of a single booster dose, to be administered at least six months after completion of the primary series in select populations.

COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19 — CDC released an advisory that encourages COVID-19 vaccination for those who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future.

Pfizer Submits Data to FDA on COVID Vaccine in Young Kids — Pfizer and BioNTech submitted initial data from a trial of their COVID-19 vaccine for children ages 5 to 11 years to FDA and said an application for emergency use authorization of the vaccine in that age-group will likely follow in the coming weeks.

CDC Tells How to Coordinate Resident, Staff Access to COVID Vaccines — An online CDC tool explains how providers can direct residents and staff willing and able to travel to a local vaccination site to get vaccinated. It also explains how long-term care providers can expect the process to play out if they host an on-site vaccination clinic for the primary vaccine series or booster doses.

$2.1 Billion To Be Invested for Infection Prevention and Control Efforts — A package of money from the American Rescue Plan will go to about 6,000 hospitals, 15,400 nursing homes and other long-term care facilities, 7,900 dialysis clinics, and 4,700 ASCs to help improve infection prevention and control.

Toolkit for Responding to COVID-19 Cases — CDC released a toolkit for K-12 school administrators on how to respond to COVID-19 cases.

Temperature and Humidity Requirements for Sterile Supplies

The Joint Commission recently published a new frequently asked question (FAQ) and answer providing guidance concerning the storage of sterile supplies, and more specifically temperature and humidity requirements. This is a timely FAQ as, for the past few months, ambulatory surgery center (ASC) clients have been reaching out to us at ICCS for assistance concerning meeting The Joint Commission's requirement relating to out-of-range temperature and humidity parameters in the perioperative environment.

Here are two examples of requests and questions submitted to us by ASCs about this issue:

• During our recent survey, the surveyor was focused on temperature and humidity in the ORs and specifically asked what protocols we have in place if these parameters are breeched. We do not have a policy that addresses this. Can you provide a policy concerning this issue?

• How would you advise us to respond to The Joint Commission on how we will proceed with regard to the contents in the OR, such as supplies and instrumentation, if our temperature and/or humidity is out of range?

If your ASC requires assistance with this area, please reach to ICCS. You may also find the FAQ helpful, which is accessible here.