How to wear a PPE efficiently and without risks of infection
Due to the COVID-19 pandemic, of course, there must be a lack of PPEs (Personal Protective Equipment). Every sector, therefore, is fully boosting their production to meet demand and to protect medical personnel at work. Lower use of PPEs can lead to risks, and too much use of them can also be a waste of time from putting them on and off, and potentially cause the transmission.
Strategies of how to use PPEs efficiently and safely PPE อย่างคุ้มค่าและปลอดภัย
Hospital in the Philippines shared a strategy to use PPEs efficiently and safely. This practice reduces the use of PPEs by 75%, from 7,920 to 1,800 sets per month.
- Classifying COVID-19-infected patients-19
Prepare buildings dedicated to COVID-19-infected patients
- At the PUI (Patients Under Investigation) screening, the medical personnel will receive coats to wear over PPEs every time they interact with PUI patients. In a day, 3-5 coats are needed while the same PPE remains as only the coat and gloves are to be changed.
- Each bed for the infected patients in the in-patient buildings must be equipped with a respirator and separated from another for 2 meters. The patient without a respirator needs to be 1 meter apart from another. Proper ventilation must also be ensured. This solution can reduce the use of PPEs given only gloves need to be changed when the personnel go to another bed.
- Classifying risk zones
Classify zones into red, orange and yellow, according to risk level, and identify the area and activity that requires PPEs.
- Assigning staff to work only at the COVID-19 division-19
The COVID-19 division has 2-5 designated physicians per day. Each staff in each division will be divided into 3 teams; 7 work days with 2 weeks off-work are rotated between teams.
- The screening area for PUI patients
- 1 nurse per shift (8 hours)
- 1 nurse assistant
- Other staff such as hematologist, radiology technologists, renal replacement therapy nurses, and others.
- In-patient buildings
- 1 nurse per 7-8 patients
- ICU (An intensive care unit)
- 1 nurse per 2 patients
- Managing PPEs at work
Arrange a central area to keep PPEs including an inspection and a tracking of PPEs in each division. If there is likely to be an overuse of PPEs, an inspector is required to solve this issue. On the contrary, if a division requests some additional PPEs, they will be considered by the procurement department instantly.
- Agreement of operational practices
How many PPEs are required daily?
- An approximate number is a double of the number of operational staff who will be in medium-to-high risk areas over the period of 24 hours. Due to a break at every 4 hour per shift, PPEs must be taken off. As a result, a staff cannot use a PPE for 8 consecutive hours.
Staff must be physically and mentally ready.
- Eat before and after the shift only
- Before wearing PPEs, staff must finish the use of bathroom. If regular urination is needed, the use of adult diapers are a must.
- The place must be properly ventilated to reduce perspiration and fatigue during work.
- Food and drinks are provided for breaks.
- If possible, one PPE is requested for 8 consecutive hours without changes.
Staff are not allowed to use mobile phones in the COVID-19 division.
- Mobile phones are kept in the cabinet for 8 hours.
- Communication in hospital is done through internal phone network and radio communication only.
- Unnecessary talks are not allowed, and no physical contact is allowed when in PPEs.
- Assigning staff to clean PPEs only
Reusable equipment such as googles must be cleansed. During work, staff must wear proper PPE and put on a coat that can be safely reused later.
How much PPE do you need to care for COVID-19 patients? , Rappler (https://www.rappler.com/views/imho/257692-how-much-ppe-do-you-need-to-care-for-covid-19-coronavirus-patients)