Many of my colleagues and I are a bit disturbed by this, and I am looking opinions/advice.
Paraphrasing the official fliers that are making their rounds, we are required to wear gown, gloves, masks, and eye protection for any suspected/confirmed H1N1 cases. The policy states that gowns and gloves are both single use items and should be thrown away after one use. The big change is that we are being "encouraged" to reuse masks - not just N95 respirators (which I can kinda understand) - but surgical masks as well until they "become wet or soiled." And while they "cannot hang on any hook, fixture, or door handle" they can "be carried in uniform pockets when not in use."
Now granted, I am still a noob of a nurse, but this goes against every bit of training related to PPE I remember.
Not only are they encouraging reusing masks, our access to supplies of them is being severly limited. My floor has unoficially been designated the "Flu Floor," 18 of our 34 patients where suspected/confirmed H1N1 last night (not to mention our plain old MRSA/VRE/etc patients). Coming onto the floor, we were told that floor stocks of masks were almost out (which proved accurate). It took 2 staff nurses, a back-up charge RN and the Clinical Coordinator to wrestle an a box and a half of various masks from central supply, because "masks are being very tightly controlled." We ended up sending out staff throughout the night on scrounging missions to dig up more to make it through the shift and give the oncoming day people some wiggle room.
Now granted, there could be some sort of mask shortage I am unaware of. But honesly, the situation is getting flat out disturbing. Especially since everything seems to be set policy. Is anyone else experiencing anything like this? Do my collegues and I have any avenue to express our concerns (the "J" acronym has been mentioned)? Should we start a fund to buy our own supplies? Or should we just take a collective chill pill and get over it?
I had a similar situation a few nights ago. A patient on our unit with suspected H1N1. The patient was placed in one of our negative pressure air flow rooms. We were told to reuse our N95 masks but then there was conflict about where to store our masks. Being that our unit has neutropenic patients, a sterile environment is critical to there safety. I suggested that we keep our used masks in the ante-room of the patients room (room before the real room). This way we could remove our masks, label them and remove other PPE according to proper policy.
We we also told to limit our use on the N95 masks since the hospital was in short supply.
Personally, I think this is a crock. If CVS and Walgreens have shelves full of N95 masks why dont we? Cost cutting can only go so far....Jepordizing patient and employee safety is not acceptable, in my opinion.
OSHA and Joint Commission should be notified of this issue - Failure to provide adaquate PPE with High Rish Flu patients.....This has serious medical, social and legal implications.
Gov. Arnold Schwarzenegger has ordered the release of up to half of California's emergency stockpile of specialized masks so that health care providers can protect patients and themselves from the spread of the H1N1 flu.
The move comes as part of the state's ongoing emergency response efforts to combat the spread of the virus.
The governor said he has directed the Department of Public Health to issue the N-95 masks to hospitals and clinics.
to start with a "chill pill" is in order. recent info has shown both types of masks are effective against the flu, but the supply of both is going to be problematic if we have a significant level of h1n1 infections. and the masks aren't cheap, especially the n95 respirators.
although having my own mask for each patient left in their room would be my preference instead of using my uniform pocket.
i have worked as an infection control nurse in 3 eras, first of all in 1968-1972, when someone thought it might be a good idea to keep trasck of organisms patients had in the hospital. then in 1979-1984, when hiv incidence started to become unavoidable to ignore, in this country. it was hellish getting the purchasing department to buy enough gloves and protective gowns; and staff to report expoisures correctly, if at all. sharps containers received the same unwelcome sign and getting staff to use them immediately after use was quite a chore!
when i reentered that arena in 2000, needless/?sharpless apparatus was a boon, but more people were misusing them than ever; and then sars scared the daylights out of everyone. we kept stands (like those in parks left for doggie waste) outside each entrance of the hospital where i worked in ca, supplied with surgical type masks, which had printed instructions about their use there. i'd like to see that, now.
but
no! no! no no nurses' masks left in patients'rooms, that could get mixed up and be used by someone other than the original wearer, or convey all sorts of organisms.....! get your id staff to give you inservices, add your name to cdc's emailing list, and keep aware of the number of cases of proven and suspected h1n1 (both staff and patients) where you work.
knowledge will dictate action regarding the course of this pandemic. it's also useful when demanding (nicely) that you have adequate ppe. there won't be enough isolation rooms with outside ventilation, so doors to rooms with patients who have h1n1, should always be closed and cleansing after discharge scrupulous. signs outside the doors indicating that will pose dicey problems due to hippa, so every door should have them. that will help to protect inpatients from their own and others' visitors, as well as staff who are symptomless and incubating h1n1.
the cdc has not changed its stance on n95 respirators as the protective device of choice for h1n1, (i keep up with their policied online, as well as indigogirl's wonderful threads at this website.) there would be a shortage of ppe supplies available now, if one hadn't happened about 6 months ago, when the government agencies pulled n95 respirators from drug stores/pharmacies, for more appropriate use later (like now). they're in limited supply back in the pharmacies now, and should have been stockpiled by your facility in the past 4 months. if they weren't, there's a huge case of denial going on. the best way to deal with that is keeping statistics, to beg your argument for more ppe to administrative folks.
use this link
interim recommendations for facemask and respirator use to reduce 2009 influenza a (h1n1) virus transmission
somehow the vision of the public here looking like people in china who don't go outside without a surgical type mask on (before the h1n1 flu was around to be identified) has been repugnant to the us government, who took a while to acknowledge that pandemic is here. surgical type masks are moist from air breathed out by the wearer, in under 10 minutes.
this is a challenging time to be in nursing, and you'll be talking about what you saw and did during the h1n1 pandemic, for years to come. please taske care of yourselves, and care for others, too.
You can reuse masks if used against dust particles, or even TB particles (dry); but against a flu/sars diseases type, you MUST use a mask only once. It is soiled likely by patient's cough and so on.
3M 1860S Size Small N95 Health Care Respirator and Surgical Mask case=120 respirators
New inventory 2009.
Small size.
Buy it now=258.00
**************************
The going price for single N95s is 5 bucks. Pathetic.
That is much higher than the cost is, for the public at pharmacies!
As happens in many presumed possible scenarios, scummy entrpreneurs try to make money on others' hardships. They get away with that until cases are won in court, and damages returned to those who have been damaged, by order of the court.
I believe practises such as that are indigenous to the USA, and are called capitalistic, better known as "make hay while the sun shines". :angryfire
abbaking
441 Posts
I had a similar situation a few nights ago. A patient on our unit with suspected H1N1. The patient was placed in one of our negative pressure air flow rooms. We were told to reuse our N95 masks but then there was conflict about where to store our masks. Being that our unit has neutropenic patients, a sterile environment is critical to there safety. I suggested that we keep our used masks in the ante-room of the patients room (room before the real room). This way we could remove our masks, label them and remove other PPE according to proper policy.
We we also told to limit our use on the N95 masks since the hospital was in short supply.
Personally, I think this is a crock. If CVS and Walgreens have shelves full of N95 masks why dont we? Cost cutting can only go so far....Jepordizing patient and employee safety is not acceptable, in my opinion.
OSHA and Joint Commission should be notified of this issue - Failure to provide adaquate PPE with High Rish Flu patients.....This has serious medical, social and legal implications.