Clean surgical masks and N95 respirators sitting on table

As nurses, we are taught and retaught each year how to manage personal protective equipment (PPE) and the importance of a good seal with our N95 respirator. Suddenly, in the past week, we are expected to take most of what we have learned and throw it away. Not the PPE, exactly, just our ingrained practice. For most of us who've been around for a while, these relaxed standards make us uncomfortable to the point of not feeling safe.

Additionally, the CDC standards for optimizing PPE supplies include extending the use of this equipment beyond the manufacturer's expiration date. No need to worry about a Joint Commission survey to ding you on those expired masks, we need all the supplies we can get during a national crisis.

There is a lot of information circulating these days, and while it's imperative that nurses stay informed and educated, information overload is overwhelming. Here are the CDC standards for most PPE, broken down into bite-sized pieces, but still based on the CDC and OSHA standards:

Masks & N95 Respirators

Face masks and N95 respirators may be reused until they are visibly soiled, or it is difficult to breathe through them. Carefully remove and store your mask and respirator when not in use. Always perform hand hygiene before donning and before doffing to minimize contaminating the device.

Masks

  • It may be worn continuously until visibly soiled or moist from respirations.
  • It should be carefully folded so that the outer surface is held inward and against itself to reduce contact with the outer surface during storage. The folded mask can be stored between uses in a clean, sealable paper bag or breathable container.

N95 Respirators

  • It may be worn continuously up to 8 hours or reused as long as the inside of the respirator remains clean, and you're able to breathe easily through it.
  • It should be stored between uses in a clean, sealable paper bag or breathable container.

I'll briefly mention that the CDC does list as a last resort, using a scarf or bandana as a protective barrier when nothing else is available. Yet it is literally the last-ditch after all other options and resources are exhausted, and they admit there is no science behind it.

RELATED: How Do Nurses Protect Themselves from Highly Infectious Patients?

RELATED: Is a KN95 Respirator Safe to Use?

Eye Protection

When face shields are not available, use reusable safety glasses or goggles.

How to Clean Eye Protection Equipment

  1. While wearing gloves, carefully wipe the inside, followed by the outside of the face shield or goggles using a clean cloth saturated with neutral detergent solution or cleaning wipe.
  2. Carefully wipe the outside of the face shield or goggles using a wipe or clean cloth saturated with EPA-registered hospital disinfectant solution.
  3. Wipe the outside of face shield or goggles with clean water or alcohol to remove residue.
  4. Fully dry (air dry or use clean absorbent towels).
  5. Remove gloves and perform hand hygiene.

RELATED: Standard Precautions, Transmission Based, Surgical Asepsis: NCLEX-RN

Gowns

Paper and plastic gowns can be reused as long as they are not visibly soiled. Alternatives to paper or plastic gowns include patient gowns, disposable lab coats, and disposable coveralls.

How to Remove a Gown for Reuse

  • While wearing clean gloves, carefully untie the gown and remove it by gently pulling forward at the sleeves. Hang the gown in an open area and avoid having the gown come in contact with other garments.

Organizations across the globe are scrambling to enact contingency, emergency, and surge policies that they never believed they would need (or didn't even have). Nurses must advocate for ourselves, our colleagues, our patients, and our communities (in that order) to reduce the contagion. Stay informed and stay committed to protecting yourself with the supplies you have on hand.

Quick Guide to Donning and Doffing PPE

Here is a quick demonstration of donning and doffing from our own, Catherine Burger, RN, BS, MSOL, NEA-BC:

This infographic gives a basic overview of how to safely don and doff PPE equipment such as masks, gowns, eye protection, and gloves in the proper order.

Taken from: http://publichealth.lacounty.gov/acd/docs/CoVPPEPoster.pdf

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EXTERNAL PPE RESOURCES

Catherine Burger, RN, BS, MSOL, NEA-BC
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