PPE for healthcare staff during the pandemic

This increase was not only in the number of RPE items necessary but also a need for a variety of types of equipment to be able to cater for all healthcare staff requirements, such as type of procedure being undertaken, face shapes and allergies. There was a particular need for mask or respiratory protective equipment (RPE).

There was also a need for increased numbers of staff to be fitted for some items of the respiratory protection, again to ensure they could safely wear the equipment. Although this had been a previous requirement for staff undertaking certain procedures, there was a significant increase in staff needing to wear this equipment. This posed a significant impact of resources and is extremely time consuming.

In my role as senior nurse in Infection Prevention and Control, I have been working with my NHS Trust to safely manage patients with Covid-19. This includes implementing national guidance across the organisation, educating and supporting staff, and developing new protocols.

From this experience, these are my recommendations for other healthcare providers:

1. Work collaboratively with specialists who can feed into the resolution of the problem. In the hospital where I work, this involved working with Infection Prevention and Control, supplies and senior managers.
2. Establish the requirements across the organisation and develop an implementation plan.
3. Procure equipment from a variety of sources to ensure resilience.
4. Utilise external assistance and expertise for training and fit testing.
5. Add RPE assessment and fit testing to the staff induction processes.

At my NHS Trust, a significant amount of additional RPE was purchased to ensure RPE availability and staff assurance. Fit testing availability was significantly increased through the training of additional staff and collaborating with a national fit testing team that was deployed by the Department of Health. We also worked with the Occupational Health Department to assess vulnerable staff needs to discuss suitable RPE options and to address staff anxieties. Hypoallergenic masks were also made available for staff who developed allergies to some masks.

Several staff were very anxious about coming to work and being exposed to patients with Covid-19. Through the procurement of various types of RPE, individual assessments and discussion, staff were able to return to work feeling secure in the PPE that had been provided for them.

Without this work, and similar work in all NHS Trusts, staff would have been unable to safely care for patients. This would have negatively affected patient outcomes, the delivery of healthcare, the mental health of staff and the number of healthcare staff acquiring Covid-19.

Going forward, we need to ensure that RPE is readily available and that a variety of types continue to be used to ensure the resilience of supply. Finally, it would be beneficial to work with manufacturers to produce reusable RPE items that better fulfil all of the necessary requirements when used in a healthcare setting, such as cleanability and valve filtration.