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On Infection Prevention & Control

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Managing Critical Shortages of Personal Protective Equipment


Robert Campbell, PharmD, director, clinical standards interpretation for hospital/ambulatory programs

Shortages of personal protective equipment (PPE) are a real concern during the COVID-19 outbreak.

If your organization cannot commercially obtain PPE, call your local health authority. They will direct health care organizations to the appropriate state-specific contact in charge of the state’s strategic stockpile.

The Office of the Assistant Secretary for Preparedness and Response (ASPR), which is part of the U.S. Department of Health and Human Services (HHS), manages the strategic national stockpile (SNS). This stockpile is designed to supplement and resupply state and local inventories of medications and supplies during emergencies which are severe enough to exhaust local supplies. In addition to the SNS, many states have their own stockpiles of medications and supplies.  

In emergency situations such as this, organizations may need to institute measures to conserve supplies of PPE. 
These may include:

  • Use of alternative products, such as powered air purifying respirators (PAPRs) in place of N95 respirators and eye protection 
  • Revising how PPE will be used (e.g., keeping the same N95 respirator or mask on for care of multiple patients unless contaminated or damaged)
  • Alternate gowns for protection of staff or sterile procedures

When instituting these measures, consider all the following:

  •  Alternate measures  must be instituted in conjunction with implementation of facility emergency management procedures 
  • The organization must involve those who are knowledgeable about the routine practices that will be impacted, as well as specific benefits and limitations of affected PPE (e.g., infection control, industrial hygiene, occupational medicine) 
  • Any revisions must be clearly communicated to involved staff 
  • Enhanced monitoring for negative impact (e.g., increased reports of exposure or infection) should be instituted

We’ve highlighted websites to help develop emergency plans, including:
FDA:  Surgical Mask and Gown Conservation Strategies - Letter to Healthcare Providers 
CDC Strategies for Optimizing the Supply of N95 Respirators: Crisis/Alternate Strategies
COVID-19 Healthcare Planning Checklist by ASPR

We’re here to keep you updated on how to care for your patients during these unprecedented times. Please follow this space as well as The Joint Commission’s Facebook, Twitter and LinkedIn pages. We are in this together!

Robert Campbell, PharmD, is director, Clinical Standards Interpretation Hospital / Ambulatory Programs and director, Medication Management. Prior to these roles, he served as the pharmacist for Clinical Standards Interpretation in the Division of Healthcare Improvement at The Joint Commission. Campbell also surveys as a field representative for The Joint Commission in the Hospital Accreditation and Critical Access Hospital Accreditation Programs and is a reviewer in the Medication Compounding Certification Program. Prior to joining The Joint Commission, Campbell worked in health care organizations and held leadership positions with oversight responsibilities for performance improvement, accreditation readiness, risk management, infection control, medical staff services, as well as inpatient and outpatient pharmacy services.