Figueroa Marta, McMullen Kathleen M, Kruger Elizabeth, Peterson Amanda Vancene, Johnson Caroline, Line Whitney
Environmental Health and Safety, NYU Langone Health, New York, NY, USA.
Infection Prevention, Christian Hospital and Northwest Healthcare, St. Louis, MO, USA.
Risk Manag Healthc Policy. 2023 Aug 31;16:1693-1702. doi: 10.2147/RMHP.S417979. eCollection 2023.
The COVID-19 pandemic exposed the limitations of global health systems' abilities to manage the rapid spread of a novel infectious disease, which was exacerbated by shortages of respiratory protective devices and other critical personal protective equipment (PPE). An advisory panel of experienced health-care professionals with backgrounds in Occupational and Environmental Health and Safety (OEHS), Infection Prevention, Nursing, and Clinical Application Specialists convened to discuss challenges and strategies associated with the selection and use of respiratory protective devices as experienced during the first year of the COVID-19 pandemic. This discussion led to the following recommendations: 1) the need for clear communication of alternative respiratory protection selection and use recommendations in accordance with US regulatory and agency guidance; 2) the need for collaboration between Infection Prevention, OEHS, clinical staff, supply chain/materials management, emergency preparedness, executive leadership, and finance; 3) the need for adequate stockpiling, inventory rotation, and diverse respiratory protection options to accommodate the majority of health-care workers; 4) the need for efficient and innovative strategies to communicate evolving regulatory, agency, and facility recommendations and to deliver appropriate training on respiratory protection; and 5) the need for additional research on respiratory protection use - involving filtering facepiece respirators (FFRs) as well as other respirator types designed to be reused - to balance infection prevention best practices with a sustainable process. In conclusion, these considerations may offer guidance and identify areas for research on preparedness, communication, education, and training to enhance the preparation of health-care facilities including community-based health-care organizations for unexpected public health events.
新冠疫情暴露了全球卫生系统在应对新型传染病快速传播方面的能力局限，而呼吸防护设备及其他关键个人防护装备（PPE）的短缺使这一情况更加恶化。一个由具有职业与环境卫生安全（OEHS）、感染预防、护理及临床应用专家背景的经验丰富的医疗专业人员组成的咨询小组召开会议，讨论了新冠疫情第一年期间在呼吸防护设备选择和使用方面遇到的挑战及应对策略。此次讨论产生了以下建议：1）需要根据美国监管和机构指南，清晰传达替代性呼吸防护选择和使用建议；2）感染预防、OEHS、临床工作人员、供应链/材料管理、应急准备、行政领导和财务部门之间需要开展合作；3）需要有充足的储备、库存轮换以及多样的呼吸防护选择，以满足大多数医护人员的需求；4）需要采取高效且创新的策略，传达不断变化的监管、机构和机构建议，并提供有关呼吸防护的适当培训；5）需要对呼吸防护用品的使用进行更多研究——包括过滤式面罩呼吸器（FFR）以及其他设计为可重复使用的呼吸器类型——以在感染预防最佳实践与可持续流程之间取得平衡。总之，这些考量可能会为增强包括社区医疗组织在内的医疗机构应对突发公共卫生事件的准备工作，在准备、沟通、教育和培训方面提供指导并确定研究领域。
