AT A GLANCE
Use of personal protective equipment during the COVID-19 pandemic Charlotte Gordon, Senior Lecturer, Adult Nursing (charlotte.a.gordon@northumbria.ac.uk), Northumbria University, and Abigail Thompson, Infection and Prevention Control Nurse, NHS County Durham and Darlington Clinical Commissioning Groups
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an overall reduction in disease spread (Gov. uk, 2020a). The overall number of deaths involving COVID-19 at the time of writing is currently at its lowest level in the past 12 weeks (Office for National Statistics, 2020). The risk of severe disease in the UK is currently considered low to moderate for the general population, but moderate to very high for populations with risk factors (aged more than 65 years of age and/or those with underlying health conditions. This is about 31% of the population of European heritage, depending on the effectiveness of physical distancing and the current level of community transmission (European Centre for Disease Prevention and Control, 2020). Daily situation reports from the WHO, while showing decreasing cases since the peak of the pandemic, continue to demonstrate that the UK has the highest number of deaths to date in Europe, with 43 550 as of 29 June, exceeded only by the USA and Brazil globally (WHO, 2020b). The ability to limit the transmission of COVID-19, the disease caused by the novel coronavirus, in the healthcare setting requires infection prevention and control measures, of which PPE is a fundamental element (PHE, 2020b). This is essential to limit the acquisition and transmission of the virus to protect both health professionals, the patients they care for and the wider community. Protecting health professionals not only limits disease spread, but also ensures that there are adequate numbers of staff to cope with inevitable increasing demands for healthcare services in the coming weeks and months ahead. When used correctly, PPE such as gloves, aprons, eye protection, masks and gowns function as a physical barrier to the transmission of infectious particles present in bodily fluids. It also protects patients from transmission via the contaminated hands or clothing of healthcare staff (Brown et al, 2019).
PPE supplies Sufficient supply of PPE is essential to meet increased demand during the COVID-19 pandemic. The Government has sought to put measures in place to improve supply chains and provisions of PPE by, for example: ■ Enabling the Health and Safety Executive (HSE) and local authorities to fast track product safety assessment processes and prioritise this activity ■ Allowing PPE lacking a European CE safety mark on to the market, provided that it meets essential safety requirements (Gov.uk, 2020b) ■ Making a public callout for organisations that can manufacture and supply testing consumables, equipment and laboratory PPE (Department of Health and Social Care (DHSC), 2020).
Mitigating risk UK-wide guidance on PPE for the care of patients with suspected or confirmed COVID-19 was updated on 18 June, issued jointly by PHE, NHS England and other key stakeholders across the devolved nations (PHE, 2020c). There are risks to both staff and patients with respect to inappropriate use of PPE, namely cross-contamination and the spread of infection. Bovin (2015) highlighted the reasons that can lead to inappropriate use, which include: ■ Lack of awareness about the importance of PPE ■ Time constraints for donning/doffing the equipment ■ Lack of realisation about the importance of the technique for proper safe removal. All of the above ultimately relies on staff being properly educated on the use of PPE. Concerns regarding the sufficient supply of PPE and the evolving nature of the current pandemic, with many staff working in
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his article provides an introduction to personal protective equipment (PPE) and looks at the latest guidelines in the context of nursing patients with COVID-19 in the UK. The current situation is such that the reader should continue to refer to contemporary guidelines because they are frequently updated as the situation evolves. COVID-19 is an infectious respiratory disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Public Health England (PHE), 2020a). The SARS-CoV-2 virus replicates efficiently in the upper respiratory tract and appears to cause less abrupt onset of symptoms than the common cold, which means that infected individuals carry on usual activities for longer, increasing asymptomatic transmission of infection (Heymann and Shindo, 2020). The virus is primarily transmitted between people through respiratory droplets and contaminated objects; airborne transmission may be possible in specific circumstances where aerosol-generating procedures (AGP), such as suctioning, are performed (World Health Organization (WHO), 2020a). The UK has seen widespread transmission of the virus with outbreaks in long-term care homes associated with high mortality, highlighting the extreme vulnerability of the elderly in this setting. The introduction of physical distancing measures, such as the cancellations of large gatherings and the closure of educational and public spaces, alongside ‘stay at home’ policies has collectively helped reduce transmission and the 14-day incidence by 18% since 8 April 2020. The reduction in lockdown measures and relaxation of physical distancing, implemented since 23 June reflects a further reduction in incidence rate within England. Data from Gov.uk as of 30 June indicate a growth rate of -4% to -2% in the UK, demonstrating
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