Summary for Healthcare Facilities: ​Strategies for Optimizing the Supply of PPE during Shortages

All PPE

• Use physical barriers and other engineering controls
• Limit number of patients going to hospital or outpatient settings
• Use telemedicine whenever possible
• Exclude all HCP not directly involved in patient care
• Limit face-to-face HCP encounters with patients
• Exclude visitors to patients with known or suspected COVID-19
• Cohort patients and/or HCP

• Selectively cancel elective and non-urgent procedures and appointments for which PPE is typically used by HCP
• Decrease length of hospital stay for medically stable patients with COVID-19

• Cancel all elective and non-urgent procedures and appointments for which PPE is typically used by HCP

N95 Respirators

• Implement just-in-time fit testing
• Limit respirators during training
• Implement qualitative fit testing
• Use alternatives to N95 respirators such as other filtering facepiece respirators, elastomeric respirators, and powered air purifying respirators
• Additional guidance

• Temporarily suspend annual fit testingexternal icon
• Use N95 respirators beyond the manufacturer-designated shelf life for training and fit testing
• Extend the use of N95 respirators by wearing the same N95 for repeated close contact encounters with several different patients
• Additional guidance on contingency capacity strategies
• Additional guidance on extended use

• Use respirators beyond the manufacturer designated shelf life for healthcare delivery
• Use respirators approved under standards used in other countries
• Implement limited re-use of N95 respirators. During times of crisis, it may be needed to practice limited re-use on top of extended use
• Use additional respirators beyond the manufacturer-designated shelf life that have not been evaluated by NIOSH
• Prioritize the use of N95 respirators and facemasks by activity
• Additional guidance on crisis capacity strategies
• Additional guidance on re-use

Facemasks

• Use facemasks according to product labeling and local, state, and federal requirements
• Additional guidance

• Place facemasks in a secure and monitored site
• Provide facemasks to symptomatic patients upon check-in at entry points
• Implement extended use of facemasks
• Restrict facemasks for use by HCP, rather than asymptomatic patients (who might use cloth face coverings) for source control
• Additional guidance

• Use facemasks beyond the manufacturer-designated shelf life during patient care activities
• Implement limited re-use of facemasks
• Prioritize facemasks for selected activities such as essential surgeries, activities where splashes and sprays are anticipated, prolonged face-to-face contact with an infectious patient, and aerosol-generating procedures

When no facemasks are available:

• Use a face shield that covers the entire front (that extends to the chin or below) and sides of the face with no facemask
• Additional guidance

Gowns

• Use isolation gown alternatives that offer equivalent or higher protection
• Additional guidance

• Shift gown use toward cloth isolation gowns
• Consider the use of coveralls
• Use gowns beyond the manufacturer-designated shelf life for training
• Use gowns or coveralls conforming to international standards
• Additional guidance

• Extend the use of isolation gowns
• Re-use cloth isolation gowns
• Prioritize gowns for activities where splashes and sprays are anticipated and during high-contact patient care

When no gowns are available:

• Consider using gown alternatives that have not been evaluated as effective
• Additional guidance

Eye Protection

• Use eye protection according to product labeling and local, state, and federal requirements
• Additional guidance

• Shift eye protection supplies from disposable to re-usable devices
• Extend the use of eye protection
• Additional guidance

• Use eye protection devices beyond the manufacturer-designated shelf life
• Prioritize eye protection for activities where splashes and sprays are anticipated or prolonged face-to-face or close contact is unavoidable
• Consider using safety glasses that cover the sides of eyes
• Additional guidance

Gloves

• Continue providing patient care as in usual infection control practice
• Additional guidance

• Use gloves past their manufacturer-designated shelf life for training activities
• Use gloves conforming to other U.S. and international standards
• Additional guidance

• Use gloves past their manufacturer-designated shelf life for healthcare delivery
• Prioritize the use of non-sterile disposable gloves
• Consider non-healthcare glove alternatives
• Extend the use of disposable medical gloves
• Additional guidance