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Biosecurity News in Brief
UK Hospital Exercise Shows Need for More Basic PPE during a PandemicBy Crystal Franco, December 10, 2008 In its November online edition, the Journal of Hospital Infection published a report on a hospital pandemic drill conducted by Wirral University Teaching Hospital of the UK. The hospital found that the use of complicated, high-level personal protective equipment (PPE) will slow hospital operations during a pandemic. In addition, basic PPE, including gloves and surgical masks, will be depleted much more quickly than previously anticipated. This report concludes that pandemic planning should place greater emphasis on stockpiling adequate amounts of basic PPE than on stockpiling high-level PPE.1 Both the UK and the WHO have proposed infection control measures for hospitals that emphasize the use of high-level PPE (eg, FFP3 respirators and disposable fluid repellant gowns). Wirral University Hospital conducted its drill to assess both the operational and economic impacts of following these practices. The drill simulated a pandemic environment in one ward of the hospital over a period of 24 hours. All staff working in or visiting the ward were required to wear PPE in accordance with UK infection control guidance.1 Overall, staff reported that normal functioning and communication was more difficult while wearing high-level PPE: 81% reported that duties took longer, and 43% thought that communication with colleagues and patients suffered. Staff also found that basic PPE was used at a much faster rate than anticipated in UK or WHO guidance.1 The report compares the numbers of PPE used in the exercise (extrapolated over 7 days) to WHO estimates of PPE use over 7 days of a pandemic. The exercise found that a greater number of masks and gloves would be needed in a pandemic than the WHO has estimated: 4550 surgical masks needed in the exercise vs. 2436 masks estimated by WHO; 8400 pairs of gloves needed in the exercise vs. only 406 pairs estimated by WHO. The exercise also found the need for FFP3 respirators to be much less than the WHO estimate: 91 respirators needed in the exercise vs. 406 estimated by WHO. There may be economic implications for hospitals that change their PPE stockpiles to reflect these findings. However, the authors of the report urge hospital pandemic planners in the UK and internationally to consider a more practical approach to pandemic infection control. This approach would focus on ensuring adequate supplies of basic PPE, which is easier for hospital staff to function in, rather than on stockpiling minimal amounts of expensive high-level PPE, which is difficult to wear and often unnecessary. References
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