National Academies Press: OpenBook
« Previous: 5 Certifying and Regulating Healthcare PPE: Defining an Integrated System
Suggested Citation:"6 Moving Forward with Urgency." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
×
Page 169
Suggested Citation:"6 Moving Forward with Urgency." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
×
Page 170
Suggested Citation:"6 Moving Forward with Urgency." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
×
Page 171
Suggested Citation:"6 Moving Forward with Urgency." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
×
Page 172

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

6 Moving Forward with Urgency If an influenza pandemic were to occur within the next 6 months or in the near future, it is likely that many of the healthcare challenges faced in addressing severe acute respiratory syndrome would be repeated— healthcare institutions and healthcare workers would face decisions about what types of personal protective equipment (PPE) would offer effective prevention; many healthcare workers would not have received recent training on the appropriate use of PPE; and questions about the effec- tiveness of PPE in preventing influenza transmission would raise con- cerns. As a result, the surge capacity to treat ill patients could be severely impaired. This report emphasizes the current lack of preparedness for effective use of personal protective equipment and acknowledges that PPE is one component of a set of strategies that offer protection to healthcare workers such as vaccines, antiviral medications, and infection control practices including hand hygiene and environmental and adminis- trative controls. The committee believes that improvements should be made so that healthcare workers have PPE that provides protection against influenza transmission based on a rigorous risk assessment with solid scientific evidence. However, this level of protection will require increased re- sources dedicated to answering the critical questions that remain regard- ing the transmission, prevention, and mitigation of influenza. Consideration should be given to the range of healthcare workplaces (in- cluding home care, nursing homes, private practices, and hospitals), the multiple types of healthcare workers who come in contact with patients or face exposure to influenza (e.g., administrative and housekeeping staff, physicians, nurses), the diverse tasks they perform with varying degrees of exposure risk, their diverse educational and cultural backgrounds, and 169

170 PREPARING FOR AN INFLUENZA PANDEMIC their diverse work environments (some of which have engineering or other controls, such as ventilation, in place). The current paucity of data on influenza transmission is hindering research and development efforts for PPE and for other influenza preven- tion and control measures. Until more is known about influenza trans- mission, it will be critical to follow current infection control practices, to ensure that all forms of protection are available to healthcare workers, and to heighten their knowledge of PPE and its use, while also obtaining the input of healthcare workers in designing, testing, and developing the next generation of PPE. It is hoped that this report will catalyze initia- tives to promote a strong emphasis on the safety of healthcare workers. Respiratory protection and some other forms of PPE have been de- signed primarily for industrial exposures. Increased focus should be placed on the unique needs of healthcare workers who are a substantial percentage of the U.S. workforce (approximately 10 percent) and who require PPE that allows for interaction with and care of patients and pro- vides protection to both the wearer and the patient. The set of recommendations emerging from this report can be grouped into three broad categories with the overarching theme of rigor- ously ensuring the safety of healthcare workers so that they can continue to care for and protect their patients as shown in Figure 6-1. The task of the committee focused on protecting workers in the emergency situation of an influenza pandemic; however, the improvements resulting from implementation of the recommendations in this report have the potential to further enhance worker safety in other healthcare situations as well as in other industries and workplaces. Ensuring Healthcare Worker Safety during an Influenza Pandemic Understand Influenza Innovate and Commit to Worker Safety Transmission Strengthen PPE and Appropriate (Recommendation 1) Design, Testing, and Use of PPE Certification (Recommendations 6-8) (Recommendations 2-5 and 9-12) FIGURE 6-1 Opportunities for action.

MOVING FORWARD WITH URGENCY 171 • Understanding influenza transmission—Influenza transmission research should become an immediate and short-term research priority so that effective prevention and control strategies can be developed and re- fined. This research has the potential for significant gains in knowledge within 1 to 3 years if the concerted efforts and increased resources of a multicenter research network are brought to bear on the critical questions. • Commit to worker safety and appropriate use of PPE—Due to a number of challenges including the wearability of available equipment and the lack of organizational and individual commitment to appropriate use of PPE, many healthcare workers do not currently use PPE in situa- tions in which they face the prospect of hazardous exposures. Efforts are needed to strengthen the culture of safety in healthcare facilities and to support institutional commitments to worker safety, including use of PPE, by healthcare organizations, healthcare workers, and training and accred- iting organizations. • Innovate and strengthen PPE design, testing, and certification— Using PPE to deliver health care places demands on the design and engi- neering of these products that are particularly focused on interactions with patients and ensuring that healthcare workers do not become in- fected and do not transmit infection. An integrated effort is needed to further understand the requirements of the worker and to develop innova- tive materials and technologies that can meet these needs. Increasing the use of field testing in the pre-market phase and conducting thorough post-marketing evaluations are vital to producing effective equipment. Further, federal agencies and other organizations with oversight should ensure that rigorous testing has been conducted and that effective equip- ment is approved and used appropriately in the workplace. Being ready for an influenza pandemic—having the necessary re- sources to minimize morbidity and mortality—is the goal of ongoing global efforts in many areas of endeavor. Because healthcare workers are essential for providing patient care during a pandemic, the PPE that can protect these workers from becoming infected or from transmitting infec- tion is a vital part of these efforts. Healthcare worker safety is essential for patient safety and patient care. Being prepared for an influenza pan- demic places a priority on protecting the healthcare workforce.

Next: Appendix A: Workshop Agenda »
Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers Get This Book
×
Buy Paperback | $62.00 Buy Ebook | $49.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

During an influenza pandemic, healthcare workers will be on the front lines delivering care to patients and preventing further spread of the disease. As the nation prepares for pandemic influenza, multiple avenues for protecting the health of the public are being carefully considered, ranging from rapid development of appropriate vaccines to quarantine plans should the need arise for their implementation. One vital aspect of pandemic influenza planning is the use of personal protective equipment (PPE)—the respirators, gowns, gloves, face shields, eye protection, and other equipment that will be used by healthcare workers and others in their day-to-day patient care responsibilities.

However, efforts to appropriately protect healthcare workers from illness or from infecting their families and their patients are greatly hindered by the paucity of data on the transmission of influenza and the challenges associated with training and equipping healthcare workers with effective personal protective equipment. Due to this lack of knowledge on influenza transmission, it is not possible at the present time to definitively inform healthcare workers about what PPE is critical and what level of protection this equipment will provide in a pandemic. The outbreaks of severe acute respiratory syndrome (SARS) in 2003 have underscored the importance of protecting healthcare workers from infectious agents. The surge capacity that will be required to reduce mortality from a pandemic cannot be met if healthcare workers are themselves ill or are absent due to concerns about PPE efficacy.
The IOM committee determined that there is an urgent need to address the lack of preparedness regarding effective PPE for use in an influenza pandemic. Preparing for an Influenza Pandemic : Personal Protective Equipment for Healthcare Workers identifies that require expeditious research and policy action: (1) Influenza transmission research should become an immediate and short-term research priority so that effective prevention and control strategies can be developed and refined. The current paucity of knowledge significantly hinders prevention efforts. (2) Employer and employee commitment to worker safety and appropriate use of PPE should be strengthened. Healthcare facilities should establish and promote a culture of safety. (3) An integrated effort is needed to understand the PPE requirements of the worker and to develop and utilize innovative materials and technologies to create the next generation of PPE capable of meeting these needs.
  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!