PDI Perspectives Q&A: “What are some effective mitigation strategies I can use during supply shortages in healthcare?”

Author: Marc-Oliver Wright, MT(ASCP), MS, CIC, FAPIC

We recently engaged members of our Clinical Affairs Team for support in answering frequently asked questions around the flood of information coming in around COVID-19 pandemic: 

Q: What are some effective mitigation strategies I can use during supply shortages in healthcare?

A: Risk mitigation is the name of the game in emergency preparedness and for good reason-the ability to effectively do so can often be the deciding factor in successfully navigating the challenging times of COVID-19.

• Personal Protective Equipment (PPE):

1. 1. While OSHA has temporarily modified its enforcement guidelines with regard to annual fit-testing requirements for respirators used in healthcare settings, principles of effective protection, worker education and others are still in effect.
   2. The use, extended-use and potential reprocessing of respirators is a topic of ongoing development
   3. Determining your organization’s rate of use of PPE is especially important and tools for doing so are available from CDC

• Surface Disinfectants:

PPE is not the only group of items in short supply. The availability of surface disinfectants can become an issue in facilities dealing with an influx of persons, even more so in a pandemic situation, like COVID-19.

• • Options may include reallocating surface disinfectants from areas of suspended activity (e.g. same day surgery when elective procedures are suspended). Another option may be to prioritize disinfectants approved for COVID-19 (to areas of a facility most probable to encounter suspect or confirmed COVID patients (emergency room, ICU) and allocate alternate non-COVID-19 approved disinfectants to lower risk settings.
  • Products that have expired are generally not recommended for use. In the case of surface disinfectants, expiration dates are based at least in part on the point in time at which the product’s efficacy is diminished.
    • For alcohol based products, the alcohol dissipates even from a sealed container over time as the micro aeration in the lid evaporates the alcohol.
    • For others like bleach, it is more about the decomposition of the product into salts, oxygen, water and absorbable organic halides.
  • In some cases, a modified delivery system can make a substantial difference.
    • For example, bulk liquid disinfectant solutions (such as those commonly used by environmental service professionals) may (with manufacturer instructions for use authorization) be used in a different format, such as dispensed into canisters or alternate receptacles with disposable or launderable cloths for point of care use. Facilities should work collaboratively with manufacturers and their internal safety department to explore outside-the-box solutions in these challenging times.