Survey Shows Dire PPE, Hand Sanitizer Shortages Across U.S.

Lack of N-95s, masks, face shields threaten workers in healthcare facilities in every state, in every size facility. Only 12% have received supplies from the Strategic National Stockpile.

Nearly half (48%) of U.S. healthcare facilities surveyed are already out of, or almost out of respirators to use in caring for a patient with COVID-19, according to a national survey of infection prevention experts conducted March 23-25, 2020 by the Association for Professionals in Infection Control and Epidemiology (APIC).

healthcare facilities infection prevention
Photo: Association for Professionals in Infection Control and Epidemiology (APIC)

The online survey asked APIC’s U.S.-based infection preventionist members to categorize their supply of personal protective equipment (PPE) and other items including hand sanitizer and cleaning products on a 5-point scale from having “plenty” to “none.” Of the 1,140 infection preventionists who completed the survey, 233 (20.46 %) reported their facilities have no respirators; an additional 317 (27.83%) say they are almost out of these critical devices used to protect healthcare workers caring for patients with COVID-19 and other infectious diseases.

Nearly half of the respondents (560 or 49.16%) said they do not have enough face shields: 416 (36.52%) are almost out; 144 (12.64%) are completely out. Regarding mask supply, nearly one-third (31%) of respondents are almost out, or completely out.

Hand sanitizer is also in short supply at more than 1 in 4 facilities surveyed (322 respondents or 28.27%): 292 respondents (25.64%) are almost out; 30 respondents (2.63%) are completely out.

APIC has called on the federal government to immediately activate the Defense Production Act and any other means at its disposal to get the supplies needed to safely treat COVID-19 patients and protect healthcare workers at the front lines of this pandemic.

“Immediate action is needed to protect healthcare workers and save lives – every minute matters,” said 2020 APIC President, Connie Steed, MSN, RN, CIC, FAPIC. “Healthcare providers need clarity, not confusion. They need to know when exactly they can expect desperately needed supplies to arrive so they don’t have to turn to unproven crisis methods for PPE. There have been grim reports from health officials about the supply shortage for weeks and we’re not getting any answers. This is unacceptable.”

Infection preventionists develop evidence-based practices to prevent the spread of infection, including protocols for hand hygiene and the proper use of PPE.

“As the COVID-19 pandemic continues to sweep the country and place an extreme burden on the U.S. healthcare system, APIC shortages of critical PPE and disinfection supplies will severely jeopardize our ability to safely treat patients and protect healthcare workers who are putting their lives on the line to fight this disease,” said Katrina Crist, MBA, CAE, APIC Chief Executive Officer. “As it stands now, infection preventionists are being forced to recommend unproven measures for PPE. Some healthcare workers have even resorted to do-it-yourself approaches, adding more risk.”

Nearly 30% of survey respondents (599 or 29.35%) have accessed supplemental PPE through state or local sources; a quarter (501 or 24.55%) have received private donations of supplies. Roughly 17% (351 or 17.2%) have created their own PPE solutions such as sewing masks. Only 12.25% (250 respondents) report receiving supplies from the Strategic National Stockpile.

Among survey respondents, more than two-thirds (765 or 67.05%) have only one or less than one full-time equivalent infection preventionist on staff to devise safe protocols for protecting against COVID-19.

The COVID-19 pandemic is occurring amidst a severe flu season in which hospitals were already crowded. The CDC estimates that 1 in 31 hospitalized patients will develop a healthcare-associated infection and 75,000 patients die each year. Consistent use of proven infection prevention measures, including proper PPE, can prevent many healthcare-associated infections.

“Hospitals and health facilities with fewer than one full-time person on staff to direct infection prevention activities may have been disadvantaged even before the COVID-19 pandemic,” said Steed. “I am concerned that many facilities will not be able to protect healthcare workers and patients from not only COVID-19, but also MRSA, C. diff and other antibiotic-resistant infections.”

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