Nationally the guidance is regularly being updated about what equipment people should use in particular circumstances and alternative forms of PPE that can be used where appropriate.
Within the Trust we currently have good stocks of the majority of PPE items that we will require when supporting people within our services who have suspected or confirmed symptoms of COVID-19. This includes gloves, aprons, eye protection and the two different styles of face masks (type 2R fluid-resistant masks and FFP3 masks).
We have little need for FFP3 masks or long-sleeved gowns and colleagues will need to wear a fluid resistant mask and a disposable plastic apron for the vast majority of scenarios within our services. The FFP3 masks and fluid repellent long-sleeved gowns are predominantly to be used by colleagues in our acute critical care services, operating theatres or labour wards, where there is a risk of splashing of body fluids such as during Aerosol Generating Procedures (AGPs) in higher risk areas or in operative procedures. There is currently a national shortage of the long-sleeved gowns that are used by colleagues in neighbouring trusts for these purposes.
Within our services colleagues would only need to wear FFP3 masks and long-sleeved gowns where resuscitation is taking place. There are FFP3 masks and gowns available on our resus trollies for this purpose, which should not be used by colleagues for other purposes. There is also a very small number of colleagues in our children’s physiotherapy services who support children through AGPs and therefore may also require use of FFP3 masks and long-sleeved gowns or a suitable fluid-repellent alternative.
Colleagues are to please not use FFP3 masks or long-sleeved gowns for procedures other than those outlined above. Whilst we appreciate there is a level of concern regarding this pandemic, this could create a risk that PPE will then not be available for colleagues who need it for use in the recommended circumstances (i.e. resuscitation or for our colleagues undertaking AGPs with children).
Useful PPE visual materials
We will continue to keep colleagues updated on any further advice regarding PPE. You can access the most recent PPE guidance at: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-personal-protective-equipment-ppe
The latest version of the PPE guide for community health and social care settings is a helpful visual guide to when and how to use PPE. It is also a useful summary for colleagues returning to clinical practice after a period of working from home.
You can also view our PPE poster, which shows examples of the types of recommended eye protection and provides advice on the importance of having a supply of PPE with you before you undertake an interaction.
The following diagrams also outline what items of PPE should be used for which purpose in primary and secondary care and what can be re-used:
- Recommended PPE for healthcare workers by secondary care inpatient clinical setting, NHS and independent sector
- Recommended PPE for primary, outpatient, community and social care by setting, NHS and independent sector.
There is also a useful visual aid to what PPE colleagues should be wearing in which circumstances, which has been developed by Public Health England.
The Trust has implemented a centrally held stock system to ensure that stocks are delivered to the areas of most need. All orders are now being managed centrally through a new PPE email address: dhcft.ppe@nhs.net
To ensure that the central stock is allocated appropriately and fairly every morning, the local PPE lead (whom we are calling the Local PPE Link/Designated Person) will submit their stock levels by 10am using a standard template form.
The products that will be covered under this system are:
- Face masks – Filtering face piece (class 3) respirator FFP3 and fluid-resistant surgical mask
- Nitrile gloves
- Hand sanitiser gel
- Disposable gowns
- Eye protection
- Red bags soluble (laundry)
- Orange bags
- Aprons (all types)
- Tiger bags.
Requesting products out of hours:
Out-of-hours PPE stocks will be held at Kingsway House, Radbourne Unit and Hartington Unit. Staff will inform the bleepholder if there is a need for stock. The bleepholder will notify the PPE Lead of what has been taken from the out-of-hours stock so that it can be replenished. If there are any issues the first on-call should be notified.
The following documents also set out this centralised ordering process in more detail:
- Supply chain system procedure for centrally held PPE stocks
- Flow chart illustrating the process for inpatient areas
- Emergency requests for PPE out-of-hours.
Please also see the Trust’s Special infection control policy, which has been updated to include COVID-19.
The guidance around this issue changed on Monday 15 June. As a Trust, we are following the national guidance, which is different depending on whether you are working in a patient facing setting or a non-hospital or non-patient facing setting.
Full guidance is available on our Connect Coronavirus resource page as follows:
- Wearing face masks: a guide for Trust colleagues working in patient facing roles in hospital and community settings
- Wearing face coverings: a guide for Trust colleagues working in non-hospital or non-patient facing settings.
If you have a long-term health problem, difficulties breathing, or severe claustrophobia, please discuss this with your line manager and escalate to our occupational health department if individual advice is required.
Detailed guidance on wearing face coverings in shops and other indoor public places came into effect on 24 July. Coverings are now mandatory in enclosed public spaces including supermarkets, indoor shopping centres, transport hubs, banks and post offices.
Coverings must also be worn when buying takeaway food and drink. As a result, the Trust has made it a requirement that everyone who uses the Ashbourne Centre restaurant wears a face covering.
The gov.uk website provides advice on how to make a face covering and also how to correctly wear and remove one.
Public Health England has advised that children under the age of three should not wear face coverings, as they could cause choking or suffocation. Children under the age of 11 are not obliged to wear a face covering, but may wish to do so.
Some people will not be able to wear a face covering for legitimate reasons. This is where an exemption card may be useful; individuals can print and show this card without needing to explain why they are not wearing a face covering if asked. The government has produced an exemption card on the gov.uk website.
Please share this link with people in our services who will need to indicate that they are exempt from wearing a face covering. We have also printed exemption cards to send to colleagues in our acute units.
