On December 22, 2020, The Centers for Disease Control and Prevention (CDC) updated their series of strategies to optimize supplies of eye protection in healthcare settings when there is a limited supply. These strategies offer a continuum of options for use when eye protections are stressed, running low, or exhausted.
The CDC definition of surge capacity refers to the ability to manage a sudden increase in patient volume that would severely challenge or exceed the present capacity of a facility. The CDC recommends that three general levels be used to describe surge capacity and that these levels be used to prioritize measures to conserve eye protection supplies. The three levels are:
- Conventional Capacity: measures consisting of engineering, administrative, and personal protective equipment (PPE) controls that should already be implemented in general infection prevention and control plans in healthcare settings.
- Contingency Capacity: measures that may be used temporarily during periods of expected eye protection or other PPE shortages. Contingency capacity strategies should only be implemented after considering and implementing conventional capacity strategies. While the available supply may meet the facility’s current or anticipated utilization rate, there may be uncertainty if future supply will be adequate and, therefore, contingency capacity strategies may be needed.
- Crisis Capacity: strategies that are not commensurate with U.S. standards of care but may need to be considered during periods of known eye protection or other PPE shortages. Crisis capacity strategies should only be implemented after considering and implementing conventional and contingency capacity strategies. Facilities can consider crisis capacity strategies when the supply is not able to meet the facility’s current or anticipated utilization rate.
The CDC recommends that contingency and then crisis capacity measures augment conventional capacity measures and are meant to be considered and implemented sequentially. Furthermore, once eye protection availability returns to normal, healthcare facilities should promptly resume standard practice. When determining the appropriate time to return to conventional strategies, the CDC recommends considering the following:
- The anticipated number of patients for whom eye protection should be worn by healthcare personnel providing their care
- The level of SARS-CoV-2 transmission in the community
- The daily supply of eye protection currently remaining at the facility
- Whether or not the facility is receiving regular resupply with its full allotment.
Recommendations by the CDC for the above Capacity Strategies include the following:
- Conventional Capacity: Shift eye protection supplies from disposable to reusable devices (i.e., reusable face shields or goggles).
- Contingency Capacity: Implement extended use of eye protection, which is the practice of wearing the same eye protection for repeated close contact encounters with several different patients, without removing eye protection between patient encounters.
- Crisis Capacity: Prioritize eye protection for selected activities that include during care activities where splashes and sprays are anticipated and during unavoidable activities with prolonged face-to-face or close contact with a potentially infectious patient for which eye protection is recommended.
A complete list of CDC recommendations for Capacity Strategies can be accessed at: Strategies for Optimizing the Supply of Eye Protection: COVID-19 | CDC.
Issue
Each facility’s Emergency Preparedness Plan should include strategies to implement when eye protection and other PPE supplies are limited. Facilities must routinely monitor their use of eye protection and other PPE stock levels and anticipated deliveries in order to determine appropriate capacity strategies.
Discussion Points:
- Review the facility’s Emergency Preparedness Plan to ensure the plan has the most recent recommendations from the CDC for eye protection and other PPE capacity strategies. Revise the Emergency Preparedness Plan as appropriate.
- Train all staff on the Emergency Preparedness Plan. Train appropriate staff on capacity strategies prior to implementation of the strategies. Document that the trainings occurred and file the signed training document in each employee’s education file.
- Periodically audit levels of all PPE, including eye protection, to ensure that supplies are adequate and that there are no anticipated shortages. Determine that the current capacity strategy is being followed by all.
