Standard surgical masks may be ‘not enough’ for nurses in the Covid-19 ward

The risk of hospital nurses contracting Covid-19 from patients could be “effectively reduced” by providing staff with higher-grade face masks, suggested a trial at a hospital in Cambridge.

The Addenbrooke hospital changed its approach after it was discovered that staff working in Covid-19 wards were 47 times more likely to get the virus at work than their counterparts in other wards.

“Our data suggests that there is an urgent need to look at the PPE offered to healthcare workers in the front line”

Michael Semana |

At the time, the national instruction for staff working with Covid-19 patients was to use a standard surgical face mask, also known as a fluid resistant surgical mask type IIR (FRSM), unless the aerosol production methods (AGPs).

For the hours when AGPs are performed, the instruction recommends the use of a more high -grade face filtration piece 3 (FFP3) respirator, which is specifically targeted for each individual.

Concerned about the rate of infections acquired by hospital staff in Covid -19 wards, known as “red wards”, Addenbrooke’s Hospital implemented a different approach in December 2020 – during the national second wave of coronavirus cases.

It was also at this time that the Royal College of Nursing and other unions were raising concerns about the guidance of personal protective equipment (PPE) regarding the wearing of the more salable variety of B.1.1.7, which in later renamed differently to Alpha World. Health Organization.

Addenbrooke Hospitall has made it a policy for all staff working with Covid-19 patients to wear FFP3 masks, regardless of whether AGPs have occurred.

The Cambridge University Hospitals NHS Foundation Trust, which runs the hospital, is monitoring the impact of the policy change as part of a University of Cambridge study.

The consequences, that is published a pre-print article online and not yet examined by the colleague, showed a “dramatic drop” in hospital-acquired infections among workers in Covid-19 wards.

Prior to the change, cases of such infections per day in the ward were significantly higher in the red wards at seven of the eight weeks analyzed, compared with the non-Covid-19 ward, which was recognized as “green ward”.

However, after the switch, the incidence of infection in the red and green wards was at the same level, according to the researchers.

They said it was clear before the change that the majority of Covid-19 infections among health workers in green wards were contracted to the community.

“This important study adds even more weight to the RCN’s ongoing call for care staff to better protect them.

Rose Gallagher

While in the red wards, it was a combination of community-acquired infections and “direct, ward-based infections from patients with Covid-19”.

But the researchers said this variation “effectively relieves the use of FFP3 respirators”-which has been found to provide 100% protection from Covid-19 in most cases.

They concluded that the use of FRSMs as respiratory protection devices “is not sufficient to protect. [healthcare workers] against infection from patients with Covid-19 ”.

“In contrast, over -infection in between [healthcare workers] the care of patients with Covid-19 can be prevented by the use of FFP3 respirators, along with other PPE and infection control measures, ”they said.

Earlier this month, the national instruction was revised to use FFP3 respirators beyond areas where AGPs are made, if it is deemed appropriate to follow local risk assessment.

However, the RCN criticized the government for not going far enough. In line with their findings, Cambridge researchers are also now calling for guidance on masks to be “further modified until more specific information is available”.

Dr Michael Weekes, one of the study’s authors, from Cambridge University’s medical department, said: “Our data suggest that there is an urgent need to look at the PPE offered to health workers going forward. .

“Upgrading the equipment so that FFP3 masks are offered to all healthcare staff caring for patients with Covid-19 could reduce the number of infections, protect many hospital staff and eliminate some of the burdens of stagnant healthcare services caused by the loss of chief staff due to illness. ”

Dr Weekes added that vaccination against Covid-19 was “clearly also an absolute priority”.

Meanwhile, Rose Gallagher, RCN’s leading professional for infection prevention and control, said: “This important study adds even more weight to our ongoing call for care staff to be more be protected from Covid-19, and provide routine access to the highest level of respiratory.protective equipment whenever they need it.

“We have yet to see cases of Covid-19, even from some who have been vaccinated, and vital staff being fully protected and there has been no attempt to prevent or hasten measures to further reduce the risk of infection.”

A spokesman for the Department of Health and Social Care said the prevention and control of infection in the UK was updated on 1 June 2021 to “reflect a much newer scientific understanding of how to prevent and control Covid- infection. 19 “, and agreed upon by the chief medical officer and nurse of the country.

“The evolving evidence and data are continuously monitored and reviewed and guided to repair as appropriate,” the spokesperson added.

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