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ONS Publishes Guidelines for Personal Protective Equipment Use During COVID-19 Pandemic

Monday, March 23, 2020
Nurses and other healthcare professionals are facing personal protective equipment (PPE) shortages across the nation due to the coronavirus disease 2019 (COVID-19). The Oncology Nursing Society (ONS) recently published interim guidelines on PPE usage in the midst of the pandemic.

“Although ONS supports full protection of healthcare workers handling drugs for cancer treatment that the National Institute for Occupational Safety and Health (NIOSH) has deemed hazardous, nurses in clinical settings are facing difficult choices if recommended PPE supplies are not available,” ONS said in a statement. “In addition, they are making choices regarding the protection of themselves and their patients from potential COVID-19 infection and use of PPE for safe handling of hazardous cancer drugs.”

The society said that they support recommendations that prioritize the protection of healthcare workers and patients from COVID-19, and when it comes to treating patients with the virus, ONS recommends following guidelines set by the Centers for Disease Control and Prevention (CDC).

But when it comes to handling chemotherapy and other hazardous cancer drugs (based on the Table 1 NIOSH List), ONS published guidelines for nurses to follow during the COVID-19 outbreak. The guidelines follow a most- to least-recommended use of gowns, masks, eye protection, gloves, and shoe covers.

“Although ONS recognizes that these are not ideal, they are interim guidelines to support decision making and staff and patient safety in clinical care during the COVID-19 pandemic,” the statement said.
  ONS recommendation If recommendation is not available Third choice
Gowns Disposable poly-coated gown Regular, water-resistant, disposable gown Cloth gown (facility laundered) for infection control and non-hazardous drugs
Masks Mask with face and eye protection only if splashing is likely or for spill cleanup Reserve N95s for symptomatic/COVID-positive patients, hazardous drug spills, and cleanup Powered air purifying respirators (PARS)
Eye Protection Mask with eye protection or goggles if splashing is likely/spill cleanup Full-facepiece air purifying respirators or PARS  
Gloves Double chemotherapy-tested gloves Single chemotherapy-tested gloves Double standard exam gloves
Shoe covers Use only in area for compounding hazardous drugs Work-only, washable shoes  

“Evaluate workflows and processes to maximize efficiency and decrease waste of PPE supplies. Cluster care activities as much as possible and avoid touch contamination of surfaces,” the statement says.

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