N95 Mask Reuse in a Major Urban Hospital – COVID-19 Response Process and Procedure

Source avec lien : Journal of Hospital Infection, 106(2), 7/31/2020. 10.1016/j.jhin.2020.07.035

Contexte La pénurie de masques respiratoires N95 à usage unique (NRM) durant la pandémie de SRAS-CoV-2 a incité les fournisseurs et les établissements de soins de santé à envisager le recyclage des NRM afin d’étendre les stocks limités. Objectif Nous avons évalué la réutilisation potentielle par autoclavage des MNO portés quotidiennement dans un grand hôpital urbain canadien.

Background The shortage of single-use N95 respirator masks (NRMs) during the SARS-CoV-2 pandemic has prompted consideration of NRM recycling to extend limited stocks by healthcare providers and facilities. Aim We assessed potential re-use via autoclaving of NRMs worn daily in a major urban Canadian hospital. Methods NRM reusability was assessed following collection from volunteer staff after 2-8 hours’ use, sterilization by autoclaving and PortaCount fit testing. A workflow was developed for reprocessing hundreds of NRMs daily. Findings Used NRMs passed fit testing after autoclaving once, with 86% passing a second re-use/autoclave cycle. A separate cohort of used masks pre-warmed before autoclaving passed fit testing. To recycle 200-1000 NRMs daily, procedures for collection, sterilization and re-distribution were developed to minimize particle aerosolization risk during NRM handling, reject NRM showing obvious wear, and promote adoption by staff. NRM recovery ranged from 49-80% across twelve collection cycles. Conclusion Reuse of NRMs is feasible in major hospitals and other healthcare facilities. In sharp contrast to studies of unused NRMs passing fit testing after 10 autoclave cycles, we show that daily wear dramatically reduces NRM fit, limiting reuse to a single cycle, but still increasing NRM stocks by ∼66%. Such reuse requires development of a comprehensive plan that includes communication across staffing levels, from front-line workers to hospital administration, to increase the collection, acceptance of and adherence to sterilization processes for NRM recovery.

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