Some nurses across the UK are facing problems accessing high-grade personal protective equipment (PPE) amid confusion over what protection staff should be wearing, a nursing leader has told.
In an interview with Nursing Times, Rose Gallagher, the Royal College of Nursing’s professional lead for infection prevention and control (IPC), stressed nurses needed “clarity” on what PPE they required in different situations.
“The main thing for nursing staff is they need clarity on what PPE is required depending on the different risks they face from Covid-19”
Rose Gallagher
In recent days, the RCN has updated its position on PPE use for Covid-19 to state that all health workers should be provided with FFP3 masks for “contact with people who are known to be or potentially infected with Covid-19”.
It said the college “recognises the airborne route of transmission” of Covid-19 that “poses a significant risk” to health workers when working within two metres of a person who has or is suspected to have the virus.
The RCN wants this to be reflected in national IPC guidance and has urged all employers to “discharge their legal duty to adequately protect the health, safety, and welfare of all their employees from the risk of Covid-19”.
Its call for high-level PPE comes as the rapid spread of the Omicron variant continues to worsen workforce absences, as previously reported.
Under government IPC guidelines, use of FFP3 masks in relation to Covid-19 had previously been limited to areas where aerosol generating procedures (AGPs) were taking places.
However, a change in guidance last year now allows for wider use of these masks in other situations if a local risk assessment determines that there is an “unacceptable risk” of Covid-19 transmission.
According to the guidelines, the risk assessment should include evaluation of ventilation, operational capacity, and prevalence of infection, including Covid-19 variants of concern in the local area.
Speaking to Nursing Times, Ms Gallagher stressed the importance of using these local risk assessments appropriately to ensure nursing staff have access to the right PPE, especially amid Omicron.
Rose Gallagher
She pointed towards a toolkit co-developed by the RCN, alongside the Covid Airborne Protection Alliance and the British Occupational Hygiene Society in December, to help nurses ensure they understood the risk assessments being used in their organisation and that they or their employer are using them correctly.
The toolkit also highlights the legal duties of employers to protect their health workers and reflects UK legislation on risk assessments.
Ms Gallagher said the RCN was aware that “many more trusts now are moving over to providing FFP3 masks, beyond areas traditionally allocated for AGP”, but that some organisations were “still not sure”.
On the whole, the RCN received “mixed messages” around nurses being able to access high-grade FFP3 masks, and in some areas, she described accessibility to use of FFP3 masks as “problematic”.
However, unlike during the early stages of the pandemic, Ms Gallagher said she continued to be told that “supply is not an issue”.
“The main thing for nursing staff is they need clarity on what PPE is required depending on the different risks they face from Covid-19,” she told Nursing Times, noting that there was “still some confusion among staff about what protection they should be wearing”.
“There are very high numbers of infection circulating and cases in hospitals will reflect this, therefore [healthcare workers] are particularly at risk at the moment and require respiratory PPE if caring for known or suspected patients with Covid-19,” she added.
During a pandemic, which saw “increases and decreases” in the number of infections, there needed to be flexibility and adaptability around the different levels of PPE available, noted Ms Gallagher.
“We have to protect the workforce we have,” she stressed. “We should be doing everything we can. They are our most precious resource.”
Throughout the pandemic, the RCN has been campaigning for adequate PPE for nursing staff, including repeated calls for higher level precautionary PPE to reduce risk of airborne transmission for staff working with patients who have Covid-19.
A Department of Health and Social Care spokesperson said: “The safety of the NHS and social care staff has always been our top priority and we continue to deliver PPE to protect those on the frontline, including FFP3 masks.”
They highlighted that guidance on PPE was written by clinical experts and that “emerging evidence and data are continually monitored and reviewed”.
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