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  • 1.  PPE for transplant recipients

    Posted 04-26-2020 05:15 PM
    Our hospital, like most, has shortages of PPE and we are not able to provide transplant patients with the box of gloves for hazardous drugs and box of disposable masks as we typically do.  Patients are also, not surprisingly, unable to locate/buy these items themselves.

    Have other transplant centers found ways to deal with these PPE shortages yet still provide adequate protection to the transplant patients and their caregivers?  Have any centers changed their education to patients about how to use more limited PPE supplies (reusing, etc)?

    Thanks,
    Jen

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    Jennifer Kanakry MD
    Associate Research Physician
    National Institutes of Health
    Bethesda MD
    240-858-9255
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  • 2.  RE: PPE for transplant recipients

    Posted 04-28-2020 09:02 AM
    When you say PPE, I am assuming you are referring to face masks for non-infected patients. Thankfully, we don't have a shortage of PPE at our institution at present. However, we are trying to be conservative and more thoughtful about PPE. We are following CDC guidance for masking, and advise/educate patients to use some kind of mask (surgical or cloth) when home or in the community. If they use a cloth mask, they are educated about washing it, etc. In the treatment areas, where our staff will have close contact with patients, they are given a surgical mask to wear. We are not routinely asking patients to wear gloves - emphasis is instead on hand hygiene. So to answer your question, if patients don't have access to surgical masks, they can be asked to use cloth masks instead. 

    Best
    Navneet

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    Navneet Majhail MD, MS
    Cleveland Clinic
    Cleveland OH
    (216) 444-2199
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    Original Message


  • 3.  RE: PPE for transplant recipients

    Posted 05-04-2020 12:47 PM

    Thanks for your response!

     

    We have transitioned to asking patients to wear cloth masks when in the community on walks, etc while maintaining good distance from others.  We typically would have recommended surgical masks for these outdoor activities, but we just don't have the supplies to give to patients.  We are not giving any masks to caregivers and are asking them to solely use cloth masks.  The patients are given a fresh surgical mask to put on when they enter the clinical center, as our policy across the board.  They are being educated about hand washing before and after touching/removing their mask to allow for longer re-use.   

     

    The gloves are for the caregiver to assist in handling of hazardous drugs, but we don't have a shortage yet on gloves. 

     

    If it is helpful to anyone else, this is the education document we put together for the patients, after discussion with Hospital Epidemiology, Material Management, Nursing, Transplanters, and the Patient Advocate:

     

    Mask Guidance

     

    If you enter the Clinical Center wearing a mask, you will be asked to take it off and you will be provided a new one.  If you are traveling to the Clinical Center in your personal car or walking from on campus housing, you may wear a cloth mask to the Clinical Center, at which time you will be given a surgical mask.

     

    You may use your disposable surgical mask throughout the day or even re-used for several if it has been gently used for an hour or so a day.  To keep it clean, wash your hands before removing.  Remove the mask by grasping the ear loops.  Wash your hands again after removing the mask.  Discard a mask if it becomes wet or soiled.

     

    Do not lower your mask when talking.

     

    For outdoor, non-public activities such as going on walks, you may wear a cloth mask.  Continue to remain at least 6 feet away from people not in your household.

     

    We are advising caregivers/household members of transplant patients to solely use cloth masks rather than surgical masks.  We will not be able to provide surgical masks to caregivers.  Please remember that the purpose of the mask is to protect others from infection.

     

    You will be given a week's supply of surgical masks at your clinic visit.  Masks will be distributed by the OP12/OP13 clinic.  Given that a clean surgical mask will be provided to you upon every entry to the clinical center, we will give a very limited number of masks.  If you do not need them, please do not take them.  The maximum number of masks that will be given each week is 7, but most patients should need far less than this.

     

    You will be asked how many masks you need during your pre-clinic COVID19 screening telephone call.

     

    The safety and health of our patients, staff, and community remain our top priority!  We appreciate your understanding.

     

     

    -Jen

     

     

     

     




    Original Message


  • 4.  RE: PPE for transplant recipients

    Posted 05-19-2020 01:11 PM
    We have long had our patients wearing masks, especially during the higher risk season from October through the end of May prior to COVID.  For them, this is not a change.  
    Most of our patients have provided themselves with cloth masks, many of which were provided by volunteers from the hospital and by the efforts of the patients themselves.  Even so, patients are screened at the door of the clinic for symptoms and droplet masks are provided, one per day per patient for use while in the clinical space.  
    We do not have patients wear masks inpatient, except when leaving their rooms, but all staff wears droplet masks along with a face shield (including outpatient).  Even though the transplant floor is a non-COVID area, the face shield allows preservation of the surgical droplet mask, which is provided one per provider per day.  Cloth masks are used for travel through the hospital or in non-face- to- face environments in the clinical spaces.  
    This has been the strategy used by our hospital group to preserve the supply of PPE.  

    Good luck and stay safe!
    John McCarty MD
    Professor of Medicine
    G Watson James Endowed Professor of Hematology
    VCU Massey Cancer Center
    Richmond, VA

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    John McCarty Professor of Medicine
    Medical Director, Cellular Immunotherapeutics and Transplantation Program
    VCU Massey Cancer Center
    Richmond VA
    804-828-4596
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    Original Message


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