On December 23, 2020, the Centers for Disease Control and Prevention (CDC) updated their series of strategies to optimize supplies of medical exam gloves in healthcare settings when there is a limited supply. These strategies offer a continuum of options for use when medical exam gloves are stressed, running low, or exhausted.
The CDC definition of surge capacity refers to the ability to manage a sudden increase in patient volume that would severely challenge or exceed the present capacity of a facility. The CDC recommends that three general levels be used to describe surge capacity and that these levels be used to prioritize measures to conserve medical exam gloves supply. The three levels are:
- Conventional Capacity: measures consisting of engineering, administrative, and personal protective equipment (PPE) controls that should already be implemented in general infection prevention and control plans in healthcare settings.
- Contingency Capacity: measures that may be used temporarily during periods of expected medical exam gloves or other PPE shortages. Contingency capacity strategies should only be implemented after considering and implementing conventional capacity strategies. While the available supply may meet the facility’s current or anticipated utilization rate, there may be uncertainty if future supply will be adequate and, therefore, contingency capacity strategies may be needed.
- Crisis Capacity: strategies that are not commensurate with U.S. standards of care but may need to be considered during periods of known medical exam gloves or other PPE shortages. Crisis capacity strategies should only be implemented after considering and implementing conventional and contingency capacity strategies. Facilities can consider crisis capacity strategies when the supply is not able to meet the facility’s current or anticipated utilization rate.
The CDC recommends that contingency and then crisis capacity measures augment conventional capacity measures and are meant to be considered and implemented sequentially. Furthermore, once medical exam gloves availability returns to normal, healthcare facilities should promptly resume standard practice. When determining the appropriate time to return to conventional strategies, the CDC recommends considering the following:
- The anticipated number of patients for whom gloves should be worn by HCP providing their care
- The number of days’ supply of gloves currently remaining at the facility
- Whether or not the facility is receiving regular resupply with its full allotment
Recommendations by the CDC for the above Capacity Strategies include the following:
- Conventional Capacity: Continue to provide patient care as in usual infection control practices, and remind healthcare personnel about indications for when gloves are needed, as well as common care situations when gloves may not be needed.
- Contingency Capacity: Use gloves past their manufacturer-designated shelf life for training activities, and use gloves conforming to other U.S. and international standards.
- Crisis Capacity: Use gloves past their manufacturer-designated shelf-life for healthcare delivery and prioritize the use of non-sterile disposable gloves. Also, consider non-healthcare gloves alternatives, such as in food service.
A complete list of CDC recommendations for Capacity Strategies can be accessed here.
Compliance Perspective
Issue
Each facility’s Emergency Preparedness Plan should include strategies to implement when medical exam gloves and other PPE supplies are limited. Facilities must routinely monitor their use of medical exam gloves and other PPE stock levels and anticipated deliveries in order to determine appropriate capacity strategies.
Discussion Points
- Review the facility’s Emergency Preparedness Plan to ensure the plan has the most recent recommendations from the CDC for medical exam gloves and other PPE capacity strategies. Revise the Emergency Preparedness Plan as appropriate.
- Train all staff on the Emergency Preparedness Plan. Train appropriate staff on capacity strategies prior to implementation of the strategies. Document that the trainings occurred and file the signed training document in each employee’s education file.
- Periodically audit levels of all PPE, including medical exam gloves, to ensure that supplies are adequate and that there are no anticipated shortages. Determine that the current capacity strategy is being followed by all.
