The challenge now is ensuring distribution and proper use.


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Midway through the COVID-19 pandemic, many nurses were still struggling to obtain proper personal protective equipment (PPE) to safeguard themselves and their patients.


A July-August 2020 survey of 21,000 nurses by the American Nurses Association (ANA) found that one in three nurses were short on N95 masks and 68% said it was their facility's policy to reuse masks and other PPE, a practice deemed "unacceptable" by ANA president Ernest Grant.


Results from a survey of 9,200 nurses in March by National Nurses United (NNU) yielded equally discouraging results: 81% of respondents said they were still reusing PPE, which NNU decried as evidence of institutional disregard for the safety of nurses and health care workers.


The supply problem is now abating, but work remains to ensure hospitals provide PPE-and make sure nurses and other clinicians use it appropriately. In California, a law endorsed by NNU that took effect April 1 not only requires hospitals to maintain a three-month stockpile of PPE, including N95 masks, but mandates that employers promulgate policies and enforcement strategies for its use.


New York similarly requires hospitals to have a 90-day supply of PPE and, like California, has set up a monitoring system to see that the equipment isn't just stockpiled but is also distributed to and appropriately used by health care workers. And in the Canadian province of Quebec, a court recently ruled in favor of a filing by the Ontario Nurses Association that N95 masks be provided to all health care workers at risk for exposure to COVID-19.


Industry analysts say smaller hospitals may struggle to comply with the new stockpile mandates because they lack the purchasing power of larger hospitals. In a statement to the U.S. Senate Finance Committee last July, ANA president Grant made this point: "Many states will not have the resources or expertise to carry out preparations or coordination without federal assistance. Hospitals and facilities with more capital will most likely benefit while rural and underserved areas will suffer." He urged the federal government to incentivize and prioritize the manufacturing of PPE, medications, and other supplies in the United States, rather than depending on other nations to export them.


That is now happening as several federal COVID-19 task forces focus on solutions. A U.S. Supply Chain Stabilization Task Force is working to accelerate manufacturing, expansion, and allocation of PPE. And, in April, the Food and Drug Administration and the Centers for Disease Control and Prevention determined that PPE supplies are now sufficient for hospitals and other health care facilities to safely transition from crisis-driven use of decontamination and other bioburden reduction systems for PPE to provision of fresh masks and protective gear to frontline health care workers.-Gail M. Pfeifer, MA, RN