The COVID-19 pandemic is creating a growing shortage of personal protective equipment (PPE). Oncology nurses are caring for people with cancer during treatment and survivorship. Although ONS supports full protection of healthcare workers handling drugs for cancer treatment that the National Institute for Occupational Safety and Health (NIOSH) has deemed hazardous, nurses in clinical settings are facing difficult choices if recommended PPE supplies are not available. In addition, they are making choices regarding the protection of themselves and their patients from potential COVID-19 infection and use of PPE for safe handling of hazardous cancer drugs.
ONS supports recommendations that the first priority when allocating PPE supplies is maintaining the protection of patients and healthcare providers from COVID-19 infection. For care of patients with COVID-positive infections, follow the Centers for Disease Control and Prevention guidelines for prevention of infection and optimizing use of PPE.
Please note that these guidelines were written as many were facing supply chain issues at the beginning of the Covid-19 pandemic. ONS recommends that all practice settings return to established PPE use procedures as supplies are available.
The following ONS interim recommendations are for the use of PPE during clinical oncology care and for safe handling and administration of hazardous cancer drugs based on the Table 1 NIOSH list. The options are presented in descending order from highest-level recommended practice based on supplies of available PPE. Although ONS recognizes that these are not ideal, they are interim guidelines to support decision making and staff and patient safety in clinical care during the COVID-19 pandemic.
Evaluate workflows and processes to maximize efficiency and decrease waste of PPE supplies.
Cluster care activities as much as possible and avoid touch contamination of surfaces.
The Interim Guidelines on PPE are also available in Spanish.