October 20, 2022 | Maira Oliveira

4 min read

How Employee Health Can Manage PPE Fatigue as COVID Continues

With job-related fatigue among healthcare workers (HCWs) already an urgent problem, Employee Health (EH) staff may now face the challenge of managing fatigue and frustration with the use of Personal Protective Equipment (PPE).1 

Below, we’ll look at what to know and ways to address issues related to the proper use of N95 respirators and other facemasks among healthcare workers. 

1) Stay In-the-Know About Current Threats and Mandates

EH employees are considered trusted sources of information about COVID who likely play a role in answering questions about PPE. That means: 

Local health departments will have regional guidelines, and hospital/clinic management staff and legal departments will play a role in formulating final institutional rules.

2) Acknowledge PPE Fatigue and Health Concerns

The use of PPE for extended periods (which may extend to 12+-hour shifts) has been shown to cause both physical and psychological challenges to HCWs.2 For example: 

  • The inability to remove PPE during a shift can cause sweating and heat stress, prevent HCWs from hydrating properly, and lead to dehydration and exhaustion during work hours.3
  • Long periods of donning PPE can lead to discomfort and skin conditions such as eczema.4
  • N95 respirators can aggravate asthma, reduce the depth of breaths taken (causing hypoventilation), and increase blood CO2 levels if worn for more than an hour (which can cause headaches, difficulty concentrating, reduced visual acuity, and more).
  • Doffing and donning PPE during a shift can become haphazard, leading to increased infection rates.
  • Shortages of PPE or ill-fitting PPE can lead to anxiety about infection risk and decreased compliance.
  • Extended shifts with PPE can create feelings of claustrophobia, which may lead to anxiety reactions.8
  • PPE and social distancing can lead to feelings of isolation or even the inability of team members to see signs of fatigue or distress in coworkers.9 
  • The inability to interact face-to-face can create psychological distance between HCWs as well as between HCWs and patients, leading to less effective care.10

There are many ways to help alleviate the challenges posed by the need for HCWs to wear N95 respirators for long periods and to help boost both their mental health and performance. Examples may include the following: 

  • Ensure HCWs take breaks for food, water, fresh air, and rest. 
  • Create a buddy system to help HCWs monitor their colleagues’ compliance and also check in about their well-being.11
  • Create a culture of openness when it comes to expressing psychological needs.
  • Ensure there is ample PPE readily available.
  • Address harassment or discrimination against those who choose to wear PPE when it’s not mandated.
  • Develop and implement a fatigue management plan that:
    • Acknowledges fatigue and other mental health issues and offers confidential support.
    • Informs employees about the risks of fatigue (to themselves and their patients).
    • Encourages the reporting of accidents.
    • Promotes rest and self-care. 
    • Examines work shift lengths.
    • Examines lighting, temperature, airflow, and other environmental conditions that affect employee mental health.12

The Importance of PPE Compliance

While Employee Health staff is not immune to feelings of PPE fatigue, they are expected to provide resilient leadership regarding COVID protocols. The good news about N95 masks is that they are an effective way of protecting healthcare workers from COVID-19. That means Employee Health departments are in a better position than ever to help minimize risk, maximize safety, and mobilize resources to protect workers.

If you’re interested in learning more about how Net Health’s Employee Health software can help you track infections and compliance during COVID-19, schedule a demo.

Note: Net Health makes no representations as to accuracy, completeness, correctness, suitability, or validity of any of the information presented herein. All information is provided on an as-is basis. It is the viewer’s responsibility to verify any and all information presented herein.

3 Best Practices for Employee Health Nurses 

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U.S. Department of Health and Human Services (HHS), “New Surgeon General Advisory Sounds Alarm on Health Worker Burnout and Resignation,” May 23, 2022.
2  Center for the Study of Traumatic Stress, “Prolonged Operations in Personal Protective Equipment During COVID-19: Recommendations for Workers and Managers,” October 10, 2022.
3 Centers for Disease Control, “Heat Stress Imposed by PPE Worn in Hot and Humid Environments,” August 6, 2020.
Journal of the American Academy of Dermatology, “Skin Damage Among Health Care Workers Managing Coronavirus Disease-2019,” March 11, 2020.
5 NIOSH Science Blog, “The Physiological Burden of Prolonged PPE Use on Healthcare Workers during Long Shifts,” June 10, 2020.
6 The Journal of Emergency Medicine, “Reuse of Personal Protective Equipment: Results of a Human Factors Study Using Fluorescence to Identify Self‐Contamination During Donning and Doffing,” March 2022. 
7 The Cochrane Collaboration, “Factors That Influence Whether Healthcare Workers Follow Infection Prevention and Control Guidelines for Respiratory Infectious Diseases,” October 10, 2022.
8-10 Center for the Study of Traumatic Stress, 2022.
11 Centers for Disease Control, “The Buddy System,” October 10, 2022.
12 National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA), “Preventing Worker Fatigue Among Ebola Healthcare Workers and Responders,” October 10, 2022.

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