Newly released survey findings from National Nurses United indicate a significant proportion of hospital nurses don't have regular access to N95s or other types of respirators, a situation the nation's largest union of registered nurses claims could worsen if the CDC moves forward with draft guidelines that don't make firm recommendations on the use of respirators to prevent the spread of common pathogens like flu and COVID-19.
In a survey of 2,656 registered nurses at hospitals in the U.S., about 61% reported wearing a respirator for every encounter with a COVID-19 patient. The survey was conducted between Aug. 18 and Nov. 30 and includes both union and nonunion nurses.
"This result underlines the issues with HICPAC's draft guidance updates, which seek to limit the use of lifesaving respirators for healthcare workers caring for patients with pathogens that can be transmitted through the air — instead, relying on loose-fitting, unprotective surgical masks," NNU said in a Jan. 17 news release on the survey.
About 72% of respondents reported having access to a sufficient supply of N95 or other types of respirators on their unit. The findings come as respiratory virus season strains hospitals, with many opening up additional units to handle surges in volumes. In recent weeks, dozens of hospitals and health systems have reinstated mask mandates.
In early November, the CDC's Healthcare Infection Control Practices Advisory Committee, or HICPAC, voted to finalize a draft of infection control guidelines that recommends healthcare workers wear masks during routine care to prevent the spread of common, endemic respiratory infections, such as the flu and COVID-19. It does recommend N95s and other higher-level respirators for "special air precautions," or in cases where patients are infected with a new or emerging respiratory pathogen for which vaccines and treatments are not available.
The NNU and other clinicians have criticized the draft for not going far enough to protect patients and staff from aerosol transmission, saying it inappropriately treats surgical and medical masks as personal protective equipment.
"Stronger, not weaker, standards are necessary," NNU said in a statement. "The CDC must reject HICPAC's draft."
The CDC's infection control guidance was last updated in 2007, and HICPAC has been meeting since last August to discuss revisions. The process is lengthy, and the CDC has previously clarified that the recommendations are not final.
"The process has been misunderstood," an agency spokesperson told Becker's in November. "The advisory committee has not introduced any binding recommendations, but is instead kicking off a process that includes a transparent, lengthy public comment period."
If approved by the agency, the draft recommendations will be published to the Federal Register and the public would have 60 days to comment. The guidelines would then potentially be revised based on public comments, according to the CDC.