So I’ve been pretty skeptical about people sewing protective face masks at home. And, as with a lot of things we don’t have all the data that we wish we had. So…I’m putting this scientific evidence out there and encouraging you to contribute to this blog by adding other scientific data.
Here is a 2015 randomized controlled trial (RCT) data: Penetration of cloth masks by particles was almost 97% and medical masks 44%. (N = 1607 HCW > 18 years).
Nevertheless, the expert opinion at CDC is that they are in the “Better Than Nothing” category and gives this additional advice. “In settings where N95 respirators are so limited that routinely practiced standards of care for wearing N95 respirators and equivalent or higher level of protection respirators are no longer possible, and surgical masks are not available, as a last resort, it may be necessary for HCP to use masks that have never been evaluated or approved by NIOSH or homemade masks. It
may be considered to use these masks for care of patients with COVID-19, tuberculosis, measles, and varicella. However, caution should be exercised when considering this option.1,2“
Anecdotally, providers are using them to extend the life of other masks or N95s. Women are also making some with little pockets for other filters, and a material called HANIBON that can be purchased online is used often on the outer layer of disposable masks and works to block out dust and fluids from entering.
- Dato, VM, Hostler, D, and Hahn, ME. Simple Respiratory Maskexternal icon, Emerg Infect Dis. 2006;12(6):1033–1034.
- Rengasamy S, Eimer B, and Shaffer R. Simple respiratory protection-evaluation of the filtration performance of cloth masks and common fabric materials against 20-1000 nm size particlesexternal icon, Ann Occup Hyg. 2010;54(7):789-98.
“Sew” there you have it. Expert opinion is that as a last resort you may use inadequately tested cloth masks if it is all you have. I am grateful for all those sewists out there responding to medical center calls to supply them with cotton and elastic homemade masks, and sending out the patterns to do so. Field medicine.
CDC also says “The filters used in modern surgical masks and respirators are considered “fibrous” in nature—constructed from flat, nonwoven mats of fine fibers” If this is true then would nonwoven interfacing improve the homemade masks?
Practice based in evidence (EBP) means that you must critique/synthesize evidence and then apply it to particular setting and populations using your best judgement. This means that you must discriminate about when (and when NOT) to apply the research. Be sure to use best professional judgment to particularize your actions to the situation!
Add to your repertoire of EBP tools, the Number Needed to Treat (NNT). This is not mumbo -jumbo. NNT explained here–short & sweet: http://www.thennt.com/thennt-explained/
CRITICAL THINKING: Check out this or other analyses at the site. How does the info on antihypertensives for mild hypertension answer the question of whether more is better? Are there patients in whom you SHOULD treat mild HTN? (“We report, you decide.”) http://www.thennt.com/nnt/anti-hypertensives-for-cardiovascular-prevention-in-mild-hypertension/
MORE INFO: Check out what the data say about other risk/benefit treatments at http://www.thennt.com/
The public and lots of nurses have lots of questions. Our evidence-based knowledge is evolving. Here’s some of the latest (Aug/July 2016).
You can set up a free account with Lippincott to access this 3 page article that translates current research into practice for you.
O’Malley – Zika virus: What we know and do not know: http://www.nursingcenter.com/pdfjournal?AID=3570052&an=00002800-201607000-00005&Journal_ID=54033&Issue_ID=3569996
Don’t Go Pokemon Go ….& if you must, watch out! New privacy and safety dangers are being recorded almost every day. The game is full of health and computer hazards, and has potential to distract workers from their life-saving care.
What is the evidence? At this point mostly anecdotal reports and the anticipated possibility that healthcare workers could be distracted from life-saving work. You need to translate this evidence into action. Why would you do this with such relatively weak research evidence? Because the risks are far higher to ignore it, & essentially NO risks if you use the evidence. The BBB lists these problems & makes some suggestions based on incoming reports:
- Privacy: In order to play the game, users must allow the app to access other applications, such as maps and camera. The iOS version for the iPhone can access all Google data.
- Malware: So far, the app is only available in the U.S., Australia and New Zealand, which has given cybercriminals an opportunity to capitalize on the demand…. Users should only download the app through official app stores, not third-party sites.
- Safety: Players should use the same safety precautions while playing the game that they would in any other outdoor setting, including caution in strange location.
- Infringement: PokeStops are supposed to all be on public property (or cooperative
private sites), but at least one health system, Dignity Health, is asking that its facilities be removed to avoid dangers to privacy and safety of patients, visitors, families & staff.
Translating this evidence into practice? Think before you Pokemon Go, if at all. Talk to your patients–when people don’t feel well they are even more likely to be distracted.
Critical thinking? 1) List specific actions that you will do to promote privacy, safety and fight malware and infringement. These can range from “never download;never play” to…..? When developing this list specifically address the challenges above. 2) What about patient players? staff players? visitor players? How should you help them to be safe?