The Despotic Supply Chain Locked Up Our PPE!

  • The Despotic Supply Chain Locked Up Our PPE!

    Posted by Laura Velarde-Eyman, R.N., B.S.N., M.B.A. on December 19, 2020 at 10:45 pm

    Given the national surge that’s occurring as I write this and Austin hitting stage 5 this weekend, I thought it would be valuable to provide some insight into why all healthcare systems sequestered PPE.

    Before Covid, many healthcare systems experienced some form of theft or excessive use of supplies. Many have stories of supplies such as stapler reloads stolen, product shoved in lockers, in ceilings, and the list goes on. The reports are factual. The ability to sell these products on the internet today is relatively easy and extremely profitable.

    Before the pandemic, all PPE was stored in point of use rooms, also called supply rooms, throughout every nursing unit and procedural area in every hospital. The supplies were readily available to clinicians. It is always supply chain’s goal to provide clinicians what they need when they need it with ease of access.

    In Q1 2020, as word started to sprinkle around the nation about Covid, supply chain began to notice trends of PPE missing, aka “MIA.” The missing inventory was verifiable by knowing the quantities of each supply in every supply room. Boxes of fit-tested N95’s started to disappear into the black hole.

    Most vendors manufactured PPE based on 2019 utilization and projections. N95’s are rarely utilized, and impervious gowns are used without much thought about the intervention needing to be performed. As a previous ICU RN, I can attest to my naïveté of never questioning supply availability and am confident I wasted my fair share during my days of practicing.

    In February 2020, we quickly realized if we were going to protect our healthcare professionals and have the ability to provide PPE down the foreseeable road, we needed to protect inventory. Rapid changes to processes and storage occurred in many healthcare systems in less than a day. All PPE was pulled from every supply room and sequestered under lock and key. Clinicians were upset, and rightly so. We were hindering clinicians’ ability to do their jobs, but we were ready to bear the onslaught of negativity as we rapidly worked to launch education.

    Supply chain is not taught in nursing schools’ curriculum, and I doubt it’s in the medical school curriculum. Most do not think about supply chain or how product magically gets replenished on the shelves. Because supply chain was aware an increase in demand was coming and vendors would be supply-constrained, many supply chain organizations and healthcare systems did not want to end up, as some mentioned in the news….without supplies. This realization meant if we were going to protect our clinicians as long as possible, we would have to do the unthinkable.

    While the CDC changed its guidance on N95 utilization and donning time, it was necessary to get all through the pandemic as safely and as long as possible. It was challenging to embrace the changes. Telling nursing directors their staff would have to don an N95 for an entire shift when we were taught they were one-time-use provoked some tearful moments for me the night before the conversation. These are my peers. I was shocked, and they would indeed be shocked. But I needed to own the conversation and lead with the safety of all in mind and grace.

    And so here we are today, December 19, 2020, and many have adapted to the changes. Some have even embraced the changes by having one nurse stay donned for an hour providing care to all patients with the other nurses being the runners for meds, additional supplies, etc. The bundling of care has helped supply chain manage inventory. Surgical masks and N95’s are issued out by each to ensure we maintain the health of inventory and appropriately used. Isolation precautions have been revised to make the most use of polypropylene and impervious gowns. While many may not realize, implementing these processes has allowed us the ability to continue to protect our clinicians and optimize inventory. These processes have also provided vendors time to ramp up production to meet global demand, but the demand will continue to increase as we continue to surge.

    While not ideal to sign out PPE, supply chain has been able to adequately provide supplies to address the visions we had in February. We aren’t out of the woods yet; therefore, the processes need to continue, but the value of what we are doing is protecting healthcare workers’ lives.

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