When the University of Iowa Hospitals & Clinics began training nurses how to don and doff the jumpsuits, hoods and coveralls necessary to treat patients with Ebola, everyone noticed how difficult it was to remove the hood from the nurses' heads without touching their skin.
Within weeks, hospital workers came up with their own design and had an in-house seamstress create a prototype hood they now plan to use.
The hoods now on the market are an example of the challenges facing hospitals ramping up orders of personal protective equipment, or PPE, and choosing which products will best protect healthcare workers against a virus that never was previously seen inside American hospitals.
“We've never needed to have personal protective equipment be so fail-proof,” said Dr. Michael Edmond, chief quality officer at the University of Iowa Hospitals & Clinics, Iowa City.
As hospitals increase PPE orders, some experts are concerned that demand will lead to price gouging, supply shortages, and in some cases, hoarding by hospitals. “There is the right opportunity to misuse the situation,” said Jeffrey Lerner, CEO of ECRI Institute, which is tracking PPE price information through its new Ebola PPE Price Index. Suppliers “may charge more or sell things that are not appropriate.”
There have been some examples of temporary supply shortages, but none related to price increases or hoarding, said Amanda Forster, spokeswoman for Premier, a Charlotte, N.C.-based group purchasing company. Premier has resolved any such shortages by reallocating supplies, she added.
PPE products are some of the cheapest medical supplies that hospitals buy. ECRI found that equipment such as boot covers can cost as little as 32 cents. Of the nine product types that ECRI plans to track, only one product—coveralls—costs an average of more than $1 an item.
But most hospitals and clinics are increasing PPE spending in anticipation of Ebola cases. That means higher costs regardless of whether a hospital ends up treating an Ebola patient.
For example, a hospital planning for a team of two nurses, one safety-protocol observer, physicians and a respiratory therapist will need at least 35 PPE suits each day, Forster said. Costs of the total disposable PPE for the group could run about $175 to $210 a day. Using a powered-air purifying respirator may add up to $1,500 in additional costs to each kit. In training, some hospitals reuse PPE suits to keep costs down.