SAGE report supports nurse demands for higher grade face masks

RCN calls for nurses in all settings to be issued with FFP3 respirators to prevent the spread of COVID-19

Nurses have repeated calls for higher grade face masks in all settings after government advisers suggested these may be needed to protect staff working outside intensive care.

A report on masks for healthcare workers from the government’s Scientific Advisory Group for Emergencies (SAGE) said it may be necessary to consider extending the use of higher standard respiratory protective equipment (RPE) to prevent the spread of COVID-19.

Need for greater consideration of airborne transmission risks

Current infection prevention control guidance says thinner surgical masks are adequate for nurses and others working outside intensive care units, but the RCN fears these do not protect against airborne spread of the virus.

The college has called for nurses in all settings to be issued with FFP3 respirators designed to filter out infectious aerosols and protect staff working in close contact with patients known or suspected to have COVID-19.

The SAGE report stresses the importance of robust infection prevention and control measures but highlights ‘clear variability in compliance’ with COVID-secure guidance among hospitals. It also flags up the need for better understanding and greater consideration of the risks of airborne transmission – including ensuring staff and patients wear standard face masks – and for good ventilation in clinical and non-clinical areas.

‘If an unacceptable risk of transmission remains after rigorous application of the hierarchy of control it may be necessary to consider the extended use of RPE for patient care in specific situations,’ said the report.

Infection guidelines should be updated to reflect SAGE’s findings, says RCN

In March an independent review commissioned by the RCN – and cited in the SAGE report – found current guidance was ‘flawed and needed replacing’ because it did not take into account the latest evidence on airborne transmission and the ventilation of healthcare settings.

RCN professional lead for infection prevention and control Rose Gallagher said the SAGE report was a ‘step in the right direction’, but called for infection prevention and control guidance to be updated to reflect its findings. ‘We have heard many reports from our members that their employers do not feel able to deviate from the letter of national guidance for fear of being criticised.

‘Changing the guidance would empower employers to find local solutions that offer a greater level of protection to nurses, midwives and patients,' she said.

• RELATED: Call for urgent review of ‘flawed’ COVID-19 infection guidelines

The Department for Health and Social Care told Nursing Standard that PPE recommendations in the infection prevention control guidance were agreed by an expert group of clinicans and scientists, based on clinical evidence.

'This guidance is kept under constant review based on the latest evidence,' a spokesperson added.

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Find out more

• Public Health England (2020) COVID-19: Guidance for Maintaining Services Within Health and Care Settings Infection Prevention and Control Recommendations
• RCN (2021) Independent Review of Guidelines for the Prevention and Control of COVID-19 in Health Care Settings in the UK
• Scientific Advisory Group for Emergencies (2021) Masks for Healthcare Workers to Mitigate Airborne Transmission of SARS-CoV-2

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