by Nancy Humphrey
A group of physicians, nurses and representatives from multiple areas throughout Vanderbilt University Medical Center came up with a process in less than a week to safely and effectively sanitize used N95 respirators — critically important personal protective equipment (PPE) used to protect health care workers and others during the COVID-19 pandemic.
The process, modified from a University of Nebraska Medical Center protocol implemented in late March and shared online for other health care facilities to use or modify, uses ultraviolet (UV) light to disinfect dozens of used masks at a time. The entire procedure, which takes place in a room near the Clinical Research Center in Medical Center North and cleans about 60 masks at a time, takes about an hour, and then the masks are ready to be redistributed to areas throughout the Medical Center.
The room is designed so that capacity can increase to meet the need, said Robin Adkins, BSN, CNOR, RNFA, senior director of Clinical Engagement at Vanderbilt Health Supply Chain Solutions and an operating room nurse with 29 years of experience. Adkins, who has been at VUMC for almost 15 years, has worked tirelessly with Jay Wellons, MD, MSPH, Thomas Talbot, MD, MPH, and others across the Medical Center to get the mask room up and running.
“The importance of having the right equipment to protect our front-line personnel is a major emphasis during this pandemic, and using innovative tools to safely reuse respirators is essential,” said Talbot, professor of Medicine and Chief Hospital Epidemiologist.
“The team’s ability to rapidly pull this together was very impressive but truly not a surprise.”
To get the room ready, reflective paint was painted on the wall and wire was hung from corner to corner. When in operation, industrial UV light cleaning robots, like those used to clean hospital rooms and operating rooms, are placed 3 feet from the masks. When they are turned on and a certain energy level is reached, they reflect off the walls and into the masks at doses recommended to adequately disinfect the respirators in preparation for re-use.
Then the sterilized masks are loaded into clean bags and taken to two main distribution points — currently at Vanderbilt University Adult Hospital and Monroe Carell Jr. Children’s Hospital at Vanderbilt.
“It represents everything that’s the best about Vanderbilt — high-level problem-solving and collaboration. It’s been phenomenal to see how many people have spent so much time over the past week, just to hammer it through and get each little detailed part done,” said Wellons, vice-chair of the Section of Surgical Sciences, vice chair for Clinical Research, professor of Neurological Surgery and Pediatrics and chief of Pediatric Neurosurgery at Monroe Carell Jr. Children’s Hospital at Vanderbilt.
Wellons said he hopes the collaborative nature of the endeavor sends a message to VUMC employees that groups all across the Medical Center are working on problems such as extending the use of critically needed masks and that the Medical Center will come through these tough times.
Adkins said she never knew her career as an operating room nurse would lead her to help design and equip a room in the midst of a worldwide pandemic.
“It’s a little sciency,” she said. “I’m an OR nurse, so science isn’t out of my realm, but this is physics and joules of electricity and reflective paint. I’ve had to learn a lot of terminology and interesting facts to make this happen. Never in a million years did I think I would be running a real science experiment.”
The team took the existing protocol and had to figure out how many UV lights were needed and how to use the available space they were given at the Medical Center.
The Nebraska protocol, although useful, had to be modified for use at Vanderbilt. The Surgical Outcomes Center for Kids (SOCKS) team broke the protocol down into a stepwise process that could be changed and modified for VUMC.
“We owe Nebraska and the other teams who are doing this a great deal of gratitude for making this available for everybody,” Wellons said. “The sharing of knowledge is the best way for us all to get through this time together.”