Institution of a Novel Process for N95 Respirator Disinfection with Vaporized Hydrogen Peroxide in the Setting of the COVID-19 Pandemic at a Large Academic Medical Center

Abstract

Personal protective equipment (PPE) has been an invaluable yet limited resource when it comes to protecting healthcare workers against infection during the 2019 coronavirus (COVID-19) pandemic. In the US, N95 respirator supply chains are severely strained and conservation strategies are needed. A multidisciplinary team at the Washington University School of Medicine, Barnes Jewish Hospital, and BJC Healthcare was formed to implement a program to disinfect N95 respirators. The process described extends the life of N95 respirators using vaporized hydrogen peroxide (VHP) disinfection and allows healthcare workers to retain their own N95 respirator across a large metropolitan healthcare system.

Figure 1

Vaporized hydrogen peroxide process map followed by the healthcare provider for packaging N95 respirators in Tyvek pouches and then labeling, picking up, and dropping off the Tyvek pouches. BJH, Barnes Jewish Hospital.

Figure 2

Process map for the vaporized hydrogen peroxide (VHP) associate from picking up the Tyvek pouches with soiled N95 respirators in collection bins to dropping back off the Tyvek pouches with clean N95 respirators at the same units. BJH, Barnes Jewish Hospital.

Figure 3

(A) Packaging of 2 different brands of N95 respirators within Tyvek pouches. The Tyvek pouch is labeled on the clear side with the healthcare provider’s ID number or name, department, and unit location. (B) Multiple labeled Tyvek pouches within a bin that was picked up by the VHP associates. VHP, vaporized hydrogen peroxide.

Figure 4

Schematic of the vaporized hydrogen peroxide (VHP) room, which includes 5 different areas: the vacant conference room is where the VHP associates work in between cycles. The soiled utility room is where the soiled collection bins are placed on the wire racks. The wire racks are then rolled into the VHP room, where each Tyvek pouch holding one N95 respirator is removed from the soiled collection bin and placed on shelves in a flat position. Next, the disinfection process occurs in the VHP room. The Bioquell Z-2, 2 Bioquell aeration units, and a fan sit in the center of the VHP room. The aeration, or off-gassing, room is where N95 respirators aerate until the H₂O₂ sensor reads 0 parts per million, both in the room and at the level of the Tyvek pouches. The workspace includes a temporary heating ventilation and air conditioning system (HVAC) unit since the central HVAC capabilities were sealed off, hand hygiene stations, and an emergency eyewash station.