As the COVID-19 pandemic strains hospice supply lines, providers are finding innovative ways to obtain essential personal protective equipment (PPE) and prevent risk of infection. Central Vermont Home Health & Hospice (CVHHH) found a cost-effective solution to protect staff and patients by employing 3D printers to produce reusable face shields.

What began as a hobby for CVHHH’s IT Manager Jon Irwin became a solution to a pressing need as the coronavirus spread into the home health and hospice provider’s Vermont service area. With a keen interest in technology, Irwin purchased his first 3D printer three years ago from a Czech Republic company called Prusa Research, creating trinkets and knickknacks for friends. As his interest grew, Irwin acquired two more printers and opened an Etsy shop selling items such as planters and pencil holders. When COVID-19 hit the United States, he halted sales and began using his 3D printers to create protective face shields, seeing a growing need at CVHHH.

“When things started to heat up over the state of Vermont, we were taking an inventory of our PPE,” said Irwin. “We had about 17 disposable face shields, but we have more than 100 staff members to protect. I kind of took it upon myself to help provide that kind of PPE for staff and some of our first responders in the area that may not have access to these types of supplies.”

While the home health and hospice provider had ordered more than a thousand disposable face shields from outside suppliers, this PPE was slow to arrive at CVHHH. Many suppliers prioritized sales to hospitals and health systems in the area. To help meet the urgent demand, Irwin utilized his 3D printers to create face shields based on a design developed by Prusa Research and approved by the National Institutes of Health (NIH) after undergoing review in clinical settings.

“Having the proper protection gives staff and their patients peace of mind, and provides optimal protection,” said CVHHH President and CEO Sandy Rousse. “Twelve members of our hospice team, including our hospice chaplain, social workers, and registered nurses, have been equipped with Jon’s reusable face shields.”

Approved by CVHHH management, Irwin revised, or “remixed” the version to comply with National Institutes of Health guidelines, allowing for more face shields to be printed in less time than the original prototype. Production typically yielded roughly 24 to 30 units daily, providing CVHHH staff and some area first responders with vital PPE during the pandemic’s initial impact.

“One challenge was sourcing the materials,” Irwin told Hospice News. “But there’s already so many people out there making new face shields that there are lots of different resources available.”

The reusable face shields Irwin supplied to CVHHH are made from an environmentally friendly, hypoallergenic, plant-based plastic called polylactic acid, or PLA. The plastic shield itself consists of a clear binder cover about seven millimeters in thickness, which came from a binding company. The straps to secure the face shields in place were made from non-roll elastic material sourced from Joanne Fabrics, typically used in waistbands.

To ensure safe handling and sanitization, Irwin placed the 3D-printed parts in films within sealed plastic bags and brought them to CVHHH for onsite assembly by personal care attendants (PCAs). This in turn created an opportunity to boost hours for some staff who had been experiencing a downturn, with CVHHH paying for any time PCAs contributed to assembly, according to Rousse.

The reusable face shields will inevitably require replacement and repair parts, and Irwin plans to keep stock on hand in an effort to keep cost down as the outbreak continues. Production of the 3D-printed face shields has slowed, but will continue as long as there is a need, according to Irwin.

Material costs were another challenge for Irwin to overcome, even though the agency reimbursed costs associated with the face shields’ production. Irwin opened a GoFundMe page and spread awareness via Facebook. Donations received went towards the cost of the face shield materials. According to Rousse, the actual cost savings to CVHHH is minimal, less than $50, but the impact is significant.

“Having these face shields was a game changer for us,” said Emily McKenna, CVHHH’s marketing and communications director. “Being resourceful, creative thinkers is a kind of beauty in home health and hospice — we can make people comfortable and keep our clinicians and community safe during this crisis.”