Healthcare Hygiene magazine May 2020 | Page 19

supply of N95 filtering facepiece respirators and prioritizing their use ● Perform initial fit tests for each HCP with the same model, style, and size respirator that the worker will be required to wear for protection against COVID-19 (initial fit testing is essential to determine if the respirator properly fits the worker and is capable of providing the expected level of protection); ● Inform workers that the employer is temporarily suspending the annual fit testing of N95 filtering facepiece respirators to preserve and prioritize the supply of respirators for use in situations where they are required to be worn ● Explain to workers the importance of performing a user seal check (i.e., a fit-check) at each donning to make sure they are getting an adequate seal from their respirator ● Conduct a fit-test if they observe visual changes in the employee’s physical condition that could affect respirator fit (e.g., facial scarring, dental changes, cosmetic surgery, or obvious changes in body weight) and explain to workers that, if their face shape has changed since their last fit test, they may no longer be getting a good facial seal with the respirator and, thus, are not being adequately protected ● Remind workers that they should inform their supervisor or their respirator program administrator if the integrity and/ or fit of their N95 filtering facepiece respirator is compromised OSHA advices that healthcare personnel visually inspect the N95 respirator to determine if the structural and “ When Qualaris created the COVID Kit, I slept like a baby because functional integrity of the respirator has been compromised. “Over time, components such as the straps, nose bridge, and nose foam material may degrade, which can affect the quality of the fit and seal,” OSHA explains. “If the structural and functional integrity of any part of the respirator is compromised, or if a successful user seal check cannot be performed, discard the respirator and try another respirator.” PPE and Exposure Prevention A 2020 update to a Cochrane Systematic Review by Verbeck, et al. (2020) sought to evaluate which type of full‐body PPE and which method of donning or doffing PPE, have the least risk of contamination or infection for healthcare personnel, and which training methods increase compliance with PPE protocols. Earlier versions of this review were published in 2016 and 2019; in the 2020 update, the authors included 24 studies with 2,278 participants, of which 14 were randomized controlled trials (RCT), one was a quasi‐RCT and nine had a non‐randomized design. Eight studies compared types of PPE. Six studies evaluated adapted PPE. Eight studies compared donning and doffing processes and three studies evaluated types of training. Eighteen studies used simulated exposure with fluorescent markers or harmless microbes. In simulation studies, median contamination rates were 25 percent for the intervention and 67 percent for the control groups. The authors note that evidence for all outcomes was of very low certainty because it is based on one or two studies, the indirectness The Qualaris COVID-19 Kit helps healthcare facilities save lives and reduce risk by implementing and adhering to an evolving set of CDC guidelines. now we can track and prove compliance with Click here to request your free kit constantly changing guidelines. Heather Nicholas Risk Manager of a Healthcare Facility Join the 100 health systems that already trust Qualaris to streamline infection prevention and quality improvement. Our COVID-19 Kit is free through 2020. https://covid19.qualaris.com/ www.healthcarehygienemagazine.com • may 2020 19