[MCOH-EH] MCOH-EH Digest, Vol 250, Issue 78 Respirator Medical Questionnaire

Kuschel-Rapaski, Betty BKUSCHE1 at hfhs.org
Tue May 12 06:06:41 PDT 2015


Good morning,
My facility reviewed the regulation and we have determined the following:
1. If the history is in the past (1 year) our Medical Assistants that are trained in fit testing are able to sign off on the questionnaire
2. If history is within the past year or the history is pulmonary or cardiac the nurse must sign the questionnaire after the RN interviews and assesses the emp.  
3. If the nurse has concerns, then the emp has an appointment with the NP or physician for final determination.

Yes, we test each  of  steps for 60 seconds.  This is clearly written in the OSHA regulation. 

We just changed our N95 mask from Kimberly-Clark to Cardinal.  We are see a higher failure rate with the Cardinal mask.  To determine a fail we fit test with Cardinal cone (Sm and M/Lg) and duck bill (Sm and M/Lg).
Is anyone else experience this with the Cardinal masks?  If so, what processes have you implemented to decrease your fail rates? 


Thank you. 

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of mcoh-eh-request at mylist.net
Sent: Tuesday, May 12, 2015 8:30 AM
To: mcoh-eh at mylist.net
Subject: MCOH-EH Digest, Vol 250, Issue 78

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Today's Topics:

   1. Re:  Respirator medical questionnaire (Sajjad_Savul at bayhealth.org)
   2. Re:  Respirator medical questionnaire (Viereck, Maryann)


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Message: 1
Date: Tue, 12 May 2015 08:25:58 -0400
From: Sajjad_Savul at bayhealth.org
To: MCOH/EH <mcoh-eh at mylist.net>
Cc: "'Seufert, Diana'" <Diana.Seufert at bmc.org>,	MCOH/EH
	<mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Respirator medical questionnaire
Message-ID:
	<OFE8D3BBB7.1F1AE758-ON85257E43.00444BEC-85257E43.00444BF0 at Bayhealth.Org>
	
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Message: 2
Date: Tue, 12 May 2015 12:29:43 +0000
From: "Viereck, Maryann" <mviereck at caperegional.com>
To: 'MCOH/EH' <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Respirator medical questionnaire
Message-ID:
	<7FCF8FE41638F943ACE320C939BC45D9EEE5B4D9 at EXSRV1.BTHOSP.INT>
Content-Type: text/plain; charset="utf-8"

We use a porta-count fit testing device which automatically times all steps and gives a quantitative result.

Maryann Viereck RN,BS,CEN,COHN-S
Employee Health Coordinator
Cape Regional Medical Center
2 Stone Harbor Blvd
Cape May Court House, NJ 08210
phone 609-463-2512
fax 609-463-2910

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Sajjad_Savul at bayhealth.org
Sent: Tuesday, May 12, 2015 8:26 AM
To: MCOH/EH
Cc: MCOH/EH
Subject: Re: [MCOH-EH] Respirator medical questionnaire

Good Morning,

We don't have any written guidelines but the following is the general protocol. The initial review may be done by a certified occ health tech or an LPN.

- the reviewer further questions/ documents comments on all "yes" answers (unless the subject has written pertinent details)
- the reviewer inquires if any of the "yes" answers are new (from last questionnaire).
- if there are any new answers, specially cardiopulmonary or the subject stating having difficulty with respirator use since last evaluation, the reviewer checks the "provider consulted" box (we have it pre-printed on our forms alongwith a comment/signature section for the provider) and puts subject in a room
- the provider then sees the subject and decides on appropriate disposition

Now I have a question too!
For the fit test, OSHA says that each of the 8 or so exercises (e.g., bending forward, deep breathing, moving head up and down, etc.) should be carried for one minute (each). In your practice, how strictly is that time followed? Thanks.

Saj


Sajjad A. Savul, MD, MS, FACOEM
Medical Director
Bayhealth Occupational Health

Dover Office:
1275 S State Street
Dover, DE 19901
Ph.: (302) 678-1303
Milford Office:
301 Jefferson Avenue
Milford, DE 19963
Ph.: (302) 430-5705


-----"MCOH-EH" <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> wrote: -----
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>, "'Seufert, Diana'" <Diana.Seufert at bmc.org<mailto:Diana.Seufert at bmc.org>>
From: "Malucky, Andrea"
Sent by: "MCOH-EH"
Date: 04/30/2015 09:55AM
Subject: Re: [MCOH-EH] Respirator medical questionaire Would anyone be willing to share the specific guidelines that you give to nurses who are reviewing questionnaires?

Thank you,
Andrea

Andrea Malucky, MSN, FNP-c
CHI St. Alexius Health Occupational Medicine
310 N. 9th St.
PO Box 5510
Bismarck, ND 58506-5510
P 701.530.8103  F 701.530.8160




-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Buchta, William G., M.D.
Sent: Wednesday, April 29, 2015 3:26 PM
To: 'Seufert, Diana'; MCOH/EH
Subject: Re: [MCOH-EH] Respirator medical questionaire

We do the same thing at Mayo Clinic but gave the nurses some basic guidelines to cull out those conditions which are likely irrelevant.

Bill Buchta

William G. Buchta, MD, MS, MPH
Assistant Professor, Mayo Clinic College of Medicine Mayo Clinic, Division of Preventive, Occupational, and Aerospace Medicine
200 First St,SW,Rochester, MN 55905
Phone: 507-266-0354 Fax: 507-284-4251



-----Original Message-----
From: Seufert, Diana [mailto:Diana.Seufert at bmc.org]
Sent: Wednesday, April 29, 2015 12:20 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Respirator medical questionaire

The RNs in the department review the questionnaires.
They consult with the NP or MD as needed on the "yes" questions to determine whether the person should be cleared.

Diana Seufert RN, MSN, NP
Boston Medical Center
Occupational & Environmental Medicine
Doctor's Office Building (DOB) 7th floor, Suite 703
720 Harrison Avenue, Boston, MA  02218
p  617-638-8400    f  617-638-8406

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Kuschel-Rapaski, Betty
Sent: Wednesday, April 29, 2015 9:41 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] Respirator medical questionaire

Good morning,
In regards to the respiratory (N95)  medical questionnaire, who provides the medical clearance for those employees that have answered "yes" to any medical question?  Is the Physician, NP, PA, or Medical assistant?
Thank you.

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of mcoh-eh-request at mylist.net<mailto:mcoh-eh-request at mylist.net>
Sent: Wednesday, April 29, 2015 9:22 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: MCOH-EH Digest, Vol 250, Issue 62

Send MCOH-EH mailing list submissions to
        mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>

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When replying, please edit your Subject line so it is more specific than "Re: Contents of MCOH-EH digest..."


Today's Topics:

   1.  Annual PPDQ's (Morelli, Karen J)
   2. Re:  Annual PPDQ's (Tebolt, Allison)
   3. Re:  Annual PPDQ's (Senior, Cathy (DRMC))
   4. Re:  Annual PPDQ's (Tebolt, Allison)


----------------------------------------------------------------------

Message: 1
Date: Wed, 29 Apr 2015 12:38:53 +0000
From: "Morelli, Karen J" <kmorelli at emhs.org<mailto:kmorelli at emhs.org>>
To: "mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: "Allard, Bonnie" <ballard at emhs.org<mailto:ballard at emhs.org>>
Subject: [MCOH-EH] Annual PPDQ's
Message-ID:
        <8B8E7138F933B54BA8DBB3AEF14A5F1AA10EBF71 at MARINA.me.emh.org<mailto:8B8E7138F933B54BA8DBB3AEF14A5F1AA10EBF71 at MARINA.me.emh.org>>
Content-Type: text/plain; charset="us-ascii"

I am wondering how you handle annual ppd questionnaires for those who have had a +ppd or IGRA tuberculosis screening.  We perform our annual questionnaires on 5/1 of each year.  My question is if you hired someone in January, February, March or April and they filled out the questionnaire on hire, would you have them make out a new questionnaire with the annual May surveillance or would you put their next due date as 5/1 of the following year (example someone hired 2/1/15-next due date for questionnaire 5/1/15 or 5/1/16?) Thank you,

Karen Morelli RN, BSN
Employee Health and Occupational Services Eastern Maine Healthcare Systems Phone 973-7335 Fax 973-7081 kmorelli at emh.org<mailto:kmorelli at emh.org>

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------------------------------

Message: 2
Date: Wed, 29 Apr 2015 12:57:30 +0000
From: "Tebolt, Allison" <ATebolt at Health-quest.org<mailto:ATebolt at Health-quest.org>>
To: 'MCOH/EH' <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Annual PPDQ's
Message-ID: <E416D5A497D18841AA6D6BA9279A5691F8B38EE4 at hqex2>
Content-Type: text/plain; charset="us-ascii"

I would forward them to the following year unless a known exposure within the organization.

Allison Tebolt, MSN, FNP-BC

Employee Health Coordinator
Vassar Brothers Medical Center
45 Reade Place
Poughkeepsie, NY 12601
(845) 483-6014
fax (845) 483-6109

From: MCOH-EH [mailto:mcoh-eh-bounces+atebolt=health-quest.org at mylist.net] On Behalf Of Morelli, Karen J
Sent: Wednesday, April 29, 2015 8:39 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Cc: Allard, Bonnie
Subject: [MCOH-EH] Annual PPDQ's

I am wondering how you handle annual ppd questionnaires for those who have had a +ppd or IGRA tuberculosis screening.  We perform our annual questionnaires on 5/1 of each year.  My question is if you hired someone in January, February, March or April and they filled out the questionnaire on hire, would you have them make out a new questionnaire with the annual May surveillance or would you put their next due date as 5/1 of the following year (example someone hired 2/1/15-next due date for questionnaire 5/1/15 or 5/1/16?) Thank you,

Karen Morelli RN, BSN
Employee Health and Occupational Services Eastern Maine Healthcare Systems Phone 973-7335 Fax 973-7081 kmorelli at emh.org<mailto:kmorelli at emh.org>

-------------------------------------------------------------------------------------------------------------------
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Message: 3
Date: Wed, 29 Apr 2015 09:00:17 -0400
From: "Senior, Cathy (DRMC)" <CESenior at phhealthcare.org<mailto:CESenior at phhealthcare.org>>
To: 'MCOH/EH' <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Annual PPDQ's
Message-ID: <222DF8583BBC7C4CB20DD7562B9DDD5E0F236761FB at ex07>
Content-Type: text/plain; charset="us-ascii"

We do the same here.  Do you require a past negative chest x-ray on start or do you do a chest x-ray on start and then do the tb f/u annually after that?

Cathy Senior RN BSN CDE
Employee Health Director
Penn Highlands DuBois
100 Hospital Avenue
P.O. Box 447
DuBois Pa 15801
Phone 814-375-3392
Fax 814-372-2610
cesenior at phhealthcare.org<mailto:cesenior at phhealthcare.org>
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Tebolt, Allison
Sent: Wednesday, April 29, 2015 8:58 AM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Annual PPDQ's

I would forward them to the following year unless a known exposure within the organization.

Allison Tebolt, MSN, FNP-BC

Employee Health Coordinator
Vassar Brothers Medical Center
45 Reade Place
Poughkeepsie, NY 12601
(845) 483-6014
fax (845) 483-6109

From: MCOH-EH [mailto:mcoh-eh-bounces+atebolt=health-quest.org at mylist.net] On Behalf Of Morelli, Karen J
Sent: Wednesday, April 29, 2015 8:39 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Cc: Allard, Bonnie
Subject: [MCOH-EH] Annual PPDQ's

I am wondering how you handle annual ppd questionnaires for those who have had a +ppd or IGRA tuberculosis screening.  We perform our annual questionnaires on 5/1 of each year.  My question is if you hired someone in January, February, March or April and they filled out the questionnaire on hire, would you have them make out a new questionnaire with the annual May surveillance or would you put their next due date as 5/1 of the following year (example someone hired 2/1/15-next due date for questionnaire 5/1/15 or 5/1/16?) Thank you,

Karen Morelli RN, BSN
Employee Health and Occupational Services Eastern Maine Healthcare Systems Phone 973-7335 Fax 973-7081 kmorelli at emh.org<mailto:kmorelli at emh.org>

-------------------------------------------------------------------------------------------------------------------
This email message, including any associated files, is for the sole use of the intended recipient(s) and may contain information that is confidential, privileged, or subject to copyright, trade secret or other protection. This message also may contain information protected by state and federal privacy laws that are enforced through serious civil and criminal sanctions. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not an intended recipient of this message, please notify the sender immediately by replying to this e-mail, and delete the original and all copies of this message from your computer or other device.

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To learn more about this policy and how to send and receive confidential and sensitive information, click Here<https://urldefense.proofpoint.com/v2/url?u=http-3A__userawareness.zixcorp.com_sites_index.php-3Fb-3D34097e0b8324f132014f612bd48e2492-26type-3D1-26p-3D0&d=AwICAg&c=aLnS6P8Ng0zSNhCF04OWImQ_He2L69sNWG3PbxeyieE&r=QrOvUjkDSNi5cIj0aanuZAiY9kpOePSAeEZ7suu85IU&m=bp8Mvl8TrvySCqvti6FTiAhT3hGLC_F6Bt4WLnwNDm8&s=6y3UbXQDL7k_rL8itStY9N0wh05Bj0bpn97xJc9pysw&e= > If you need assistance, please Send a message to the Help Desk<mailto:hqithelpdesk at health-quest.org> or call 845-483-6789.

The information contained in this e-mail is intended for the use of the named recipient only. It may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any use, dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify me immediately by using your reply option to advise me of such error. Thank you

This email and any attached files are confidential and intended solely for the intended recipient(s). If you are not the named recipient you should not read, distribute, copy or alter this email. Any views or opinions expressed in this email are those of the author and do not represent those of Penn Highlands Healthcare or its affiliates.. Warning: Although precautions have been taken to make sure no viruses are present in this email, the company cannot accept responsibility for any loss or damage that arise from the use of this email or attachments.

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Message: 4
Date: Wed, 29 Apr 2015 13:22:03 +0000
From: "Tebolt, Allison" <ATebolt at Health-quest.org<mailto:ATebolt at Health-quest.org>>
To: 'MCOH/EH' <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Annual PPDQ's
Message-ID: <E416D5A497D18841AA6D6BA9279A5691F8B38F3C at hqex2>
Content-Type: text/plain; charset="us-ascii"

If they have had one in the past year, we accept that. If not, we complete at time of hire and then do an annual questionnaire.

Allison Tebolt, MSN, FNP-BC

Employee Health Coordinator
Vassar Brothers Medical Center
45 Reade Place
Poughkeepsie, NY 12601
(845) 483-6014
fax (845) 483-6109

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Senior, Cathy (DRMC)
Sent: Wednesday, April 29, 2015 9:00 AM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Annual PPDQ's

We do the same here.  Do you require a past negative chest x-ray on start or do you do a chest x-ray on start and then do the tb f/u annually after that?

Cathy Senior RN BSN CDE
Employee Health Director
Penn Highlands DuBois
100 Hospital Avenue
P.O. Box 447
DuBois Pa 15801
Phone 814-375-3392
Fax 814-372-2610
cesenior at phhealthcare.org<mailto:cesenior at phhealthcare.org>
https://urldefense.proofpoint.com/v2/url?u=http-3A__www.phhealthcare.org&d=AwICAg&c=aLnS6P8Ng0zSNhCF04OWImQ_He2L69sNWG3PbxeyieE&r=QrOvUjkDSNi5cIj0aanuZAiY9kpOePSAeEZ7suu85IU&m=bp8Mvl8TrvySCqvti6FTiAhT3hGLC_F6Bt4WLnwNDm8&s=LKcnfyL1RgGSJmdAKdwzpnsl6_9P1SUiV0tTpdvN448&e=

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Tebolt, Allison
Sent: Wednesday, April 29, 2015 8:58 AM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Annual PPDQ's

I would forward them to the following year unless a known exposure within the organization.

Allison Tebolt, MSN, FNP-BC

Employee Health Coordinator
Vassar Brothers Medical Center
45 Reade Place
Poughkeepsie, NY 12601
(845) 483-6014
fax (845) 483-6109

From: MCOH-EH [mailto:mcoh-eh-bounces+atebolt=health-quest.org at mylist.net] On Behalf Of Morelli, Karen J
Sent: Wednesday, April 29, 2015 8:39 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Cc: Allard, Bonnie
Subject: [MCOH-EH] Annual PPDQ's

I am wondering how you handle annual ppd questionnaires for those who have had a +ppd or IGRA tuberculosis screening.  We perform our annual questionnaires on 5/1 of each year.  My question is if you hired someone in January, February, March or April and they filled out the questionnaire on hire, would you have them make out a new questionnaire with the annual May surveillance or would you put their next due date as 5/1 of the following year (example someone hired 2/1/15-next due date for questionnaire 5/1/15 or 5/1/16?) Thank you,

Karen Morelli RN, BSN
Employee Health and Occupational Services Eastern Maine Healthcare Systems Phone 973-7335 Fax 973-7081 kmorelli at emh.org<mailto:kmorelli at emh.org>

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Subject: Digest Footer

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Subject: Digest Footer

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