[MCOH-EH] Respirator fit testing

[Abhijay Karandikar]

 As hospitals become "health care systems" having a larger footprint and encompassing multiple facilities, what is the current consensus or thoughts regarding initiating and/or maintaining a respiratory protection program (RPP) for outpatient facilities such as system owned or affiliated urgent care centers, medical practices, etc? Specifically, I would very much be interested in knowing if you are including your clinics and community based urgent care centers in your annual respirator fit testing programs. If yes, how do you implement this - have them come to the hospital EH department, have local fit testers doing this, etc? If not, is there a plan for "just in time" fit testing based on pandemics or new/emerging infections, such as the current novel coronavirus?

As an aside, do you fit test your own occupational health / employee health departments / clinics?

Would appreciate any and all feedback! 

Abhijay

Abhijay P. Karandikar, MD, MPH, FACOEM
     On Thursday, January 16, 2020, 10:45:30 AM EST, Cockrum, MD David S <dcockrum at frhs.org> wrote:  
 
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The intent of the Respiratory Protection Program is to protect all HCWs who might come into contact with a patient that has an airborne transmissible disease (ATD, in CDC parlance). This can extend to any HCW that might enter the patient care area, even briefly – so dietary, lab, x-ray, etc should be included. A thorough program will need to include ALL HCWs with potential exposure – which can be a challenge to interpret how far this extends. Hopefully you have close collaboration with the Infection Control team as well as Safety experts.
 
  
 
In some institutions, the responsibility for compliance falls on management. In these places, the Employee Health (or equivalent) is responsible for communicating to the department heads who has been fit tested, and the managers ensure that their employees get it done. In other institutions, the entire responsibility falls on EH. I tend to prefer the former – let the managers do what they are paid to do, and that is manage their own employees, to include ensuring that employees are compliant with EH requirements (fit testing, flu shots, etc).
 
  
 
How you structure your program to make that happen is up to you, and meeting the challenge of a mobile employee population can be difficult. Your program has to be tailored to the needs of your own organization – I suspect there are about 20 correct answers to this challenge.
 
  
 
A long, but thorough, treatise on this topic may be found here:https://www.cdc.gov/niosh/docs/2015-117/pdfs/2015-117.pdf?id=10.26616/NIOSHPUB2015117
 
  
 
Hope this helps a bit.
 
  
 
David
 
  
 
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From: MCOH-EH [mailto:mcoh-eh-bounces+dcockrum=frhs.org at mylist.net]On Behalf Of Massey-Jenkins, Angela M
Sent: Wednesday, January 15, 2020 5:39 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: [MCOH-EH] RFT
 
  
 
This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. If you suspect the content of this email is malicious, please forward the email to abuse at frhs.org .
 
 
 
I was wondering what method other facilities are using in determining # of employees should be fit tested to support  # of negative airflow rooms on a particular unit?  I can’t find any regulatory guidelines on this, and considering it is necessary to fit test all employees, 100% of them, in a particular unit that have a negative airflow rooms, but maybe a portion of them, which would also make it more difficult to track.  Which brings me to my next question, how do you track these employees to ensure compliancy if it isn’t 100% of the entire dept., with employee movement from one dept to another?  We have a very large system, approx. 30,000 employees, total.   
 
  
 
Thanks for any feedback.
 
  
 
Angela Massey-Jenkins, RN, BSN
 
AHC EOHS-Clinical Operations Manager
 
IU Health
 
317.962.2563
 
  
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