[MCOH-EH] Respirator fit testing

[Higazi, Patricia]

We do include our pediatric urgent cares and specialty clinics.  They purchase a central disposable respirator fit test kit (we use 3M) and occupational health trains multiple fit testers for their areas.  They can decide who to do annually and who can do “just in time”.  Urgent cares are by default annual.  We do their medical clearance through an online app (our IT created), so there is no HIPAA violation, education for those with access to Healthstream is via online CBT.
For those without Healthstream access they view a powerpoint and sign and date that they have reviewed and have no questions.  This is handed to the fit tester.  Education records are maintained within their department.

Patricia Higazi  MSN RN COHN
Occupational Health Director
Children’s Hospital of The King’s Daughters
Norfolk, Virginia 23507
Tel: 757 668 7852
Fax: 757 668 8775

Occupational Health has MOVED to Medical Tower I, 5th Floor




From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Patricia L. Stupfel
Sent: Thursday, January 23, 2020 5:48 PM
To: MCOH-EH
Subject: Re: [MCOH-EH] Respirator fit testing


External:


I would appreciate feedback on this as well, particularly as it pertains to the current novel coronavirus and potential future pandemics.  Thanks for posing the question.

Patricia Stupfel, MSN, ANP-C
Nurse Practitioner
Employee Health

SALEM HEALTH
Hospitals & Clinics
Patricia.Stupfel2 at salemhealth.org<mailto:Patricia.Stupfel2 at salemhealth.org>
1002 Bellevue St. S.E. | Salem, OR 97301
Phone: 503-814-7252
Fax: 503-814-7253



From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of Abhijay Karandikar via MCOH-EH
Sent: Thursday, January 23, 2020 9:42 AM
To: MCOH-EH <mcoh-eh at mylist.net>
Cc: Abhijay Karandikar <dr_abhik at yahoo.com>
Subject: Re: [MCOH-EH] Respirator fit testing

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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<mailto:dcockrum at frhs.org>> wrote:



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<https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cdc.gov_niosh_docs_2015-2D117_pdfs_2015-2D117.pdf-3Fid-3D10.26616_NIOSHPUB2015117&d=DwMFaQ&c=QJ58bBQqmBpRvQu0jO8J9K23JIZMXnhfemqUWyE_uOk&r=I9hIU6uiJ_GOcZJDqFSrEJMBH4pupH77eeO805YQPhO55QEQXQ7kfP211kky4Glo&m=Nl-HXPTUFMP8oZKAJtQJRvljaBDC-DIP2URlGRrUB3I&s=nSVPEkRkIfEpbqgA4NbB2QAUX_husS_ydrUckc682Xg&e=>



Hope this helps a bit.



David


DAVID​


COCKRUM

,

MD



Physician

Faith Regional Physician Services

Occupational Health



[cid:image001.png at 01D5D2B2.B1ACEF50]

(402) 844 8300




[cid:image002.png at 01D5D2B2.B1ACEF50]

2024 Pasewalk Avenue, Suite 2

,

Norfolk

,

NE



68701




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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<mailto:mcoh-eh at mylist.net>>
Subject: [MCOH-EH] RFT



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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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