Medical Environment Update—Just-in-time fit testing offers quick, easy solution

By: July 6th, 2009 Email This Post Print This Post

The influenza outbreak this spring served as wake-up call for respiratory protection plans, reports the July issue of Medical Environment Update.

When influenza A H1N1, or swine flu, hit Mexico and subsequently the United States, there were two priorities for safety officers healthcare facilities:

  • Mitigate the spread of disease
  • Ensure protection of healthcare workers so they felt safe to come to work

For many facilities, that meant developing a way to quickly fit test employees for N95 respirators. Numerous surveys have already found that a portion of the healthcare work force would not come in during a pandemic due to fear for their own health or the health of their family, so having a plan in place that is part of your pandemic planning will help ensure protection and provide reassurance for workers.

With the initial swine flu scare largely behind us, health officials are concerned about its resurgence in the fall and winter months, when flu season is in full force. An escalated flu season could affect physician offices and outpatient clinics as much as hospitals since patients will likely consult their primary care physician before an emergency room.

Although the outbreaks served as an opportunity to fit test employees who typically get a pass on annual testing, for others it was a wake-up call to implement a plan that provides employee protection during a pandemic. Doing so will help prevent the spread of the disease and protect your work force, says Bruce E. Cunha, RN, MS, COHN-S, manager of employee health and safety at the Marshfield (WI) Clinic.

“We want to make sure we are taking care of our patients and taking care of our employees,” Cunha says.

The Medical Environment Update article explains how to establish a just-in-time program, and how to incorporate it into your employee training.

The July issue also includes:

  • Details on California’s aerosol transmissible disease standard and what it may mean for federal OSHA
  • Survey report on outpatient MRI infection control problems
  • Notes from the field on glutaraldehyde safety
  • Quick self-inspection checklist for your emergency action plan
  • Ask the expert Q&As on filing OSHA paperwork, under the sink storage, and postexposure management and employee termination
  • A quiz designed to test your understanding of OSHA standards and government regulatory guidelines applying to healthcare facilities covered in this issue of the newsletter


I thought in a previous article sent out by you (not sure about that) but the point made was that N95 were not necessary. This whole fit testing need will only increase costs for primary care doctors who are barely making it now if they service the underserved.
We need to emphasize good handwashing and “cover your cough” techniques to our staff.

By David LaHoda on July 15th, 2009 at 11:48 am

There is debate among the CDC and SHEA about the transmission dynamics of novel influenza A H1N1 and the necessity of N95 respirator use.

Also, it depends on your facility-specific risk and your pandemic influenza policy.

If your practice is such that it will not be accepting patients presenting with flu-like symptoms, then your respiratory protection policy, including the need for wearing respirators, will certainly be simplified.

If your practice treats for flu symptoms, then respirator use will probably be necessary.

By Margaret DeBacco on July 16th, 2009 at 1:28 pm

SHEA said N95 masks are not required for H1N1. That surgical masks would suffice. I consult for a physical rehabilitation facility that does not have negative air pressure rooms, therefore fit testing and N95 masks are not required.
Should their policy for H1 N1 be revised to say they will not accept those patients and will transfer out anyone has H1N1?

By David LaHoda on July 16th, 2009 at 1:51 pm

Despite what SHEA recommends, the CDC’s Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission still calls for healthcare workers caring for persons with known, probable or suspected novel H1N1 or influenza-like illness to wear a respirator, not a face mask.

See Table 1 of the guidance. It gives respiratory protection recommendations for home, community and occupational settings.


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