Evaluation of respiratory protection programs and practices in California hospitals during the 2009-2010 H1N1 influenza pandemic

• Published in: American journal of infection control 2013-11, Vol.41 (11), p.1024-1031
• Main Authors: Beckman, Stella, MPH, Materna, Barbara, PhD, CIH, Goldmacher, Suzi, RN, Zipprich, Jennifer, PhD, D'Alessandro, Maryann, PhD, Novak, Debra, RN, DSN, Harrison, Robert, MD, MPH
• Format: Article
• Language: English
• Subjects: Aerosol transmissible disease; Biological and medical sciences; California - epidemiology; Cross Infection - epidemiology; Cross Infection - prevention & control; Epidemiology. Vaccinations; General aspects; Health care; Hospital; Hospitals; Human viral diseases; Humans; Infection Control; Infectious Disease; Infectious diseases; Influenza A Virus, H1N1 Subtype - isolation & purification; Influenza, Human - epidemiology; Influenza, Human - prevention & control; Medical personnel; Medical sciences; N95 respirator; Pandemics; Preparedness; Public health; Respiratory Protective Devices - utilization; Swine flu; Viral diseases; Viral diseases of the respiratory system and ent viral diseases
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2013.05.006

Background Emergence of the novel 2009 influenza A H1N1 virus in California led to an evaluation of hospital respiratory protection programs (RPPs) and practices by the California Department of Public Health during the 2009-2010 influenza season. Methods Onsite evaluation of 16 hospitals consisted of interviews with managers and health care workers about RPPs and practices, review of written RPPs, and limited observations of personnel using respirators. Data were analyzed using descriptive statistics. Results All hospitals had implemented policies requiring the minimum use of N95 filtering facepiece respirators when working with patients with H1N1 virus infection; 95.5% of health care workers (n = 199) reported they would wear at least this level of protection when in close contact with a patient with confirmed or suspected H1N1 virus infection. However, evaluation of written RPPs indicated deficiencies in required areas, most commonly in recordkeeping, designation of a program administrator, program evaluation, employee training, and fit testing procedures. Conclusions Health care workers were aware of respiratory protection required when providing care for patients with confirmed or suspected H1N1 virus infection. Hospitals should improve written RPPs, fully implement written procedures, and conduct periodic program evaluation to ensure effectiveness of respirator use for health care worker protection. Increased accessibility of resources tailored for hospital respirator program administrators may be helpful.