care worker respirator protection employee health workstation
DESCRIPTION
TRANSCRIPT
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Employee Health
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a Health Care Worker
GUIDE for RESPIRATORY PROTECTION
RESPIRATORY PROTECTIONfor TUBERCULOSIS
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Tuberculosis is a contagious bacterial disease. Tuberculosis is spread by the respiratory route: TB bacteria contaminate droplets that get into the air when a patient with the disease speaks, coughs, or sneezes. A person breathes in these droplets from the air. If you inhale the Tuberculosis bacteria, you may get infected but not get sick with TB disease. A tuberculosis infection can be detected with a PPD (tuberculosis skin test). Tuberculosis disease is potentially severe and usually affects the lungs but may affect other organs.
HCW = Healthcare Worker
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SYMPTOMS OF TUBERCULOSIS
chronic cough
unexplained weight loss fever night sweats
coughing up bloodWhat is the difference between TUBERCULOSIS INFECTION and TUBERCULOSIS DISEASE?
NOT INFECTED
INFECTED No DISEASE
INFECTED +
DISEASE
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NOT
INFECTED
PPD NEGATIVE
Chest X-RAY NEGATIVE
NOT
CONTAGIOUS
NO RESPIRATOR REQUIRED
PATIENTHEALTHCARE
WORKER
N95
PPD
X-RAY
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N95
HEALTHCARE WORKER
PPD POSITIVE
PPD
INFECTEDNO
DISEASE
Chest X-RAY NEGATIVE
X-RAY
NO RESPIRATOR REQUIRED
NOT
CONTAGIOUSPATIENT
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CONTAGIOUS
Chest X-RAY POSITIVE
PPD POSITIVE
INFECTED+
DISEASE
X-RAY RESPIRATOR REQUIRED
N95
HEALTHCARE WORKER
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The FIRST STEP
in preventing the spread of TB
is to quickly identify
isolate and
treat contagious patientsPREVENTION MEASURES
TB patients are put in rooms with special ventilation systemsBUT
When you are in close contact with a contagious TB patient
RESPIRATORS ARE NECESSARYTO PROTECT YOU
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RESPIRATOR DEFINITION
Respirators are protective equipment that are designed to protect the wearer against harmful airborne agents. A seal is formed between face and the respirator.
Because the surgical mask does not fit tightly to the face it does not provide good protection against airborne hazards.
A surgical mask is not a respirator
REQUIREMENTS Wearing a respirator reduces your chances of becominginfected with TB. The Hospital Infection Control committeedetermines when a healthcare worker must wear a respirator. The Occupational Safety and HealthAdministration (OSHA) regulates the use ofrespirators. NIOSH approves respirators for use.
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Respirator Types-Air purifying respirators filter out harmful agents from the air -Air supplying respirators supply clean air to the person for breathing
Healthcare workers wear AIR PURIFYING respirators to protect against TB. OSHA requires the use of certified respirators when respiratory protection is needed. The National Institute for Occupational Safety and Health (NIOSH) gives each certified respirator and certification number which is usually present on the respirator or attached on an instruction sheet.
AS WITH ALL PERSONAL PROTECTION EQUIPMENT
RESPIRATORS MUST BE USED CORRECTLY
TO PROVIDE THE HEALTHCARE WORKER WITH THE BEST PROTECTION
TRAINING AND EDUCATION ARE KEY FOR YOUR PROTECTION
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Respirator Training
Procedures for
selectingrespirators
MedicalEvaluations
forrespirator
users
FitTesting
Proceduresfor
respiratorusers
Proceduresfor
Properuse of
respirators
Proceduresfor
CleaningStoring
InspectingDiscardingRespirators
Topics to cover
RESOURCESISOLATIONSIGNS
forAIRBORNE
PRECAUTION
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Respirator TrainingProcedures
forselecting
respirators
N-95 The respirator to use when
respiratory protection for Tuberculosis is needed.
N95
HEALTHCARE WORKER
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Respirator TrainingMedical
Evaluations for
respiratorusers
Employee Health will provide a medical evaluationto determine the HCW ability to use a respirator.This is done before the employee is fit tested oris required to use the respirator.
Using a respirator may place a physiological burden on the HCW that varies with the type of respirator worn, job conditions, and medical status of the HCW. A licensed health care professional will perform the evaluation using a medical questionnaire. The contents of the medical questionnaire are mandated by OSHA. This questionnaire is administered to the HCW in a confidential manner and the HCW can request to discuss the results of the medical evaluation with the licensed health care professional. EMPLOYEE HEALTH will provide the HCW with a WRITTEN STATEMENT regarding the outcome of the MEDICAL EVALUATION.
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Respirator TrainingMedical
Evaluations for
respiratorusers
FOLLOW UP MEDICAL EVALUATIONS are performed:
1- if HCW reports medical signs or symptoms that are related to ability to use the respirator. 2- if the supervisor informs Employee Health of the need for re-evaluation3- if information from the respirator program monitoring activities indicates a need for re-evaluation4- if the workplace conditions significantly change
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Respirator TrainingFitTesting
Proceduresfor
respiratorusers
FIT TEST procedure is done:
1- before initial use of the respirator
2- whenever a different size, style, model or make of respirator is used
3- if HCW has a change in facial structure such as: facial trauma, facial surgery, loss of body weight, or dental changes.
4- if the HCW worker notifies the employer that the respirator fit is unacceptable.
5- at least annually
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Respirator TrainingFitTesting
Proceduresfor
respiratorusers
FIT TESTING is done using an OSHA accepted qualitative fit test procedure.
N95
HEALTHCARE WORKER puts on the RESPIRATOR -- a HOOD is applied over the head of the HCW -- sweet tasting aerosol mist is introduced into the hood -- if the seal is tight the HCW should not experience any sweet taste. The test simulates activities such as turning the head, talking, and other possible activities that might occur during job tasks.
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
1. Separate the mask to fully open
2. Gently bend the nose piece to conform the mask to face
3. Hold mask upside down to expose the two head bands
4. Separate the head bands with the index fingers
5. Cup the mask under chin - ORANGE side out
6. Bring the head bands over the head
7. Place first head band at neck - pull the second head band up and place at crown of head
8. Form nose piece across bridge of nose for tight fit
N95
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
1. Separate the mask to fully open N95
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
2. Gently bend the nose piece to conform the mask to face
N95
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
3. Hold mask upside down to expose the two head bands
N95
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
4. Separate the head bands with the index fingers
N95
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
5. Cup the mask under chin - ORANGE side out
N95
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
6. Bring the head bands over the head
N95
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
7. Place first head band at neck - pull the second head band up and place at crown of head
N95
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Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
8. Form nose piece across bridge of nose for tight fit
N95
8
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Each time the HCW enters the contaminated area, face seal should be checked to make sure the fit is tight. Adjust the nosepiece if there is air leakage aroundthe nose.Reposition head bands to secure facial seal aroundthe edges of respirator.
Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR USING THE RESPIRATOR
IT IS THE HEALTHCARE WORKER’S RESPONSIBILITYTO OBTAIN A PROPER FIT EACH AND EVERY TIME.
IF YOU DO NOT OBTAIN A PROPER FIT, DO NOT ENTER THE ISOLATION AREA.
N95
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Facial hair will make the seal looseand will not provide protectionfrom harmful airborne hazards
Even one or two days beard growthcan effect the seal.Male HCWs should be clean shavenThis to ensure that the respirator is fully protective.
Respirator TrainingProcedures
forProperuse of
respirators
DIRECTIONS FOR USING THE RESPIRATOR
HEALTHCARE WORKER
N95
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Respirator TrainingProceduresfor
CleaningStoring
InspectingDiscardingRespirators
Respirators used for TB protection are disposable.
DISPOSE of used respirators in the biohazard container outside the isolation roomDo not attempt to clean the respirator.
If the respirator become soiled or wet, it should be changed.If the respirator gets a hole in the face piece, it should be changed.If the elastic head bands break, the respirator should be changed.
Respirators should not be shared between employees.Respirators should be stored in a clean dry container.
INSPECTIONRespirators should be inspected prior to use.
Make sure the face piece has no defect: such as a rip or tear.Inspect the elastic head straps to make sure they are not defective.
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ISOLATIONSIGN for
AIRBORNEPRECAUTION
STOP ISOLATION STOP
PLEASE READ PRECAUTIONS BEFORE ENTERING
AIRBORNE YES NO YES XXXX
PRIVATE
CONTACT YES YES NO XXXX
PRIVATE
DROPLET YES NO YES XXXX
PRIVATE
An ISOLATION SIGN as this one will appear on the entrance to the patient room. Instructions for personal protective equipment are listed on the card. TAKE NOTE and FOLLOW THE INSTRUCTIONS
PRECAUTIONS GLOVES GOWNS MASKS TRANSPORT ROOM
Respirator Training
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RESOURCESPROGRAM ADMINISTRATOR -- Iva Jones, RN CIC
INFECTION CONTROL
www.osha-slc.gov/OshStd_data/1910)0134.html
www.cdc.gov/nchstp/tb/pubs/corecurr.htm
www.cdc.gov/niosh/tb.html
American Lung Association -- 1-800-586-4872
St. Louis City Health Department -- 314-658-1128
St. Louis County Health Department -- 314-522-6410 -- 314-842-1300
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Employee Health