Tips and Tools for Creating a Respiratory Protection Plan

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					  Tips and Tools for
Creating a Respiratory
   Protection Plan

  Denice Tracy, RN, PHN, BSN
   Vicki Schrupp, CRT, RCP
          May 1, 2007
Introduction

   Denice Tracy, Disease Prevention &
    Control Coordinator, Wright County
    Public Health
   Vicki Schrupp, Emergency
    Preparedness Outreach Coordinator,
    Central MN Region
Overview

   History
   How to develop your respiratory
    protection program
   How to implement your program
   Resources
   Stay up to date
History

   Wright County Emergency Medical
    Services (EMS) Advisory Committee
   Central MN Regional Hospital Resource
    Center (RHRC)
References
 U.S. Department of Labor
Occupational Safety and Health Administration
  (OSHA)
www.osha.gov
 Centers for Disease Control and Prevention
  (CDC)
www.cdc.gov
 U.S. Food and Drug Administration (FDA)
www.fda.gov
 Minnesota Department of Health (MDH)
www.health.state.mn.us
Purpose & Disclaimer

   Intended as a Guide
   Agencies need to develop a program
    that meets THEIR OWN needs
   Materials in the program are examples
   Encourage to work with community,
    regional, state & federal partners
Reviewed & Field Tested

 Reviewers
 Wright County First Responders:
  Fire, EMS, Law
  Developing YOUR Own
        Program
4 Sections
1. Policy & Procedures

2. Medical Evaluation

3. Education

4. Fit Testing
     1. Policy & Procedures
            Templates
   Agency specific: EMS, Fire, Law,
    Medical Clinics, Hospitals
   Referenced
   Covers all OSHA required components
    for respiratory protection
   Appendixes
   Can personalize to your agency/dept
       Written Policy &
    Procedure Components
   Program Administration
   Program Scope/Application
   Identifying Work Hazards
   Respirator Selection
   Medical Evaluations
   Fit Testing
   Proper Respirator Use
   Cleaning and Disinfecting
   Inspecting, Maintenance and Repairs
   Respirator Training
   Evaluating/Updating Program
   Roles and Responsibilities
   Documentation and Recordkeeping
Identifying Work Hazards
               Appendix A


Highest Risk
                              Direct
                              Patient
                               Care




                       Direct Patient Contact




                              All Staff


Lowest Risk
                            Guide on Surgical Mask, N95
                              Respirator or PAPR Use
                                                       Appendix B
S
t   Will worker be within three feet                                                                   Worker should use a
a   or a confined space (vehicle) of
                                             Will worker perform a procedure that will produce   Yes   N95 respirator & full
r   a patient who is coughing,          No   respiratory secretions or induce coughing or              face shield.
    sneezing or has a runny nose?
                                             sneezing in the patient?
t                   OR
    Does patient have a known
                                                                                                 No    Worker does not need
    infectious respiratory disease?                                                                    a surgical mask or N95
                                                                                                       respirator.
                                                                 Worker should use a
                   Yes                                           N95 respirator & full
                                                                 face shield.
    Can the patient wear a surgical mask*
    or cover their cough/sneeze without        No
    compromising their breathing?
                                                                 Worker should use a
                                                                 N95 respirator & full
                   Yes                                           face shield
                                                 Yes
    Are there known infectious diseases                          Worker does not
    currently in the community? Suspected                        need a surgical mask
    special pathogen involved?                   No              or N95 respirator.
Other Sample Templates

   MDH: Public Health Respiratory
    Protection Program Template
    www.health.state.mn.us/divs/idepc/dtopics/i
    nfectioncontrol/rpp/template/index.html
   3M Administrative Respiratory Protection
    Program
    Call your 3M representative or Helpline at
    1-800-228-3957
Evaluating/Updating
Program Component
Program Survey Appendix E
      2. Medical Evaluation
           Component
   Questionnaire (or medical exam)
   Reviewed by physician or other
    licensed health care professional
   Rationale (Allina Hospitals & Clinics)
   Frequency
Medical Evaluation
  Questionnaire
     Appendix C
Medical Evaluation
  Questionnaire
 Appendix C (continued)
Medical Evaluation
  Questionnaire
 Appendix C (continued)
     Other Sample Medical
         Evaluations
   OSHA Medical Evaluation:
    www.osha.gov/pls/oshaweb/owadisp.show_d
    ocument?p_table=STANDARDS&p_id=9783
   3M On-Line Respirator Medical Evaluation:
    www.respexam.com or call 1-800-383-3393
   3M Mail-In Respirator Medical Evaluation:
    Fax 1-877-609-3832 or mail
    3. Respirator Training -
    Education Component
   Infection Control (not an OSHA requirement)
   Identify hazards, potential exposure to these
    hazards, and health effects of hazards.
   Respirator fit, improper fit, usage, limitations, and
    capabilities for maintenance, usage, cleaning and
    storage.
   Emergency use if applicable.
   Inspecting, donning, removal, seal check and
    troubleshooting.
   Explaining respirator program (policies, procedures,
    OSHA standard, resources).
Infection Control Tools
   MDH/CDC Disease Fact Sheets
    examples: Pertussis
    www.health.state.mn.us/divs/idepc/diseases/pertussis/pfacts.pdf
    example: Anthrax – EMS
    www.health.state.mn.us/oep/training/bhpp/docs/Anthraxrevised_6-15-06.pdf
   MDH Infection Control Precautions for Avian
    Influenza (Standard & Full Barrier
    checklists)
    Full: www.health.state.mn.us/divs/idepc/diseases/flu/avian/hcp/fullbarrier.pdf
    Standard:
    www.health.state.mn.us/divs/idepc/diseases/flu/pandemic/plan/icstandard.pd
    f
   MDH Infection Control website:
    www.health.state.mn.us/divs/idepc/dtopics/infectioncontrol/index.html
Infection Control Tools
Online Education Tools

   MDH Respiratory Protection Training
    Toolkit:
    www.health.state.mn.us/oep/training/bhpp/documents/Toolkit
    -RespiratoryProtection.pdf

   MDH – EMS training
    www.health.state.mn.us/oep/training/bhpp/hosp-ems.html

   3M Health & Safety Services – Respiratory
    Protection e-Training and Instructions
    www.respexam.com
              Audio-Visual
             Education Tools
   DVD (clinic/hospital): MDH “Protect Yourself
    First”
   4 Videos (First Responders): MDH “Public
    Safety Preparedness in the Age of Bioterrorism,
    SARS, and Other Emerging Health Threats”
   3 Power Point Presentations:
     – Personal Protective Equipment N95 Respirators
       (Stearns County Public Health)
     – Preventing Infection: Infection Control for Pre-
       hospital Providers (MDH)
     – OSHA’s Respiratory Protection Standard:
      Healthcare, Public Health & Public Safety
      Settings (MDH)
   Posters
Respirator Selection

www.cdc.gov/niosh/npptl/topics/respirat
 ors/disp_part/n95list1.html
4. Fit Testing Component
        Appendix D
Fit Testing Component
     Rainbow Passage
Fit Testing Component
   Qualitative Fit Test Form
    Fit Testing Component
   3M Products
    – Memos (i.e. Fit Test Policy for Persons with
      Facial Hair)
    – Instruction Sheets
    – Forms & Certificates
    – Poster Cards (How to apply & remove N95
      respirators)
    – Video or DVD: “First Responder/First Receiver
      Training” & “3M Health Care - Respirator Fitting
      Instructions & Qualitative Fit Test”
    How will these Respiratory
     Protection Programs be
            available?
 Order CD/DVD from Wright
  County – sign up sheet
 Central Minnesota Bioterrorism
  Task Force – download
  information at www.cmbpp.org
       Staying Current

We are providing you with a base to
 develop your program. It is your
 responsibility to stay current as
 requirements, guidelines,
 recommendations and standards of
 practice may change in the future.
Questions?
Thank You!