Characteristics Associated With Health Care Worker Knowledge and Confidence in Elastomeric Half-Mask Respirator Use

Thurman, Paul; Zhuang, Eileen; Chen, Hegang H.; McClain, Caitlin; Sietsema, Margaret; Fernando, Rohan L.; McDiarmid, Melissa A.; Hines, Stella E.

doi:10.1097/jom.0000000000002611

Cited by 3 publications

(10 citation statements)

References 35 publications

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“…Prior literature suggests that video‐based respirator education may predict better performance months later compared to printed training materials 39 . Use of a practice or competence validation would have clarified the effectiveness of the disinfection training modalities at both sites and should be studied in future respiratory protection studies 37 . While 74% reporting of recall of training in disinfection was imperfect, this percentage is similar in scale to prior studies of HCP recall of annual respirator training 40 .…”

Section: Discussionmentioning

confidence: 54%

“…Additionally, workers in these environments may perceive greater risks to occupational exposures and greater knowledge and confidence with EHMR use, influencing compliance with expected protocols. 27,32,37 Similar factors might relate to understanding risks that a contaminated respirator may pose to a user, also influencing compliance with disinfection practices. medical/surgical units reported centralized disinfection less often, likely reflecting similar behavioral drivers.…”

Section: Discussionmentioning

confidence: 99%

“…39 Use of a practice or competence validation would have clarified the effectiveness of the disinfection training modalities at both sites and should be studied in future respiratory protection studies. 37 While 74% reporting of recall of training in disinfection was imperfect, this T A B L E 3 Odds of using central sterile processing for disinfection (n = 1026). percentage is similar in scale to prior studies of HCP recall of annual respirator training.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the higher acuity of patient care needs in ICU/ED environments, it is possible that HCP experience more frequent use of respiratory protection, with potentially more risk and perhaps more direct oversight. Additionally, workers in these environments may perceive greater risks to occupational exposures and greater knowledge and confidence with EHMR use, influencing compliance with expected protocols 27,32,37 . Similar factors might relate to understanding risks that a contaminated respirator may pose to a user, also influencing compliance with disinfection practices.…”

Section: Discussionmentioning

confidence: 99%

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Elastomeric half‐mask respirator disinfection practices among healthcare personnel

Hines,

Thurman,

Zhuang

et al. 2023

American J Industrial Med

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BackgroundDisposable N95 respirator shortages during the COVID‐19 and 2009 H1N1 influenza pandemics highlighted the need for reusable alternatives, such as elastomeric half‐mask respirators (EHMRs). Two US medical organizations deployed reusable EHMRs during the COVID‐19 response. In addition to wipe‐based disinfection following patient care episodes expected per local policies at both organizations, postshift centralized cleaning and disinfection (C&D) was expected at one site (A), permitting shared‐pool EHMR use, and optional at the other (Site B), where EHMRs were issued to individuals. Using a survey, we evaluated disinfection practices reported by EHMR users and predictors of disinfection behaviors and perceptions.MethodsSurveys assessed EHMR disinfection practices, occupational characteristics, EHMR use frequency, training, and individual‐issue versus shared‐pool EHMR use.ResultsOf 1080 EHMR users completing the survey, 76% reported that they disinfect the EHMR after each patient encounter, which was the expected practice at both sites. Increasing EHMR use, recall of disinfection training, and work in intensive care or emergency settings significantly influenced higher reporting of this practice. 36% of respondents reported using centralized C&D, although reporting was higher at the site (A) where this was expected (53%). Confidence in cleanliness of the EHMR following centralized C&D was not influenced by individual versus shared‐pool EHMR issue.ConclusionsMost EHMR users reported adherence with expected post‐care individual‐based disinfection of EHMRs but did not necessarily use standardized, centralized C&D. Future efforts to limit reliance on behavior related to respirator disinfection may improve EHMR implementation in healthcare to avert dependence on single‐use, disposable N95 respirators.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Elastomeric half‐mask respirator disinfection practices among healthcare personnel

Hines,

Thurman,

Zhuang

et al. 2023

American J Industrial Med

Self Cite

View full text Add to dashboard Cite

show abstract

“…Research has addressed the importance of confidence in the efficacy of respirators (disposable and reusable) both prior to and during the COVID-19 pandemic [8,[13][14][15]. However, this research was completed prior to manufacturer development and NIOSH approval of EHMRs without an EV/with an EVF.…”

Section: The Importance Of Building Confidence In Respiratory Protectionmentioning

confidence: 99%

Examining the Roles of Training, Fit Testing, and Safety Climate on User Confidence in Respiratory Protection: A Case Example with Reusable Respirators in Health Delivery Settings

Edirisooriya,

Haas

2023

Sustainability

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A lack of confidence in the efficacy of respiratory protection can contribute to uncertainty among workers and cast doubt on workplace safety. To date, no research has been conducted to study and understand the introduction of elastomeric half-mask respirators (EHMRs)—without exhalation valves (EVs) or with exhalation valve filters (EVFs), both representing new designs that address source control—in the workplace. To study this issue, researchers collaborated with partners at 32 health delivery settings that received EHMRs from the Strategic National Stockpile during the COVID-19 pandemic. EHMR users (n = 882) completed an online survey between October 2021 and September 2022. Analyses demonstrated that employees were statistically significantly more confident in the efficacy of EHMRs with no EV/with an EVF (including the efficacy in protecting the user from COVID-19) if they had been fit tested and received training. Respondents were also statistically significantly more confident in the efficacy of their EHMR if they had a more positive perception of their organization’s safety climate. The results provide insights for tailored fit testing and training procedures as manufacturers continue to improve respirator models to enhance worker comfort and use. Results also show that, even during a public health emergency, the role of safety climate cannot be ignored as an organizational factor to support worker knowledge, attitudes, and participation in health and safety behaviors specific to respirator use.

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Identifying leadership practices to support the uptake of reusable elastomeric half mask respirators in health delivery settings

Haas,

Furek,

Greenawald

2024

Healthc Manage Forum

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An increase in reusable elastomeric half mask respirators among healthcare personnel has been documented during pandemic emergencies; however, research has not detailed leadership practices to support their use. Forty-three organizations implemented EHMRs received from the United States federal government which prompted interviews with 73 individuals who managed respirator distribution and fit testing between October 2021 and November 2022. Interview data was qualitatively analyzed. Themes around organizational culture and leadership practices emerged when discussing how elastomeric half mask respirators were integrated into health delivery settings including communication and outreach methods to aid worker support. Example included on-line and hands-on training, peer support, leadership support, and a culture that supports respirator use. To support a shift to reusable respiratory protection being procured and implemented, organizational- and individual-level perspectives are needed. Employee engagement, respirator champions, and updated verbal and written communication mechanisms are important takeaways for leaders to consider during any routine or emergency scenario.

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Characteristics Associated With Health Care Worker Knowledge and Confidence in Elastomeric Half-Mask Respirator Use

Cited by 3 publications

References 35 publications

Elastomeric half‐mask respirator disinfection practices among healthcare personnel

Elastomeric half‐mask respirator disinfection practices among healthcare personnel

Examining the Roles of Training, Fit Testing, and Safety Climate on User Confidence in Respiratory Protection: A Case Example with Reusable Respirators in Health Delivery Settings

Identifying leadership practices to support the uptake of reusable elastomeric half mask respirators in health delivery settings

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