DOCSLIB.ORG

Implementing Hospital Respiratory Protection Programs: Strategies from the Field

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Implementing Hospital Respiratory Protection Programs: Strategies from the Field Implementing Hospital Respiratory Protection Programs: Strategies from the Field ® Implementing Hospital Respiratory Protection Programs: Strategies from the Field Joint Commission Project Staff provide guidance on compliance with OSHA regulations, • Barbara Braun, PhD, Associate Director, Department of state legislative requirements, or Joint Commission stan- Health Services Research, Division of Healthcare dards. Readers should refer to the source documents listing Quality Evaluation requirements from the respective organizations for guidance • Brette Tschurtz, BA, Project Director, Department of on compliance issues. Similarly, recommendations for practice Health Services Research, Division of Healthcare described herein should not be construed as policy or practice Quality Evaluation recommendations from The Joint Commission or NIOSH. • Hasina Hafiz, MPH,Research Associate, Department of Health Services Research, Division of Healthcare Many of the examples in this monograph come from self- Quality Evaluation reported methods, tools, and data submitted by healthcare • Scott Williams, PsyD, Director, Department of Health organizations in response to The Joint Commission’s call for Services Research, Division of Healthcare Quality Evalu- practices (see 1.4); thus, the information is not necessarily ation evidence-based. Although some suggestions and recommenda- tions are derived from literature, a systematic literature review Joint Commission Resources Editorial and was not performed. In addition, practices that are referenced Production Support in the text should not be considered evidence-based because • Katie Byrne, Executive Editor, Department of Publica- of the limited amount of rigorous research in this area. tions and Education Resources • Cheryl Firestone, Senior Project Manager, Department of The content and recommendations are solely the responsi- Publications and Education Resources bility of the Joint Commission project staff and others who contributed material. We have worked to ensure that this The Joint Commission Mission monograph contains useful information; however, because the The mission of The Joint Commission is to continuously information contained herein is derived from many sources, improve health care for the public, in collaboration with other The Joint Commission cannot guarantee that the information stakeholders, by evaluating health care organizations and is completely accurate or error free. The Joint Commission is inspiring them to excel in providing safe and effective care of not responsible for any claims or losses arising from the use the highest quality and value. of, or from any errors or omissions in, this monograph. Disclaimer © 2014 The Joint Commission This monograph was developed by The Joint Commission under a project supported in part by the National Institute Permission to reproduce this guide for noncommercial, for Occupational Safety and Health (NIOSH), under con- educational purposes with display of attribution is granted. tract no. 254-2011-M-41082. This educational monograph For other requests regarding permission to reprint, please call is intended to stimulate greater awareness and knowledge of Hasina Hafiz at 630-792-5955. the importance of effective respiratory protection programs in hospitals, as well as to provide examples of strategies for Suggested Citation overcoming common implementation challenges. The views The Joint Commission. Implementing Hospital Respiratory expressed in written materials and by speakers do not neces- Protection Programs: Strategies from the Field. Oakbrook sarily reflect the official policies of NIOSH; nor does mention Terrace, IL: The Joint Commission, Dec 2014. of trade names, commercial practices, or organizations imply http://www.jointcommission.org. endorsement by the U.S. government. For more information about The Joint Commission, please This monograph is designed to introduce concepts and topics visit http://www.jointcommission.org. but is not intended to be a comprehensive source of all rele- vant information relating to respiratory protection programs For more information about NIOSH/NPPTL, please visit: in healthcare settings. The monograph is not designed to http://www.cdc.gov/niosh/npptl/ i Implementing Hospital Respiratory Protection Programs: Strategies from the Field Table of Contents Acknowledgments .............................................................................................................................. v Chapter 1: Introduction and Overview of Methodology ................................................................... 1 1.1 Purpose of Monograph ....................................................................................................................................................1 1.2 Scope, Target Audience, and Limitations .......................................................................................................................2 Scope .............................................................................................................................................................................2 Target Audience ............................................................................................................................................................. 2 Limitations .......................................................................................................................................................................2 1.3 Related Studies and Initiatives ........................................................................................................................................3 REACH I and II Initiatives ...............................................................................................................................................3 Development of Publicly Available Toolkits for Respiratory Protection Programs ...........................................................3 Examples of Additional NIOSH Research in Progress ....................................................................................................4 1.4 Project Organization and Methodology ...........................................................................................................................4 Technical Expert Panel ....................................................................................................................................................4 NIOSH Stakeholder Workshop ........................................................................................................................................5 Call for Practices Methodology........................................................................................................................................5 1.5 Key Points for Chapter 1 .................................................................................................................................................8 References .............................................................................................................................................................................9 Chapter 2: Administration of the Respiratory Protection Program .............................................. 10 2.1 Program Structure and Overview of Requirements ......................................................................................................10 Issue: Should an organization have a centralized program that addresses all respiratory hazards simultaneously? ..10 2.2 Leadership of the Respiratory Protection Program and Who Should Be Involved ........................................................12 Issue: Who should be in charge of the program? Should it be a single person, department, or multidisciplinary team approach? Should the program be led by staff from employee health or infection control? What about leadership by teams versus individuals? .......................................................................................................................12 2.3 Authority, Cooperation, and Accountability ................................................................................................................... 13 Issue: How can the RPP administrator ensure the cooperation of staff from other departments? ................................13 Issue: How can full staff compliance be encouraged? Do incentives or penalties help improve compliance? .............14 2.4 The Role of Organizational Leadership and the Relationship to Safety and Quality Improvement ...............................14 Issue: What is the role of hospital leadership in the respiratory protection program? ...................................................14 Issue: How does an effective respiratory protection program relate to patient safety and contribute toward becoming a high reliability organization? ......................................................................................................................15 Issue: How might quality improvement initiatives impact a respiratory protection program? ........................................17 Issue: What is The Joint Commission’s role in respiratory protection programs? .........................................................17 Issue: In addition to OSHA, are there other healthcare oversight and regulatory bodies that address respiratory protection programs? ....................................................................................................................................................19 2.5 Key
Load more

Recommended publications
  • COVID-19 Infection Prevention Control Strategies For
    COVID-19 Infection Prevention Control Strategies for Massachusetts Masonic Facilities DRAFT 4/6/2020 Introduction With phrases such as “social distancing,” “self-quarantine,” and “flattening the curve” still showing up in the media, flattening the curve” still showing up in the media, blood donations have plummeted as schools, offices and other sites that typically host blood drives shut down to prevent the spread of coronavirus. As Masonic lodges across the commonwealth rise to meet the growing demand for locations, all masons must understand and be able to effectively communicate to others the importance of precautionary measures against the potential spread of CODID-19 while hosting blood drives in our buildings. Background The COVID-19 virus has actually been named "SARS-CoV-2," and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19"). The virus looks like it's wearing a spiky crown, so it gets the name "corona" from the Latin word for crown. The virus enters cells using the "spike" on its surface to enter and bond with a human cell. Once inside human cells, the virus reproduces. Those reproductions break out of cells and infect other human cells. At a certain point, there are so many virus particles being produced that our normal cells can't work properly and we get sick. Viruses are believed to be transmitted from person-to-person primarily through virus-laden droplets that are generated when infected persons speak, cough, or sneeze. These droplets can be deposited onto the mucosal surfaces of susceptible persons or hard surfaces that are within 6 feet of the droplet sourcei.
    [Show full text]
  • Prevention and Control of Influenza During a Pandemic for All Healthcare Settings
    Annex F Prevention and Control of Influenza during a Pandemic for All Healthcare Settings Date of Latest Version: May 2011 1. E-Links have been inserted to direct the reader to the appropriate Section of the Annex. 2. This Annex has been developed for use by healthcare workers including but not limited to those working in infectious diseases, risk management, infection prevention and control, occupational health, occupational hygiene and/or emergency response. 3. The recommendations in this Annex must be interpreted by trained personnel prior to implementation in specific situations, organizations or healthcare settings. 4. A major assumption underlying this Annex was that a pandemic virus would cause severe disease in patients. - Should mild disease occur as in pH1N1, recommendations related to PPE may change. 5. As with all guidance documents related to pandemic influenza, healthcare organizations and personnel should be mindful of specifc provincial/ territorial legislation and policies that may influence or supersede the application of some of the recommendations in this Annex. 6. NOTE: This version of Annex F is being published after the pH1N1 Pandemic (H1N1). The assumptions about influenza epidemiology in this document are generalized to include all potential influenza pandemics and are not specific to pH1N1. To view the PHAC Guidance Documents related to pH1N1 go to: http:///www.phac-aspc.gc.ca/alert-alerte/h1n1/ guidance_lignesdirectrices-eng.php. These Guidance Documents have been adapted from this Annex based on emerging epidemiologic evidence and the impact of pH1N1 infection. 7. In Canada, public health is a shared responsibility of the Federal, Provincial and Territorial governments.
    [Show full text]
  • HHS 2009 H1N1 Influenza Improvement Plan
    U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 2009 H1N1 Influenza Improvement Plan May 29, 2012 TABLE OF CONTENTS Contents STATEMENT BY SECRETARY SEBELIUS.......................................................................... iii EXECUTIVE SUMMARY ......................................................................................................... iv CHAPTER 1: INTRODUCTION................................................................................................ 1 CHAPTER 2: DETECTION AND CHARACTERIZATION OF A FUTURE INFLUENZA PANDEMIC ................................................................................................................................... 5 CHAPTER 3: COMMUNITY MITIGATION MEASURES ................................................... 8 CHAPTER 4: MEDICAL SURGE CAPACITY ..................................................................... 12 CHAPTER 5: MEDICAL COUNTERMEASURES (MCM) FOR INFLUENZA OTHER THAN VACCINES ..................................................................................................................... 17 CHAPTER 6: VACCINE MANUFACTURING, DISTRIBUTION, AND POST- DISTRIBUTION......................................................................................................................... 25 CHAPTER 7: COMMUNICATIONS....................................................................................... 17 CHAPTER 8: CROSS-CUTTING PREPAREDNESS ISSUES............................................ 33 CHAPTER 9: INTERNATIONAL PARTNERSHIPS AND CAPACITY BUILDING ACTIVITIES
    [Show full text]
  • Non-Pharmaceutical Measures to Prevent Influenza Transmission
    September 2011 Non-Pharmaceutical Measures to Prevent Influenza Transmission: The Evidence for Individual Protective Measures Alexis Crabtree, MPH, 1 and Bonnie Henry,MD, MPH, FRCP(C)1,2 1University of British Columbia; 2British Columbia Centre for Disease Control Key Points Introduction • Mask use by cases and/or household contacts may be efficacious A wealth of knowledge has become in reducing the transmission of influenza, but that effectiveness available concerning influenza is likely reduced by poor compliance. Mask use in the community prevention and control in the wake of setting is of dubious benefit, as is the use of N95 respirators rather the 2009 H1N1 pandemic. The purpose than surgical masks outside of health care settings. of this review is to summarize the recent • Isolation and quarantine are effective and acceptable interventions literature on several non-pharmaceutical to reduce the spread of influenza, particularly pandemic influ- interventions: masks; quarantine, enza. Social distancing measures (excluding school closures and isolation, and social distancing; and prohibitions on mass gatherings, which are covered in another hand hygiene, respiratory hygiene, and paper in this series (Roth, 2011)), however, are of unproven value cleaning of fomites. and associated with low uptake. Special attention should be paid to providing tools and supports to those in quarantine or isolation, particularly to vulnerable groups. Masks A recently updated Cochrane review • Moderate evidence exists to support recommendations for hand concluded that mask use can interrupt and respiratory hygiene, especially in children. Further research is the transmission of influenza (1). While needed to show benefits from cleaning and disinfection of surfac- es in household and public spaces.
    [Show full text]
  • 2017 Update to the Hhs Pandemic Influenza Plan
    Pandemic Influenza Plan 2017 UPDATE U.S. Department of Health and Human Services Contents FOREWORD .............................................................................................................. 3 EXECUTIVE SUMMARY ........................................................................................... 5 INTRODUCTION ........................................................................................................ 7 SCOPE, AUDIENCE, AND PURPOSE ................................................................... 10 INFLUENZA RESPONSE ACTIVITIES ................................................................... 11 PLANNING TOOLS FOR PREPARATION AND RESPONSE ............................... 12 THE 2017 UPDATE TO THE HHS PANDEMIC INFLUENZA PLAN ..................... 13 Domain 1 – Surveillance, Epidemiology, and Laboratory Activities .................. 14 Domain 2 – Community Mitigation Measures .................................................... 18 Domain 3 – Medical Countermeasures: Diagnostic Devices, Vaccines, Therapeutics, and Respiratory Devices ............................................................. 21 Domain 4 – Health Care System Preparedness and Response Activities ....... 27 Domain 5 – Communications and Public Outreach ........................................... 30 Domain 6 – Scientific Infrastructure and Preparedness .................................... 32 Domain 7 – Domestic and International Response Policy, Incident Management, and Global Partnerships and Capacity Building ........................
    [Show full text]
  • Better Global Tools for Influenza
    11–12 June 2019 | Geneva, Switzerland BETTER GLOBAL TOOLS FOR INFLUENZA Technical consultation on product research & innovation for influenza prevention, control & treatment Prevent. Control. Prepare. 11–12 June 2019 | Geneva, Switzerland BETTER GLOBAL TOOLS FOR INFLUENZA Technical consultation on product research & innovation for influenza prevention, control & treatment WHO/WHE/IHM/IPR/2019.1 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons. org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. Better global tools for influenza. Technical consultation on product research and innovation for influenza prevention, control and treatment, Geneva, Switzerland, 11-12 June 2019.
    [Show full text]
  • Disinfecting and Sanitizing
    Volume 4, Issue 2 Disease Prevention Information for Child Care Providers December 2014 Disinfecting and Sanitizing Group care settings such as child cares, preschools, and school-age programs provide ideal conditions for spreading germs that cause illness. Caregivers use cleaning, sanitizing, and disinfecting to help reduce the Call or Email Us! number of germs in the environment. Due to some recent changes made by the bleach industry, now is a good time to review your child Main line care’s cleaning and sanitizing/disinfecting practices and make sure the 425.339.5278 products and procedures you are using are doing the job right. [email protected] What three steps are required? Public Health Nurse Alba Suárez It is important to follow all three steps in order to get rid of germs on 425.339.5228 surfaces: 1) Clean the surface with plain soap and water. [email protected] 2) Rinse the soap off the surface with plain water. Environmental Health Specialist 3) Sanitize or disinfect the surface. Micha Horn 425.339.8712 How did bleach solutions recently change? [email protected] In the past, almost all bleach that one could find on store shelves was between 5.25% and 6.0% sodium hypochlorite (the active ingredient in bleach). All the In this issue… recipes that had previously been published for child cares to make bleach Disinfecting & Sanitizing… water solutions assumed a concentration Chemical Safety…. of 5.25% to 6.0% bleach. Last year, many Bleach Chart…. bleach manufacturers started making a Disease in the News…….. “concentrated” bleach formula containing 8.25% sodium hypochlorite.
    [Show full text]
  • Research Findings from Nonpharmaceutical Intervention Studies for Pandemic Influenza And&Nbsp
    Research findings from nonpharmaceutical intervention studies for pandemic influenza and current gaps in the research Allison E. Aiello, PhD, MS,a Rebecca M. Coulborn, MPH,a Tomas J. Aragon, DrPH,b Michael G. Baker, MBChB, DPH, FAFPHM,c Barri B. Burrus, PhD,d Benjamin J. Cowling, PhD,e Alasdair Duncan, MPH,c Wayne Enanoria, PhD, MPH,b M. Patricia Fabian, ScD, MS,f,g Yu-hui Ferng, MPA,h Elaine L. Larson, PhD, RN, FAAN, CIC,h,i Gabriel M. Leung, MD, MPH, CCFP, FFPH, FHKCCM, FHKAM,e Howard Markel, MD, PhD,j Donald K. Milton, MD, DrPH,k Arnold S. Monto, MD,a Stephen S. Morse, PhD,i J. Alexander Navarro, PhD,j Sarah Y. Park, MD, FAAP,l Patricia Priest, DPhil, MBChB, MPH, FAFPHM,c Samuel Stebbins, MD, MPH,m Alexandra M. Stern, PhD,j Monica Uddin, PhD,a Scott F. Wetterhall, MD, MPH,d and Charles J. Vukotich Jr, MSm Ann Arbor, Michigan; Berkeley, California; Otago, New Zealand; Research Triangle Park, North Carolina; Hong Kong, People’s Republic of China; Lowell, Massachusetts; Boston, Massachusetts; New York, New York; College Park, Maryland; Honolulu, Hawaii; and Pittsburgh, Pennsylvania In June 2006, the Centers for Disease Control and Prevention released a request for applications to identify, improve, and evaluate the effectiveness of nonpharmaceutical interventions (NPIs)—strategies other than vaccines and antiviral medications—to mitigate the spread of pandemic influenza within communities and across international borders (RFA-CI06-010). These studies have provided major contributions to seasonal and pandemic influenza knowledge. Nonetheless, key concerns were identified related to the accept- ability and protective efficacy of NPIs.
    [Show full text]
  • Your Best Protection Against Flu
    Your Best Protection Against Flu Millions of people get the flu every year, hundreds of thousands of people are hospitalized, and thousands or tens of thousands of people die. The Centers for Disease Control and Prevention (CDC), public health professionals, and our practice recommend that everyone 6 months of age and older should get a flu vaccine every year. Flu vaccination can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent serious flu complications that can result in hospitalization and even death.1,2 CDC estimates that during the 2016–2017 flu season, flu vaccination prevented an estimated 5.3 million flu illnesses, 2.6 million flu medical visits, and 85,000 flu hospitalizations.3 Flu Vaccine Reduces Your Risk of Flu A flu vaccine is the best way to help During recent seasons, flu vaccine has While some people who get a flu vaccine prevent flu and its potentially serious reduced the risk of flu illness in vaccinated still get sick, vaccination can make their complications. Remember that flu vaccine people by between 30% and 60%.(4,5) A 2017 illness less severe. Two studies among not only protects you, but it also can help study was the first of its kind to show that flu hospitalized flu patients showed that flu protect those around you. vaccination can significantly reduce vaccination reduced intensive care unit a child’s risk of dying from influenza. admissions and duration of hospitalization. Flu Vaccination Especially Important for Some Flu vaccination is especially important for people who are at high risk of developing serious complications from flu, including adults 65 and older, children younger than 5 years, pregnant women, and people with certain chronic health conditions, such as diabetes, heart disease, and asthma.
    [Show full text]
  • Use of Facemasks and Respirators in an Influenza Pandemic” Published in 2011
    The Use of Facemasks and Respirators during an Influenza Pandemic Scientific Evidence Base Review May 2014 Title: The Use of Facemasks and Respirators during an Influenza Pandemic: Scientific Evidence Base Review Author: PH-HPER-ID&BP 10200 Commissioned by the Department of Health and produced by Public Health England Document Purpose: A review of the scientific evidence base on the use of facemasks and respirators during an influenza pandemic Publication date: 05/2014 Target audience: Supporting Documents for UK Influenza Pandemic Preparedness Strategy Contact details: Elizabeth Paterson Richmond House 79 Whitehall LONDON SW1A 2NS Email: [email protected] You may re-use the text of this document (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence/ © Crown copyright Published to gov.uk, in PDF format only. www.gov.uk/dh May 2014 Table of contents Page Executive summary 5 Background 15 Methods 16 Results 20 Discussion 43 Conclusion and acknowledgements 51 References 53 Annexes 59 2 Document information Document date: March 2013 Final Version Document sponsor: Influenza and Respiratory Virus Delivery Board, Public Health England Authorised by: Professor John Watson Update authors and affiliations: Matthew Dixon Scientific Review Coordinator, Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England Nick Phin Consultant Epidemiologist, Public Health England Head of Legionella and Influenza Preparedness and Response Section Visiting Professor, Department of Health and Social Care, University of Chester Contact: [email protected] 3 Acknowledgements The original review was written by Dr Faisal Bin-Reza and Dr Mary Chamberland in 2010.
    [Show full text]
  • HAI Action Plan HCP
    NATIONAL ACTION PLAN TO PREVENT HEALTH CARE-ASSOCIATED INFECTIONS: ROAD MAP TO ELIMINATION APRIL 2013 CHAPTER 7: INFLUENZA VACCINATION OF HEALTH CARE PERSONNEL I. INTRODUCTION Health care personnel (HCP) can acquire influenza and transmit it to patients and other HCP. Many HCP provide care for or are in frequent contact with patients with influenza or patients at high risk for complications of influenza, and their involvement in influenza transmission is a long-standing concern.1,2,3 Influenza vaccination is effective and can prevent many illnesses, deaths, and losses in productivity.4 Expanding influenza vaccine use among HCP is a high priority. Achieving and sustaining high influenza vaccination coverage among HCP is intended to help protect HCP and their patients and reduce disease burden and health care costs. Until recently, vaccination coverage among HCP has been well below the national Healthy People 2010 target of 60%5 (see Figure 2), but preliminary data show that 63% of HCP reported receiving seasonal influenza 6,7 vaccine in 2010–2011 and 67% reported receiving the vaccine in 2011–2012. 1 Maltezou HC, Drancourt M. Nosocomial influenza in children. Journal of Hospital Infection 2003; 55:83-91. 2 Hurley JC, Flockhart S. An influenza outbreak in a regional residential facility. Journal of Infection Prevention 2010; 11:58-61. 3 Salgado CD, Farr BM, Hall KK, Hayden FG. Influenza in the acute hospital setting. The Lancet Infectious Diseases 2002; 2:145-155. 4 Wilde JA, McMillan JA, Serwint J, Butta J, O’Riordan MA, Steinhoff MC. Effectiveness of influenza vaccine in health care professionals: a randomized trial.
    [Show full text]
  • Influenza Division Factsheet
    Influenza Division Influenza is a serious disease that can lead to hospitalization and sometimes death, even among healthy people. In the United States, millions of people are sickened, hundreds of thousands are hospitalized, and tens of thousands of people die from flu every year. The Centers for Disease Control and Prevention’s (CDC’s) Influenza Division (ID) provides scientific and programmatic leadership for the diagnosis, prevention, and control of influenza domestically and internationally. Mission • Improve global control and prevention of seasonal and novel influenza, and • Improve influenza pandemic preparedness and response. Core Activities • Build influenza disease surveillance and response capacity, • Monitor and assess influenza viruses, • Improve influenza vaccines and other medical interventions, and • Conduct research to improve the scientific basis for enhancement of influenza prevention and control policies and programs. Organization CDC’s Influenza Division is comprised of the Office of the Director and three Branches. The Office of the Director provides strategic vision and leadership for the division and houses policy, communications, and informatics functions of the division, as well as animal interface, molecular genetics, and international capacity-building. The three Branches include the Virology, Surveillance, and Diagnosis Branch (VSDB); the Epidemiology and Prevention Branch (EPB); and the Immunology and Pathogenesis Branch (IPB). Leadership and Collaboration CDC’s Influenza Division also has served since 1956
    [Show full text]