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

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Introduction

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

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Overview

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

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History

• Wright County Emergency Medical Services (EMS)
  Advisory Committee
• Central MN Regional Hospital Resource Center
  (RHRC)

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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

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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

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Reviewed Field Tested

• Reviewers
• Wright County First Responders Fire, EMS, Law

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Developing YOUR Own Program

• 4 Sections
• Policy Procedures
• Medical Evaluation
• Education
• Fit Testing

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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

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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

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Identifying Work HazardsAppendix A

• Highest Risk
• Lowest Risk

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

• MDH Public Health Respiratory Protection
  Program Template
• www.health.state.mn.us/divs/idepc/dtopics/infecti
  oncontrol/rpp/template/index.html
• 3M Administrative Respiratory Protection Program
• Call your 3M representative or Helpline at
• 1-800-228-3957

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Evaluating/Updating Program Component Program
Survey Appendix E
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2. Medical Evaluation Component

• Questionnaire (or medical exam)
• Reviewed by physician or other licensed health
  care professional
• Rationale (Allina Hospitals Clinics)
• Frequency

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Medical Evaluation QuestionnaireAppendix C
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Medical Evaluation QuestionnaireAppendix C
(continued)
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Medical Evaluation QuestionnaireAppendix C
(continued)
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Other Sample Medical Evaluations

• OSHA Medical Evaluation www.osha.gov/pls/oshaweb/
  owadisp.show_document?p_tableSTANDARDSp_id9783
• 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

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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).

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Infection Control Tools

• MDH/CDC Disease Fact Sheets
• examples Pertussis www.health.state.mn.us/divs/i
  depc/diseases/pertussis/pfacts.pdf
• example Anthrax EMS
• www.health.state.mn.us/oep/training/bhpp/docs/Ant
  hraxrevised_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/disea
  ses/flu/pandemic/plan/icstandard.pdf
• MDH Infection Control website
  www.health.state.mn.us/divs/idepc/dtopics/infectio
  ncontrol/index.html

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Infection Control Tools
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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

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Audio-VisualEducation 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)
• OSHAs Respiratory Protection Standard
  Healthcare, Public Health Public Safety
  Settings (MDH)
• Posters

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Respirator Selection

• www.cdc.gov/niosh/npptl/topics/respirators/disp_pa
  rt/n95list1.html

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4. Fit Testing ComponentAppendix D
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Fit Testing ComponentRainbow Passage
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Fit Testing ComponentQualitative Fit Test Form
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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

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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

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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.

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• Questions?

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• Thank You!