LAUSR

SBM’s Respiratory Protection Program (RPP) fit tested clinical staff that may perform direct care to patients with confirmed/suspect airborne pathogenic illness (i.e., TB, SARS, smallpox, and measles), support staff and facilities staff. Early 2020, SBM was faced with deficiencies in the RPP. The number of staff requiring immediate fit testing dramatically increased. Most MDs did not comply with the annual fit testing requirement. Off-site medical staff, many never fit tested, were redeployed to COVID-19 units when the clinics closed. Supply chain shortages and counterfeits made providing adequate respiratory protection challenging. Fit testing solutions: •Mass fit testing for staff and first responders: •Lecture halls were secured to provide space for larger groups, social distancing, and rigorous sanitizing. •Multiple daily fit test sessions provided. •Powered Air Purifying Respirators (PAPRs) PAPRs were purchased for staff: not fitting Hospital approved N95s; with religious or medical accommodations; should N95s not be available. •Reusable half-face elastomeric respirators were secured should N95s not be available. •Air-line teams used PAPRs to reduce the # of contaminated respirators discarded. •EH&S’s fit testing data was available when OSHA suspended the requirement for annual fit testing. Concerns about adequate fit were addressed. •PortaCount was used for: staff previously unable to pass qualitative fit tests, evaluate unfamiliar vendors/respirators to rule out counterfeit masks, aid research for reprocessing N95s and evaluate the interference of skin dressing on fit. •Research into the integrity of sanitized respirators demonstrated a method that did not compromise fit. Currently - SBM adopted quantitative fit testing.