Fit testing program – Can you please help?

[Thomson, Rachel EA (THS)]

Hi all

We are interested in other states/jurisdictions/facilities approaches to fit-testing, either qualitative or quantitative.
We had a qualitative fit-testing program within our hospital previously and we made the decision to disband this earlier in the year for a number of reasons.
We are now getting significant pressure from a particular clinical group to re-establish fit-testing again.
We had a number of issues with the fit-testing program previously and our rationale for not re-establishing fit-testing currently include the following:

* Fit-testing has not been proven to provide safer P2 (N95) mask use compared with fit-checking alone
* Despite the presence of the Australian Standard, fit-testing is not mandatory and ‘fit-checking is accepted to be the minimum standard’
* There are a number of practical difficulties to be considered with the re-introduction of a fit-testing program;
* If fit-testing is offered to one craft group, all healthcare workers that require a P2 (N95) mask within their clinical role will expect a similar approach. Equitable approach would need to be considered for all.
* Some individuals will not have a successful ‘fit-test’ e.g. do not taste the fit-testing solution, do not have a successful fit-test with any of the available masks. Does this equate to that healthcare worker being unsafe with an appropriately fit-checked P2 (N95) mask?
* Resources required for fit-testing program is not insignificant i.e. human resources and PPE required, with consideration for annual testing thereafter
* What to do for individuals that have not been fit-tested as yet but they are required to work with the requirement of a P2 (N95) mask?
* What to do if individuals’ fit-tested mask is not available at the point of care, particularly in the setting of the current PPE stock issues?
We would be really keen to understand others’ thoughts and experiences and approaches.

Your urgent advice would be much appreciated. Please feel free to email me off-line or even call me if you can

Thanks in advance
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

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[Anonymous]

Thankyou Rachel for raising this challenging issue.

As we reintroduce elective procedures into the privately operated Day Surgery environment and where Aerosol Generating Procedures are being performed, some state and territory guidelines require P2 / N95 masks to be worn for all patients, not just those that have suspected or confirmed COVID-19.

Apart from the issues with lack of supply, there is limited expertise in fit testing / fit checking in this sector healthcare and I am concerned about the risks to the personnel working in these operating rooms.

In my humble opinion, there needs to be a nationally endorsed response to your questions.

Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination

PO BOX 2249, Greenvale, VIC Australia 3059

[cid:image001.png@01D61A13.0390F260]

I endeavour to achieve a sensible work-life balance: There is no need to reply to this email from you outside of your normal working hours. Please expect the same from me.

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Hi all

We are interested in other states/jurisdictions/facilities approaches to fit-testing, either qualitative or quantitative.

We had a qualitative fit-testing program within our hospital previously and we made the decision to disband this earlier in the year for a number of reasons.

We are now getting significant pressure from a particular clinical group to re-establish fit-testing again.

We had a number of issues with the fit-testing program previously and our rationale for not re-establishing fit-testing currently include the following:

* Fit-testing has not been proven to provide safer P2 (N95) mask use compared with fit-checking alone
* Despite the presence of the Australian Standard, fit-testing is not mandatory and ‘fit-checking is accepted to be the minimum standard’
* There are a number of practical difficulties to be considered with the re-introduction of a fit-testing program;
* If fit-testing is offered to one craft group, all healthcare workers that require a P2 (N95) mask within their clinical role will expect a similar approach. Equitable approach would need to be considered for all.
* Some individuals will not have a successful ‘fit-test’ e.g. do not taste the fit-testing solution, do not have a successful fit-test with any of the available masks. Does this equate to that healthcare worker being unsafe with an appropriately fit-checked P2 (N95) mask?
* Resources required for fit-testing program is not insignificant i.e. human resources and PPE required, with consideration for annual testing thereafter
* What to do for individuals that have not been fit-tested as yet but they are required to work with the requirement of a P2 (N95) mask?
* What to do if individuals’ fit-tested mask is not available at the point of care, particularly in the setting of the current PPE stock issues?

We would be really keen to understand others’ thoughts and experiences and approaches.

Your urgent advice would be much appreciated. Please feel free to email me off-line or even call me if you can

Thanks in advance
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
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[Michael Wishart]

Hi Rachel

We stopped actual fit testing HCWs some years ago, due to all of the issues you had listed. We now rely solely on every HCW fit checking each mask at each use.

With the possibility of HCWs having to use various brands and styles of masks over the coming months when we see a surge in COVID-19 cases, the logistics of fit testing would add an enormous strain to an already stressed health system.

I agree with Terry that there should be a national approach to this issue, to provide reassurance to all HCWs that the masks they are wearing are being used in a safe manner.

Cheers
Michael

Michael Wishart | Infection Control Coordinator, CICP-E

St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au

[cid:image001.jpg@01D46C86.4CDB6090]

Hi all

We are interested in other states/jurisdictions/facilities approaches to fit-testing, either qualitative or quantitative.

We had a qualitative fit-testing program within our hospital previously and we made the decision to disband this earlier in the year for a number of reasons.

We are now getting significant pressure from a particular clinical group to re-establish fit-testing again.

We had a number of issues with the fit-testing program previously and our rationale for not re-establishing fit-testing currently include the following:

* Fit-testing has not been proven to provide safer P2 (N95) mask use compared with fit-checking alone
* Despite the presence of the Australian Standard, fit-testing is not mandatory and ‘fit-checking is accepted to be the minimum standard’
* There are a number of practical difficulties to be considered with the re-introduction of a fit-testing program;
* If fit-testing is offered to one craft group, all healthcare workers that require a P2 (N95) mask within their clinical role will expect a similar approach. Equitable approach would need to be considered for all.
* Some individuals will not have a successful ‘fit-test’ e.g. do not taste the fit-testing solution, do not have a successful fit-test with any of the available masks. Does this equate to that healthcare worker being unsafe with an appropriately fit-checked P2 (N95) mask?
* Resources required for fit-testing program is not insignificant i.e. human resources and PPE required, with consideration for annual testing thereafter
* What to do for individuals that have not been fit-tested as yet but they are required to work with the requirement of a P2 (N95) mask?
* What to do if individuals’ fit-tested mask is not available at the point of care, particularly in the setting of the current PPE stock issues?

We would be really keen to understand others’ thoughts and experiences and approaches.

Your urgent advice would be much appreciated. Please feel free to email me off-line or even call me if you can

Thanks in advance
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.

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[Keven Renshaw]

Hi Terry and Rachel

When doing fit checking of P2/N95 masks, the most common sense approach I’ve found is that when fitted, inhaling and exhaling, is the mask moving ?. This is a similar check that as an anaesthetic nurse I found that if an airway mask is not fitted correctly to the face, you will leak air ergo, no seal and inadequate ventilation of a patient.

I see no difference in this. Every persons face is unique, every contour is different. Putting the onus on the staff to ensure this simple step is managed means they can wear the mask with the confidence that at that time, their airway is as tight as it can be.

I hope this may help ?. I do a series of P2/N95 training to the units at the hospital and as soon as the member of staff are comfortable with the visual seal caused by breathing in and out, I am satisfied a seal is produced.

Keven Renshaw
Infection Control Practitioner
Mater Health

Infection Control | Mater Hospital | Ward Street | Rockhampton | 4700
t: 07 49313420 e: krenshaw@mercycq.com w: mater.org.au

Human dignity | Justice | Compassion | Service | Special concern for the poor

Please consider the environment before printing this email

[Mater picture]

Thankyou Rachel for raising this challenging issue.

As we reintroduce elective procedures into the privately operated Day Surgery environment and where Aerosol Generating Procedures are being performed, some state and territory guidelines require P2 / N95 masks to be worn for all patients, not just those that have suspected or confirmed COVID-19.

Apart from the issues with lack of supply, there is limited expertise in fit testing / fit checking in this sector healthcare and I am concerned about the risks to the personnel working in these operating rooms.

In my humble opinion, there needs to be a nationally endorsed response to your questions.

Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination

PO BOX 2249, Greenvale, VIC Australia 3059

[cid:image001.png@01D61A13.0390F260]

I endeavour to achieve a sensible work-life balance: There is no need to reply to this email from you outside of your normal working hours. Please expect the same from me.

CONFIDENTIAL COMMUNICATION: The information contained in this message may contain confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or duplication of this transmission is strictly prohibited. If you have received this communication in error, please notify us by telephone or email immediately and return the original message to us or destroy all printed and electronic copies. Nothing in this transmission constitutes an agreement of any kind unless otherwise expressly indicated.

Hi all

We are interested in other states/jurisdictions/facilities approaches to fit-testing, either qualitative or quantitative.

We had a qualitative fit-testing program within our hospital previously and we made the decision to disband this earlier in the year for a number of reasons.

We are now getting significant pressure from a particular clinical group to re-establish fit-testing again.

We had a number of issues with the fit-testing program previously and our rationale for not re-establishing fit-testing currently include the following:

* Fit-testing has not been proven to provide safer P2 (N95) mask use compared with fit-checking alone
* Despite the presence of the Australian Standard, fit-testing is not mandatory and ‘fit-checking is accepted to be the minimum standard’
* There are a number of practical difficulties to be considered with the re-introduction of a fit-testing program;
* If fit-testing is offered to one craft group, all healthcare workers that require a P2 (N95) mask within their clinical role will expect a similar approach. Equitable approach would need to be considered for all.
* Some individuals will not have a successful ‘fit-test’ e.g. do not taste the fit-testing solution, do not have a successful fit-test with any of the available masks. Does this equate to that healthcare worker being unsafe with an appropriately fit-checked P2 (N95) mask?
* Resources required for fit-testing program is not insignificant i.e. human resources and PPE required, with consideration for annual testing thereafter
* What to do for individuals that have not been fit-tested as yet but they are required to work with the requirement of a P2 (N95) mask?
* What to do if individuals’ fit-tested mask is not available at the point of care, particularly in the setting of the current PPE stock issues?

We would be really keen to understand others’ thoughts and experiences and approaches.

Your urgent advice would be much appreciated. Please feel free to email me off-line or even call me if you can

Thanks in advance
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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[Chris Pollard]

Hi All,

Certainly happy to provide as much (or as little) resource.

https://europepmc.org/article/med/20658919 : Link to large scale quantitative respirator fit testing program for HCW (SA Health, Prof Dino Pisaniello circa 2010). SA Health have had a fit test for many years now. Only Healthcare network in Australia to do so.

* Extract of Order 43 Legislation (NSW) for different industry, but highlight new law for Quantitative Fit Testing introduced over past 18 months or.
* Focus on Health of Frontline Staff
* New OSHA Guidelines for 2.5 minute Fit Testing (released in Sept 2019)
* Fit Testing for healthcare Professionals
* Example of test report (Santa)

Please don’t confuse the term Fit Testings vs Fit Checking – Quantitative Fit Testing is exactly that, a way of quantitatively measure the efficiency of the seal of the mask on the wearers face, unable to answer questions re stock.

Hope this assist.

Kind regards

[cid:image007.png@01D3A1A9.77E508C0]

Chris Pollard
Sales Engineer
Kenelec Scientific Pty Ltd, 23 Redland Drive, Mitcham VIC 3132
d 03 9872 9929 | m 0437 007 810 | e chris.pollard@kenelec.com.au
Visit our website | View our Terms and Conditions
[cid:image004.png@01D61A16.67152510]

Hi all

We are interested in other states/jurisdictions/facilities approaches to fit-testing, either qualitative or quantitative.

We had a qualitative fit-testing program within our hospital previously and we made the decision to disband this earlier in the year for a number of reasons.

We are now getting significant pressure from a particular clinical group to re-establish fit-testing again.

We had a number of issues with the fit-testing program previously and our rationale for not re-establishing fit-testing currently include the following:

* Fit-testing has not been proven to provide safer P2 (N95) mask use compared with fit-checking alone
* Despite the presence of the Australian Standard, fit-testing is not mandatory and ‘fit-checking is accepted to be the minimum standard’
* There are a number of practical difficulties to be considered with the re-introduction of a fit-testing program;
* If fit-testing is offered to one craft group, all healthcare workers that require a P2 (N95) mask within their clinical role will expect a similar approach. Equitable approach would need to be considered for all.
* Some individuals will not have a successful ‘fit-test’ e.g. do not taste the fit-testing solution, do not have a successful fit-test with any of the available masks. Does this equate to that healthcare worker being unsafe with an appropriately fit-checked P2 (N95) mask?
* Resources required for fit-testing program is not insignificant i.e. human resources and PPE required, with consideration for annual testing thereafter
* What to do for individuals that have not been fit-tested as yet but they are required to work with the requirement of a P2 (N95) mask?
* What to do if individuals’ fit-tested mask is not available at the point of care, particularly in the setting of the current PPE stock issues?

We would be really keen to understand others’ thoughts and experiences and approaches.

Your urgent advice would be much appreciated. Please feel free to email me off-line or even call me if you can

Thanks in advance
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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[Nicky Whitehouse]

As a scrub/ scout RN I whole heartily agree with Terry.

Nicky Whitehouse RN
Ipswich Day Hostpital

> On 24 Apr 2020, at 8:37 am, Terrye wrote:
>
>
> Thankyou Rachel for raising this challenging issue.
>
> As we reintroduce elective procedures into the privately operated Day Surgery environment and where Aerosol Generating Procedures are being performed, some state and territory guidelines require P2 / N95 masks to be worn for all patients, not just those that have suspected or confirmed COVID-19.
>
> Apart from the issues with lack of supply, there is limited expertise in fit testing / fit checking in this sector healthcare and I am concerned about the risks to the personnel working in these operating rooms.
>
> In my humble opinion, there needs to be a nationally endorsed response to your questions.
>
> Kind Regards
> Terry McAuley
> Director
> MSc Medical Device Decontamination
>
> PO BOX 2249, Greenvale, VIC Australia 3059
> Mobile: +61 (0)438 109 692
> Email: terry@steamconsulting.com.au
> Website: http://www.steamconsulting.com.au
>
>
>
>
> I endeavour to achieve a sensible work-life balance: There is no need to reply to this email from you outside of your normal working hours. Please expect the same from me.
>
>
> CONFIDENTIAL COMMUNICATION: The information contained in this message may contain confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or duplication of this transmission is strictly prohibited. If you have received this communication in error, please notify us by telephone or email immediately and return the original message to us or destroy all printed and electronic copies. Nothing in this transmission constitutes an agreement of any kind unless otherwise expressly indicated.
>
> From: ACIPC Infexion Connexion On Behalf Of Thomson, Rachel EA
> Sent: Friday, April 24, 2020 8:06 AM
> To: ACIPCLIST@ACIPC.ORG.AU
> Subject: [ACIPC_Infexion_Connexion] Fit testing program – Can you please help?
>
> Hi all
>
> We are interested in other states/jurisdictions/facilities approaches to fit-testing, either qualitative or quantitative.
>
> We had a qualitative fit-testing program within our hospital previously and we made the decision to disband this earlier in the year for a number of reasons.
>
> We are now getting significant pressure from a particular clinical group to re-establish fit-testing again.
>
> We had a number of issues with the fit-testing program previously and our rationale for not re-establishing fit-testing currently include the following:
> Fit-testing has not been proven to provide safer P2 (N95) mask use compared with fit-checking alone
> Despite the presence of the Australian Standard, fit-testing is not mandatory and fit-checking is accepted to be the minimum standard
> There are a number of practical difficulties to be considered with the re-introduction of a fit-testing program;
> If fit-testing is offered to one craft group, all healthcare workers that require a P2 (N95) mask within their clinical role will expect a similar approach. Equitable approach would need to be considered for all.
> Some individuals will not have a successful fit-test e.g. do not taste the fit-testing solution, do not have a successful fit-test with any of the available masks. Does this equate to that healthcare worker being unsafe with an appropriately fit-checked P2 (N95) mask?
> Resources required for fit-testing program is not insignificant i.e. human resources and PPE required, with consideration for annual testing thereafter
> What to do for individuals that have not been fit-tested as yet but they are required to work with the requirement of a P2 (N95) mask?
> What to do if individuals fit-tested mask is not available at the point of care, particularly in the setting of the current PPE stock issues?
>
> We would be really keen to understand others thoughts and experiences and approaches.
>
> Your urgent advice would be much appreciated. Please feel free to email me off-line or even call me if you can
>
> Thanks in advance
> Rachel
>
> ..
> Rachel Thomson
> Nurse Unit Manager
>
> Infection Prevention & Control Unit
> Royal Hobart Hospital
> Tasmanian Health Organisation-South
>
> (: 03 6166 7882/ 6166 8658
>
> Mobile: 0400 718 574
> Email: rachel.thomson@ths.tas.gov.au
>
> Level 4, H Block
> 48 Liverpool Street
> Hobart, 7000
>
>
>
> CONFIDENTIALITY NOTICE AND DISCLAIMER
> The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
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[Thomson, Rachel EA (THS)]

Thanks Chris,

I am not seeking assistance to run or set up a quantitative fit-test program. I am aware of the difference between qualitative and quantitative approaches

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi All,

Certainly happy to provide as much (or as little) resource.

https://europepmc.org/article/med/20658919 : Link to large scale quantitative respirator fit testing program for HCW (SA Health, Prof Dino Pisaniello circa 2010). SA Health have had a fit test for many years now. Only Healthcare network in Australia to do so.

* Extract of Order 43 Legislation (NSW) for different industry, but highlight new law for Quantitative Fit Testing introduced over past 18 months or.
* Focus on Health of Frontline Staff
* New OSHA Guidelines for 2.5 minute Fit Testing (released in Sept 2019)
* Fit Testing for healthcare Professionals
* Example of test report (Santa)

Please don’t confuse the term Fit Testings vs Fit Checking – Quantitative Fit Testing is exactly that, a way of quantitatively measure the efficiency of the seal of the mask on the wearers face, unable to answer questions re stock.

Hope this assist.

Kind regards

[cid:image007.png@01D3A1A9.77E508C0]

Chris Pollard
Sales Engineer
Kenelec Scientific Pty Ltd, 23 Redland Drive, Mitcham VIC 3132
d 03 9872 9929 | m 0437 007 810 | e chris.pollard@kenelec.com.au
Visit our website | View our Terms and Conditions
[cid:image004.png@01D61A16.67152510]

Hi all

We are interested in other states/jurisdictions/facilities approaches to fit-testing, either qualitative or quantitative.

We had a qualitative fit-testing program within our hospital previously and we made the decision to disband this earlier in the year for a number of reasons.

We are now getting significant pressure from a particular clinical group to re-establish fit-testing again.

We had a number of issues with the fit-testing program previously and our rationale for not re-establishing fit-testing currently include the following:

* Fit-testing has not been proven to provide safer P2 (N95) mask use compared with fit-checking alone
* Despite the presence of the Australian Standard, fit-testing is not mandatory and ‘fit-checking is accepted to be the minimum standard’
* There are a number of practical difficulties to be considered with the re-introduction of a fit-testing program;
* If fit-testing is offered to one craft group, all healthcare workers that require a P2 (N95) mask within their clinical role will expect a similar approach. Equitable approach would need to be considered for all.
* Some individuals will not have a successful ‘fit-test’ e.g. do not taste the fit-testing solution, do not have a successful fit-test with any of the available masks. Does this equate to that healthcare worker being unsafe with an appropriately fit-checked P2 (N95) mask?
* Resources required for fit-testing program is not insignificant i.e. human resources and PPE required, with consideration for annual testing thereafter
* What to do for individuals that have not been fit-tested as yet but they are required to work with the requirement of a P2 (N95) mask?
* What to do if individuals’ fit-tested mask is not available at the point of care, particularly in the setting of the current PPE stock issues?

We would be really keen to understand others’ thoughts and experiences and approaches.

Your urgent advice would be much appreciated. Please feel free to email me off-line or even call me if you can

Thanks in advance
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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________________________________

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[Anonymous]

Hi Rachel,
I have been reading your comments and other ACIPC members with interest, as I have been interested in the whole fit testing/ fit checking in hospitals for many years, particularly as an element of a wider respiratory protection program. It is concerning that other industries take very seriously, the efficacy of RPE worn by employees.

I have been asked to look into fit testing for N95 masks for our hospital, using 2 different brands and a limited range of sizes.

The problem is, to ensure a scientifically robust program, we need to have a range of brands and sizes available to ensure the most appropriate fit for each person. Using the qualitative approach isn’t without challenges, what do we do if the person can detect the sweet or bitter taste with the one and only brand that we can obtain, with current limitations in PPE? Do we still send them to work in high risk areas, knowing that potentially, they are unprotected, and hope for the best?

I am not sure if the quantitative approach is a viable option either, given the cost of the Portacount machines and training needed to use this?

I agree with Terry, it is time we look at a national approach to this issue.

ind regards

[cid:image002.png@01D61AF2.414CD350]

Helen Truscott RN,RM,MPH,GDipTMH,CIPC-A
Ph:0410 011983
E:Helentruscott@hotmail.com

Thankyou Rachel for raising this challenging issue.

As we reintroduce elective procedures into the privately operated Day Surgery environment and where Aerosol Generating Procedures are being performed, some state and territory guidelines require P2 / N95 masks to be worn for all patients, not just those that have suspected or confirmed COVID-19.

Apart from the issues with lack of supply, there is limited expertise in fit testing / fit checking in this sector healthcare and I am concerned about the risks to the personnel working in these operating rooms.

In my humble opinion, there needs to be a nationally endorsed response to your questions.

Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination

PO BOX 2249, Greenvale, VIC Australia 3059

[cid:image001.png@01D61A13.0390F260]

I endeavour to achieve a sensible work-life balance: There is no need to reply to this email from you outside of your normal working hours. Please expect the same from me.

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Hi all

We are interested in other states/jurisdictions/facilities approaches to fit-testing, either qualitative or quantitative.

We had a qualitative fit-testing program within our hospital previously and we made the decision to disband this earlier in the year for a number of reasons.

We are now getting significant pressure from a particular clinical group to re-establish fit-testing again.

We had a number of issues with the fit-testing program previously and our rationale for not re-establishing fit-testing currently include the following:

* Fit-testing has not been proven to provide safer P2 (N95) mask use compared with fit-checking alone
* Despite the presence of the Australian Standard, fit-testing is not mandatory and ‘fit-checking is accepted to be the minimum standard’
* There are a number of practical difficulties to be considered with the re-introduction of a fit-testing program;
* If fit-testing is offered to one craft group, all healthcare workers that require a P2 (N95) mask within their clinical role will expect a similar approach. Equitable approach would need to be considered for all.
* Some individuals will not have a successful ‘fit-test’ e.g. do not taste the fit-testing solution, do not have a successful fit-test with any of the available masks. Does this equate to that healthcare worker being unsafe with an appropriately fit-checked P2 (N95) mask?
* Resources required for fit-testing program is not insignificant i.e. human resources and PPE required, with consideration for annual testing thereafter
* What to do for individuals that have not been fit-tested as yet but they are required to work with the requirement of a P2 (N95) mask?
* What to do if individuals’ fit-tested mask is not available at the point of care, particularly in the setting of the current PPE stock issues?

We would be really keen to understand others’ thoughts and experiences and approaches.

Your urgent advice would be much appreciated. Please feel free to email me off-line or even call me if you can

Thanks in advance
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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