Selection and Use of Respiratory Protection by Healthcare Workers to Protect from Infectious Diseases in Hospital Settings
Selection and Use of Respiratory Protection by Healthcare Workers to Protect from Infectious Diseases in Hospital Settings
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DOI：
10.1093/annweh/wxaa020
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发表时间：
2020-05-01
影响因子：
2.6
通讯作者：
Macintyre, C. Raina
中科院分区：
文献类型：
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作者：
Chughtai, Abrar Ahmad;Seale, Holly;Macintyre, C. Raina
目标：感染控制政策和指南建议使用口罩和呼吸器来保护医护人员 (HCW) 免受呼吸道感染。医疗机构中使用的常见呼吸器类型是过滤式面罩呼吸器 (FFR) 和电动空气净化呼吸器 (PAPR)。本研究的目的是调查目前医护人员对呼吸防护设备的选择和使用的态度和做法，并确定新型 PAPR 的可接受性。方法：对来自澳大利亚悉尼一家大型三级医院的 20 名医护人员进行了深入访谈。参与者使用 TSI (TM) Portacount 定量适合性测试方法，使用轻型紧身半面罩 PAPR（CleanSpace2 (TM) Power Unit，PAF-0034，由 CleanSpace Technology (R) 生产）进行适合性测试。结果：访谈结果显示，医护人员在口罩和呼吸器的选择和使用方面作用有限，一直在使用医院提供的设备。大多数受试者不了解医院使用口罩和呼吸器的政策，没有接受过使用呼吸器的培训，也没有进行过适合性测试。人们认为对使用口罩和呼吸器的依从性较低，并且通常仅短时间使用口罩和呼吸器。所有 20 名参与者均成功通过了 CleanSpace2 (TM) PAPR（整体几何平均适合系数 - 6768）的适合度测试。根据退出调查，CleanSpace2 (TM) PAPR 易于穿脱 (14/20) 和脱脱 (15/20)，并且佩戴舒适 (14/20)。大多数参与者认为，PAPR 比 N95 FFR 提供更高的保护性、舒适性和可重复使用性，并且可以在大流行和其他高风险情况下使用。结论：医护人员应了解感染控制政策，并应提供正确使用呼吸防护装置的培训。 PAPR 可在医院环境中使用，以保护医护人员免受某些高传染性和新出现的病原体的侵害，但是，医护人员需要对 PAPR 的存储、使用和清洁进行充分的培训。
Objectives: Infection control policies and guidelines recommend using facemasks and respirators to protect healthcare workers (HCWs) from respiratory infections. Common types of respirators used in healthcare settings are filtering facepiece respirators (FFRs) and powered air-purifying respirators (PAPRs). Aims of this study were to examine the current attitudes and practices of HCWs regarding the selection and use of respiratory protection and determine the acceptability of a novel PAPR.Methods: In-depth interviews were undertaken with 20 HCWs from a large tertiary hospital in Sydney, Australia. Participants were fit tested with a lightweight tight-fitting half-facepiece PAPR (CleanSpace2 (TM) Power Unit, PAF-0034, by CleanSpace Technology (R)) using the TSI (TM) Portacount quantitative fit test method.Results: Interview results showed that HCWs had a limited role in the selection and use of facemasks and respirators and had been using the devices provided by the hospital. The majority of subjects had no knowledge of hospital policy for the use of facemasks and respirators, had not been trained on the use of respirators, and had not been fit tested previously. Compliance with the use of facemasks and respirators was perceived as being low and facemasks and respirators were typically used only for short periods of time.All 20 participants were successfully fit tested to the CleanSpace2 (TM) PAPR (overall geometric mean fit factor-6768). According to the exit surveys, CleanSpace2 (TM) PAPRs were easy to don (14/20) and doff (15/20) and comfortable to wear (14/20). Most participants believed that PAPRs provide higher protection, comfort and reusability over N95 FFR and can be used during pandemics and other high-risk situations.Conclusions: HCWs should be aware of infection control policies and training should be provided on the correct use of respiratory protective devices. PAPRs can be used in hospital settings to protect HCWs from certain highly infectious and emerging pathogens, however, HCWs require adequate training on storage, use, and cleaning of PAPRs.