Navigating the shifting sands of filtering facepiece respirator provision during the COVID-19 pandemic: a system response for maximising staff safety.
Navigating the shifting sands of filtering facepiece respirator provision during the COVID-19 pandemic: a system response for maximising staff safety.
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DOI：
10.1136/bmjoq-2020-001163
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发表时间：
2021-08
期刊：
影响因子：
1.4
通讯作者：
Wilton N
中科院分区：
文献类型：
--
作者：
Allison C;Tennant M;Xiang P;Stephens J;Ball O;Wilton N
个人防护装备对于保护卫生工作者和患者以及在处理雾化疾病传播时确保信心至关重要。我们描述了在COVID-19大流行期间确保在地方一级进行充分的过滤式面罩呼吸器（FFR）定性匹配测试的过程。描述了级联训练，它允许测试过程的快速传播，监督允许整个质量保证。测试包括主观的“适合检查”，检查泄漏，然后是定性的引擎盖测试。原始呼吸器（3M 1870）防护罩测试合格率为87.5%。在确定这是一种不可再生和不可持续的选择之后，采用了一种国内制造的可持续的Help-It P2鸭嘴型呼吸器作为主要的FFR。该口罩的防护罩测试合格率仅为54%。第三种呼吸器可用（3M 1860），通过率高达80%，但也是有限的不可再生资源。根据最有限的资源，构建了突出不同比例使用呼吸器的算法。所使用的测试格式简单，可重复，当职业健康和安全部门在需求巨大的情况下无法提供服务时，任何医院组织都可以使用。定性匹配测试是一种可扩展且有效的方法，可确保ffr的尺寸和形状合适，从而最大限度地减少过程中的资源消耗。使用具有适当过滤能力但适合测试合格率较低的产品（国内鸭嘴鸭呼吸器）作为替代资源，促进了工作人员获得足够的呼吸器，否则是不可能的。提供FFR匹配注册表允许组织根据供需变化为不同来源的员工提供合适的呼吸器。
Personal protective equipment is essential to protect health workers and patients and to ensure confidence when dealing with aerosolised disease transmission. We describe the process for ensuring adequate filtering facepiece respirator (FFR) qualitative fit testing at a local level during the COVID-19 pandemic. Cascaded training is described, which allowed rapid spreading of the testing process, with supervision allowing quality assurance throughout. Testing consisted of subjective ‘fit checking’, checking for leaks, followed by qualitative hood testing. The original respirators (3M 1870) had a hood test pass rate of 87.5%. Following identification of this as a non-renewable and unsustainable option, a domestically manufactured and sustainable Help-It P2 duckbill-type respirator was adopted as the primary FFR. The hood test pass rate for this respirator was only 54%. A third respirator was made available (3M 1860), with a high pass rate of 80% but also a limited and non-renewable resource. Algorithms were constructed highlighting different proportional use of the respirators depending on the most limited resource. The testing format used is simple, reproducible and can be used by any hospital organisation when occupational health and safety departments are unable to provide the service during overwhelming demand. Qualitative fit testing is a scalable and effective method for ensuring appropriately sized and shaped FFRs, minimising resource consumption in the process. The use of a product with appropriate filtration capacity but a lower fit test pass rate (domestic duckbill respirator) as a replaceable resource facilitated adequate respirator availability for staff that would otherwise not have been possible. The provision of an FFR fit registry allows an organisation to make appropriate respirators available to staff from different sources as supply and demand changes.