Infection Prevention Manual

EXPOSURE CONTROL PLAN REQUIREMENTS FOR THE SELECTION AND USE OF RESPIRATORY PROTECTIVE DEVICES 1. The agency shall provide for employee use of a NIOSH-approved respirator equipped with high efficiency particulate air (HEPA) filters, the minimally acceptable level of respiratory protection. 2. If disposable respirators are used, their reuse is permitted as long as the respirator maintains its structural and functional integrity. The agency must address the circumstances in which a disposable respirator will be considered to be contaminated and not reusable. 3. Whenever respirators are required to be used, the agency must have a complete respiratory protection program in place. A. Respirators are recommended under the following circumstances: (1) when employees enter the homes or rooms of individuals with suspected or confirmed infectious TB disease (2) when employees perform high hazard procedures on individuals who have suspected or confirmed TB disease including but not limited to: (a) aerosolized medication e .g. Pentamidine (b) bronchoscopy (c) sputum induction (d) endotracheal intubation (e) suctioning procedures (f) when transporting an individual with suspected or confirmed TB disease in a closed vehicle (g) during performance of cough-inducing procedures in a well-ventilated area away from other household members B. The agency will use only respiratory protective devices certified by NIOSH for protection against M. Tuberculosis. C. Respiratory protective devices used for M. Tuberculosis shall meet the following criteria: (1) They will have a NIOSH filter category rating of 95, 99, or 100. (2) They will be able to be qualitatively or quantitatively fit-tested to manufacturer's specifications for most health care workers. (3) They will fit most agency staff with different facial sizes and characteristics. D. Agency staff will be medically screened for conditions which would prohibit wearing respiratory protection prior to being fit tested. E. Agency staff will be fit tested prior to use. F. Agency staff will be required to wear respiratory protection when entering the homes of patients with suspected or confirmed TB. G. Respiratory precautions may be discontinued when the patient is no longer infectious. H. Agency staff unable to wear respiratory protection for medical reasons or because they are unable to obtain a proper fit in the fit test will not be assigned to care for patients with suspected or confirmed TB during the time they are infectious. 4. The agency shall provide the wearer of the respirator mask with education and training in: A. the need for wearing their respirator mask and the potential risks of not wearing it; B. how to properly use the respirator mask and the capabilities, and limitation of the mask; C. inspecting, donning, fit checking, and correctly wearing the respirator mask; with the chance to handle it, learn how to don and wear it properly, and check its important parts. D. the recognition of an inadequately functioning respirator mask. E. the manufacturer's instructions for storage, inspection, cleaning, and maintenance of the respirator mask. 5. The agency will evaluate the effectiveness of the respiratory program.