N95 RESPIRATOR Personal Protective Equipment and Fit Testing - - PowerPoint PPT Presentation

N95 RESPIRATOR

Personal Protective Equipment and Fit Testing

Outline

 Personal Protective Equipment (PPE)

 Hand Hygiene  Donning and Doffing

 N95 Respirators

 Use and Limitations  Donning and Doffing

 Fit Testing

 Quantitative Test  Results

Personal Protective Equipment

 Personal Protective Equipment or PPE is

very important to protect healthcare personal and prevent the spread of infection

 All PPE should be put on before

entering a patient room or receiving a patient into your procedure room

Personal Protective Equipment

 Different types of isolation, i.e.

airborne, droplet, or contact, require different combinations of PPE to be worn

 Check for the type of isolation the

patient is on or an isolation precaution sign outside of the patient’s room to know what PPE is recommended

Personal Protective Equipment

 Hand Hygiene

 This is the single most important thing to

prevent the spread of infection

 Can use soap and water or an alcohol-

based hand rub

 An exception is when your hands are visibly

dirty or after contact with chemicals (regardless

• f having worn gloves) – then hands must be

washed with soap and water

Personal Protective Equipment

 Hand Hygiene

 Must be done:

 When hands are visibly soiled (* use soap and water)  After coughing, sneezing or blowing your nose  After personal hygiene  Between patients  Touching blood or body fluids regardless of whether gloves were

worn

 After touching potentially contaminated surfaces  Prior to invasive procedures  After exposure to chemicals regardless of whether gloves were

worn (* use soap and water)

Personal Protective Equipment

 PPE includes the following:

 Gowns  Masks  Eye Protection  Gloves

 Once on, don’t touch your skin, clothes,

• r equipment underneath – take out

what you need before you don the PPE

Donning Procedure (Putting On)

 1. Hand Hygiene

• r

Donning Procedure

 2. Gown – Yellow Isolation

Gown

 Opening is to the back  Gown should cover from neck to

knees to wrist

 Tie at back at neck and waist

Donning Procedure

 3. Masks

 Can be a procedure/surgical mask or N95

mask depending on the patient condition

 Check if there are isolation protocols associated

with the patient or an isolation precaution sign

• utside the patient’s room to determine what is

required

 Follow your workplace Occupational Health

and Safety procedures and protocols as to what mask is needed

Donning Procedure

Procedure/Surgical Masks N95 Respirators

Donning Procedure

 3a. Procedure/Surgical Masks

 Secure the ties or elastics around your

head or ears so the mask stays in place

 Fit snugly to your face, over nose and

below chin

 Press metal strip at nose with 2 fingers of

both hands and starting at bridge of nose roll down each side to shape mask around nose – Don’t pinch

Donning Procedure

 3b. N95 Respirators

 Pre-stretch straps prior to donning  Cup the N95 in your hand  Position the N95 under your chin with nose piece

up and stretch the straps over your head

 Press metal strip at nose with 2 fingers of both

hands and starting at bridge of nose roll down each side to shape mask around nose – Don’t pinch

 Fit check the N95 (cover with hands and exhale

sharply looking for leaks) – and adjust if necessary

Donning Procedure

 4. Eye Protection

 Consists of goggles or a face shield

 Place over eyes or face and adjust to fit  Goggles are worn over glasses

Donning Procedure

 5. Gloves

 Pull the ends of the gloves over the cuffs of

the gown

Donning Procedure

 Hand Hygiene should

always be the first step

 Gloves should always be

the last step

Doffing Procedure (Taking Off)

 General rules:

 Remove gloves and gown inside the

patient’s room

 After leaving the patient’s room and closing

the door (depending on isolation protocol), remove mask and eye protection

 The outsides of all PPE are considered

contaminated and should not be touched

Doffing Procedure

 1. Gloves

 Grasp the outside edge of a glove near the wrist

and peel away from the hand, turning the glove inside out

 Hold the glove in the opposite gloved hand  Slide ungloved finger or thumb under the wrist of

the remaining glove

 Peel the glove off, making a bag for both gloves  Put the gloves in the garbage  Should be done without bare skin touching the

• utside surface of any glove

Doffing Procedure

 2. Hand Hygiene

• r

Doffing Procedure

 3. Gown

 Carefully undo ties  Slide fingers under 1 cuff and pull hand into sleeve  With hand in sleeve, hold other sleeve so 2nd hand

can be pulled into sleeve

 Pull both hands through, turning gown inside out

and wrapping into ball

 Dispose of into hamper  Bare skin should not touch the outside of the

gown which is considered contaminated

Doffing Procedure

 4. Hand Hygiene

• r

Doffing Procedure

 5. Eye Protection

 Handle goggles or face shield by headband

• r ear pieces only

 Pull away from face  Throw disposable items into garbage and

clean reusable items with sani-wipes for reuse

Doffing Procedure

 6. Mask or N95 Respirator

 Bend forward slightly and remove mask by

touching only the straps or ties

 Throw the mask or N95 respirator in the

garbage

 Do not touch the outside of the mask as it

is considered contaminated

Doffing Procedure

 7. Hand Hygiene

• r

N95 Respirator

N95 Respirator

 What is a respirator?

 It is a device that is used to protect the

user from breathing in hazardous substances

 There are many different types of

respirator depending on the hazardous substances

N95 Respirator

 What is the function of the N95

Respirator?

 To filter out particles in the air so they are

not inhaled by the user

 Airborne diseases such as Tuberculosis,

chicken pox and measles exist as bacteria

• r virus particles in the air that can be

filtered out by the N95 respirator

N95 Respirator

 Your job duties may require you to be in

contact with patients that are infected

• r are suspected of being infected with

an airborne disease

 Wearing a NIOSH approved N95

respirator is one way to protect a healthcare worker from inhaling these infectious particles

N95 Respirator

 What does an N95 Respirator not

protect against?

 Chemical vapors  Gases  Oxygen deficient atmospheres

N95 Respirator

 When does an N95 Respirator need to

be worn?

 Check Infection Prevention and Control set

guidelines for N95 use

 Read instructions posted outside isolation

rooms as to what PPE is needed

 Know the department’s standard operating

procedures for infection control

 When in doubt, ask for assistance

N95 Respirator

 What needs to happen before wearing

an N95 Respirator?

 Must be clean shaven in area of face seal  Must receive training on use, care, donning

and doffing procedures

 Must pass a quantitative fit test – to know

make and model of mask that fits the user

N95 Respirator

 Donning the N95 Respirator

 Select proper N95 that you have been fit

tested for

 Stretch out elastic straps  Hold mask in one hand  Move elastic straps to the front of the mask  Hold mask to face with one hand, fitting

mask over chin, mouth and nose

N95 Respirator

 Donning the N95 Respirator

 With the other hand stretch top elastic

strap over your head and adjust to fit comfortably at the crown of your head

 Stretch the bottom elastic strap over your

head and adjust to fit comfortably under your ears

N95 Respirator

 Donning the N95 Respirator

 Ensure a snug fit over your nose and

cheeks

 Use 2 fingers of both hand and starting

from the bridge of your nose, roll and press the metal strip along the contour of your nose – Do not pinch!

N95 Respirator

 Donning the N95 Respirator

 Fit test

 With both hands over mask inhale deeply to

ensure the mask adheres to your face

 Exhale sharply to check for any air leaks –

readjust respirator if there are leaks

N95 Respirator

 Doffing the N95 Respirator

 Lean forward slightly  Pull bottom elastic strap over your head  Pull top elastic strap over your head  Discard into garbage using the elastic

straps and without touching outer surface

• f mask which is considered contaminated

 N95 respirators are for a single use only

Fit Testing

 Quantitative Fit Test

 Uses an instrument that measures the

concentration of airborne particles inside the respirator and compares that to the number of airborne particles in the room air

 Provides a measured quality of fit

Fit Testing

PortaCount Fit Testing Equipment

Fit Testing

 Quantitative Fit Test

 The person being tested wears a respirator that is

attached to the machine – glasses are worn if normal

 The person being tested must not have smoked ½

hour prior to testing

 The person will exhale smoke particles into the respirator

resulting in an erroneous score and most likely a fail

 No chewing tobacco or gum allowed  Face must be clean shaven in the area of the face

shield

 A cold will not affect test results

Fit Testing

 Quantitative Fit Test

 7 mini tests are conducted to check the fit:

 Regular breathing  Deep breathing  Moving head side to side  Moving head up and down  Talking – reading out loud  Bending forward and then straightening  Regular breathing

Fit Testing

 Results

 If the respirator provided adequate

protection over the range of exercises, the instrument will display a pass

 A failure in one exercise will not necessarily

mean that the overall fit test will fail

 If the first attempt fails then you will be

asked to either adjust the respirator or try a different model

Fit Testing

 Fit Test Card

 After you have passed a Fit Test, the tester

will give you a card that lists the make and model of mask that you are deemed fit to wear

 The card also had an expiry date of 2

years, when testing is recommended again

 Retesting should also take place if you

have gained or lost a lot of weight or if you have had a significant change in face shape

More Information

 More information can be found:

 Infection Prevention and Control Guidelines of

practicum site or employer

 Alberta Occupational Health and Safety Code  Canadian Standards Association (CSA). Standard

Z94.4-02. Selection, Use, and Care of Respirators. Rexdale, Ontario; 2002

 National Institute for Occupational Safety and

• Health. NIOSH Guide to the Selection and Use of

Particulate Respirators. Publication no. 96-101; NIOSH, Cincinnati, Ohio, 1996