Evaluation of respiratory protection programs and practices in California hospitals during the 2009-2010 H1N1 influenza pandemic.
BACKGROUND
Emergence of the novel 2009 influenza A H1N1 virus in California led to an evaluation of hospital respiratory protection programs (RPPs) and practices by the California Department of Public Health during the 2009-2010 influenza season.


METHODS
Onsite evaluation of 16 hospitals consisted of interviews with managers and health care workers about RPPs and practices, review of written RPPs, and limited observations of personnel using respirators. Data were analyzed using descriptive statistics.


RESULTS
All hospitals had implemented policies requiring the minimum use of N95 filtering facepiece respirators when working with patients with H1N1 virus infection; 95.5% of health care workers (n = 199) reported they would wear at least this level of protection when in close contact with a patient with confirmed or suspected H1N1 virus infection. However, evaluation of written RPPs indicated deficiencies in required areas, most commonly in recordkeeping, designation of a program administrator, program evaluation, employee training, and fit testing procedures.


CONCLUSIONS
Health care workers were aware of respiratory protection required when providing care for patients with confirmed or suspected H1N1 virus infection. Hospitals should improve written RPPs, fully implement written procedures, and conduct periodic program evaluation to ensure effectiveness of respirator use for health care worker protection. Increased accessibility of resources tailored for hospital respirator program administrators may be helpful.
Epidemiology Fellowship Program, Council of State and Territorial Epidemiologists, Atlanta, GA; California Department of Public Health, Occupational Health Branch, Richmond, CA.
Stella
S
Beckman
Barbara
B
Materna
Suzi
S
Goldmacher
Jennifer
J
Zipprich
Maryann
M
D'Alessandro
Debra
D
Novak
Robert
R
Harrison
D002140:California / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D006761:Hospitals; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D058873:Pandemics; D012134:Respiratory Protective Devices / Q000706:statistics & numerical data*
Aerosol transmissible disease; Health care; Hospital; N95 respirator; Preparedness