title: Hospital respiratory protection practices in 6 U.S. states: a public health evaluation study.
abstract: BACKGROUND
  Lessons learned from the influenza A (H1N1) virus revealed a need to better understand hospitals' respiratory protection programmatic practice gaps. This article reports findings from a multistate assessment of hospitals' adherence to the Occupational Safety and Health Administration's respiratory protection program (RPP) requirements and the Centers for Disease Control and Prevention's infection control guidance.
  
  
  METHODS
  Onsite surveys were conducted in 98 acute care hospitals in 6 U.S. states, including >1,500 hospital managers, unit managers, and health care workers. Descriptive statistics were used to assess hospital adherence.
  
  
  RESULTS
  Most acute care hospitals adhere to requirements for initial medical evaluations, fit testing, training, and recommended respiratory protection when in close contact with patients who have suspected or confirmed seasonal influenza. Low hospital adherence was found for respiratory protection with infectious diseases requiring airborne precautions, aerosol-generating procedures with seasonal influenza, and checking of the respirator's user seal. Hospitals' adherence was also low with follow-up program evaluations, medical re-evaluations, and respirator maintenance.
  
  
  CONCLUSIONS
  Efforts should be made to closely examine ways of strengthening hospitals' RPPs to ensure the program's ongoing effectiveness and workers' proper selection and use of respiratory protection. Implications for improved RPPs and practice are discussed.
authors.affiliation: RTI International, Research Triangle Park, NC.
authors.forename: Kristina
authors.initials: K
authors.lastname: Peterson
authors.affiliation: National Institute for Occupational Safety and Health/National Personal Protective Technology Laboratory, Pittsburgh, PA. Electronic address: ian5@cdc.gov.
authors.forename: Debra
authors.initials: D
authors.lastname: Novak
authors.affiliation: National Institute for Occupational Safety and Health/National Personal Protective Technology Laboratory, Pittsburgh, PA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Stradtman
authors.affiliation: RTI International, Research Triangle Park, NC.
authors.forename: David
authors.initials: D
authors.lastname: Wilson
authors.affiliation: RTI International, Research Triangle Park, NC.
authors.forename: Lance
authors.initials: L
authors.lastname: Couzens
mesh_terms: D000818:Animals; D003428:Cross Infection / Q000517:prevention & control*; D019983:Guideline Adherence; D006779:Hospitals, Public; D006801:Humans; D017053:Infection Control / Q000379:methods*; D016272:Occupational Health; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D014481:United States
keywords: Health care workers; Respiratory protection; Survey