Respirator Use in a Hospital Setting: Establishing Surveillance Metrics.
Information that details use and supply of respirators in acute care hospitals is vital to prevent disease transmission, assure the safety of health care personnel, and inform national guidelines and regulations.


OBJECTIVE
To develop measures of respirator use and supply in the acute care hospital setting to aid evaluation of respirator programs, allow benchmarking among hospitals, and serve as a foundation for national surveillance to enhance effective Personal Protective Equipment (PPE) use and management.


METHODS
We identified existing regulations and guidelines that govern respirator use and supply at Vanderbilt University Medical Center (VUMC). Related routine and emergency hospital practices were documented through an investigation of hospital administrative policies, protocols, and programs. Respirator dependent practices were categorized based on hospital workflow: Prevention (preparation), patient care (response), and infection surveillance (outcomes). Associated data in information systems were extracted and their quality evaluated. Finally, measures representing major factors and components of respirator use and supply were developed.


RESULTS
Various directives affecting multiple stakeholders govern respirator use and supply in hospitals. Forty-seven primary and secondary measures representing factors of respirator use and supply in the acute care hospital setting were derived from existing information systems associated with the implementation of these directives.


CONCLUSIONS
Adequate PPE supply and effective use that limit disease transmission and protect health care personnel are dependent on multiple factors associated with routine and emergency hospital practices. We developed forty-seven measures that may serve as the basis for a national PPE surveillance system, beginning with standardized measures of respirator use and supply for collection across different hospital types, sizes, and locations to inform hospitals, government agencies, manufacturers, and distributors. Despite involvement of multiple hospital stakeholders, regulatory guidance prescribes workplace practices that are likely to result in similar workflows across hospitals. Future work will explore the feasibility of implementing the collection and reporting of standardized measures in multiple facilities.
Department of Health and Wellness, Vanderbilt University, 1211 21 Avenue South, 640 Medical Arts Building, Nashville, TN.
Mary I
MI
Yarbrough
InfoWorks, Inc., 102 Woodmont Blvd., Suite 500, Nashville, TN.
Meredith E
ME
Ficken
Department of Health and Wellness, Vanderbilt University, 1211 21 Avenue South, 640 Medical Arts Building, Nashville, TN.
Christoph U
CU
Lehmann
Department of Health and Wellness, Vanderbilt University, 1211 21 Avenue South, 640 Medical Arts Building, Nashville, TN.
Thomas R
TR
Talbot
Department of Health and Wellness, Vanderbilt University, 1211 21 Avenue South, 640 Medical Arts Building, Nashville, TN.
Melanie D
MD
Swift
Department of Health and Wellness, Vanderbilt University, 1211 21 Avenue South, 640 Medical Arts Building, Nashville, TN.
Paula W
PW
McGown
Department of Health and Wellness, Vanderbilt University, 1211 21 Avenue South, 640 Medical Arts Building, Nashville, TN.
Robert F
RF
Wheaton
Department of Health and Wellness, Vanderbilt University, 1211 21 Avenue South, 640 Medical Arts Building, Nashville, TN.
Michele
M
Bruer
InfoWorks, Inc., 102 Woodmont Blvd., Suite 500, Nashville, TN.
Steven W
SW
Little
National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA.
Charles A
CA
Oke
Hospital settings; PPE Surveillance System; Personal Protective Equipment; Respirator use and supply