Demonstration and Sentinel Surveillance System for Ongoing and Continuous Monitoring of PPE (Respirator) Usage by Healthcare Workers (HCW) in the US. Charles A. Oke, VMD, MPH, 1 FACE ; Mary Yarbrough, MD, MPH, 2 FACOEM NIOSH/National Personal Protective Technology Laboratory1; Vanderbilt University2 Objectives • Utilize the Vanderbilt Occupational Health Information System (VOHIS) to gather data about HCW protection related to PPE: selection, usage, supply, ordering, defects, fitting, safety programs and implementation • Determine what specific activities and resources are utilized by the hospital systems in their hazard prevention programs (HPP) • Evaluate the quality and effectiveness of PPE in HPP • Use system to demonstrate and report best practices of PPE in HPP Background • 13 Million workers in healthcare • IOM report Preparing for an Influenza Pandemic: PPE for Healthcare Workers (2008) states PPE is a vital component of a system safety controls and preventive measures used in healthcare facilities • Value of monitoring and evaluating the activities and resources regarding PPE use among HCWs and safety prevention programs in hospital systems not formally assessed (Figure 1) Methods Results • Examine current state of medical center PPE usage surveillance at the national level • Documented and described existing system at VUMC • Survey top hospitals and state/national agencies • Survey HCW knowledge, attitudes, and beliefs about N-95 respirators See companion poster for more detail • Described the process needed to monitor the operations Figure 2 column two • Identified data collection points to be used in the system • Survey HCWs exposed to airborne infection Figure 2 columns one and three Criteria Evaluation • Acceptability Next Steps • Flexibility • Cost • Timeliness • Specificity • Sensitivity • Feasibility • Data collection points • Pilot expanded system at Vanderbilt • Produce formal needs assessment document • Roll the system out to 5 large hospital systems • Incorporation into a national system (Figure 3) • Standardization & Harmonization PREVENTION Respirator Medical Clearance and N95 Fit Testing Employee Community Vaccination Programs Employer Vaccination and Training Programs Patient Surveillance Reports to managers PATIENT ADMISSION Disease report to state/federal public health agencies Patient airborne infectious disease identified Laboratory Identification Medical Provider orders isolation Patient placed on Airborne Precautions Negative pressure room Treatment plan implemented HCW implements isolation and dons PPE (N95 ) INFECTION SURVEILLANCE Central Supply manages supply and recall of PPE Recognition of unprotected exposure to patient Unprotected HCW notification Signs on doorway Visitors informed HCW tested and PPE given Friends and family notified and advised to seek medical follow-up Periodic surveillance to identify disease in HCW Ongoing surveillance Report injury / illness to OSHA Report to Workers’ Compensation Report to hospital IC committee Figure 3. Simplified Flow Chart of a National Surveillance System Report to hospital committees (JCAHO) Disclaimer Figure 1. Simplified example of steps in a surveillance system Figure 2 is a model of how a respiratory safety program is enacted in a hospital, what happens at each stage of the safety program, what measures could be used to assess the effectiveness of the safety program, and what database sources could be used here to provide information on those measures. The findings and conclusions in this poster have not been formally disseminated by the National Institute for Occupational Safety and Health and should not be construed to represent any agency determination or policy.