Comparing Written Programs and Self-Reported Respiratory Protection Practices in Acute Care Hospitals

Abstract

Airborne biological hazards in hospitals require the use of respiratory protection. A well-implemented respiratory protection program can protect health care workers from these exposures. This study examines the relationship between written respiratory programs and reported practices in health care settings. Twenty-eight hospitals in Illinois and Minnesota were recruited to a study of respiratory protection programs and practices in acute care settings. Interviews were conducted with hospital managers, unit managers, and health care workers from departments where respirators are commonly required. Each hospital's written respiratory protection program was scored for the 11 elements required by the Occupational Safety and Health Administration (OSHA), using a standardized tool, for a maximum possible score of 22 (2 pts. per element). Twenty interview questions associated with program practices were also scored by percent correct responses. Written program scores ranged from 2–17 with an average of 9.2. Hospital and unit managers scored on average 82% and 81%, respectively, when compared to the OSHA standard; health care workers scored significantly lower, 71% (p < 0.001). Minnesota written program scores were not significantly higher than Illinois hospitals (p = 0.16), while all Illinois survey respondents scored higher than those in Minnesota (p < 0.001). There was no trend between written programs and interview responses. Written respiratory protection programs in the study sites did not provide the level of detail required OSHA. Interview responses representing hospital practices surrounding respiratory protection indicated that hospitals were aware of and following regulatory guidelines.

Keywords:

• aerosol transmissible disease
• program evaluation
• respiratory protection
• scoring

ACKNOWLEDGMENTS

None of the authors has any financial or other conflicts of interest. We would like to acknowledge the support of infection control and health and safety professionals in both states. We thank graduate students Jason Lotter and Lasbat Ergobogbo for their assistance with interviews in Illinois hospitals and Kara Durski and Kari Cline with interviews in Minnesota hospitals.

FUNDING

This project was funded by a University of Minnesota contract with the National Institute for Occupational Safety and Health (No. 254-2010-36476) and a University of Illinois Chicago (UIC) subcontract (No. P001873801). Some UIC research staff also received support from NIOSH Grant No. T42/OH008672.

SUPPLMENTAL MATERIAL

Supplemental data for this article can be accessed at tandfonline.com/uoeh. AIHA and ACGIH members may also access supplementary material at http://oeh.tandfonline.com/.