Respirator use Evaluation in Acute care California Hospitals (REACH): An assessment of respirator policies and practices for H1N1 influenza in the health care setting

The California Department of Public Health, Occupational Health Branch, in collaboration with the National Institute for Occupational Safety and Health (NIOSH), is performing an evaluation of respiratory protection programs in a sample of California hospitals during the H1N1 pandemic of 2009-2010. The objectives of this evaluation are to assess the implementation of respiratory protection programs in acute care hospitals in California in the context of H1N1, and to identify common barriers and successes in effective program implementation. Sixteen hospitals were randomly selected for participation, and approximately 21 interviews of hospital managers, unit managers, and healthcare workers were conducted in each hospital using a standardized survey instrument. Interviews included questions about the facility's respiratory protection program and implementation of this program, knowledge and beliefs regarding respirators, and safety climate of the facility. Clinical practices regarding respirator use were observed in each hospital. An anonymous online survey about respirator practices, knowledge, and beliefs was distributed via union email lists to healthcare workers throughout California. Descriptive statistics will be used to identify best practices and limitations of hospital respiratory protection programs. Results are expected to be available by the second quarter of 2010. Preliminary results suggest that there are common shortcomings in hospital respiratory protection program implementation and adherence. The results of this evaluation will be used to identify barriers to implementing and sustaining successful respiratory protection programs for pandemic influenza. This knowledge will aid CDPH and NIOSH in providing useful and timely guidance to healthcare facilities regarding respiratory protection for healthcare workers.