Phenelle Segal Presents Webinar on the Future of Infection Prevention

ICCS Founder Phenelle Segal, RN, CIC, FAPIC, recently presented a webinar for McKesson as part of its ongoing educational webinars series.

The program was titled "The future of infection prevention: Expert insights on the lasting impact of COVID-19" and focused on infection prevention in the era of COVID-19 and beyond.

Phenelle tackled top COVID-19 questions, shed light on critical lessons learned from this and previous pandemics, and detailed what organizations should be doing now to strengthen their facility's infection prevention program to better prepare for the future.

The webinar’s recording can be viewed below.

OSHA Outlines New Enforcement Discretion Policy for Respiratory Protection

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The Occupational Safety & Health Administration (OSHA) has issued a new memorandum that provides temporary enforcement guidance concerning tight-fitting powered air-purifying respirators (PAPRs) used during the COVID-19 pandemic.

The memorandum outlines the new enforcement discretion policy that permits the use of National Institute for Occupational Safety and Health (NIOSH)-approved tight-fitting PAPRs for protection against the novel coronavirus.

There are a few caveats:

  • Usage is only acceptable when initial and/or annual fit-testing is infeasible due to respirator and fit-testing supply shortages. 

  • The guidance only applies to fit-testing of NIOSH-approved tight-fitting PAPRs used as a contingency capacity strategy when performing job tasks with high or very high occupational exposure risk to the novel coronavirus. An example of a tight-fitting PAPR is the elastomeric half-facepiece respirator, which can be cleaned, decontaminated and reused.

OSHA stated that will exercise enforcement discretion, on a case-by-case basis, when considering issuing citations in cases where the employer has:

  • provided NIOSH-approved tight-fitting PAPRs to protect personnel against SARS-CoV-2 (the virus that causes COVID-19) using a high efficiency particulate cartridge or filter, when initial and/or annual fit-testing is infeasible due to shortages of N95, N99, N100, R95, R99, R100, P95, P99, and P100 respirators and/or fit-testing supplies;

  • monitored fit-testing supplies and made good faith efforts to obtain fit-testing supplies;

  • implemented, to the extent feasible, engineering controls, work practices, and/or administrative controls that reduce the need for respiratory protection, such as using partitions, restricting access, and cohorting patients; and

  • maintained a fully-compliant respiratory protection program, other than fit-testing requirements, including ensuring personnel are informed of new policies and trained on new procedures, ensuring employees receive required medical evaluations, ensuring batteries and filters for PAPRs are well maintained to provide positive pressure throughout the entire shift or procedure, and ensuring employees wearing tight-fitting PAPRs maintain neatly trimmed facial hair that does not compromise the seal of the respirator or come between the sealing surface of the facepiece and the face, and that does not interfere with valve function.

The guidance does not apply to PAPRs that have not been approved by NIOSH; PAPRs used by any workers with low or medium exposure risk to SARS-CoV-2; PAPRs used by any workers for protection against airborne hazards other than SARS-CoV-2; and loose-fitting hooded PAPRs that do not require fit-testing.

The interim guidance takes effect immediately and remains in effect until further notice. It is intended to be time-limited to the current public health crisis.

While this temporary enforcement guidance does provide organizations with some flexibility concerning the usage of respirators and fit-testing supplies, organizations should only consider usage of NIOSH-approved tight-fitting PAPRs if absolutely necessary. As OSHA notes, where the above efforts are absent and respiratory protection use is required, or voluntary use is permitted, and an employer fails to comply with applicable medical evaluation, fit-testing, maintenance, care, and training requirements, an organization may face serious violations. 

ECRI Analysis: Majority of KN95 Masks Fail to Meet Minimum Standards

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An analysis of imported Chinese KN95 masks by the not-for-profit organization ECRI showed that up to 70% of these masks fail to meet the minimum U.S. standards for effectiveness, according to a news release.

ECRI tested 15 different manufacturer models of masks and nearly 200 total masks that had been purchased by large U.S. health systems. The tests, which ECRI indicated were performed according to "rigorous product testing protocols," showed that a majority of the masks did not filter 95% of aerosol particulates, as the "95" in KN95 is supposed to indicate. Thus, they do not meet the U.S. National Institute for Occupational Safety and Health (NIOSH) N95 standard.

While this analysis further supports that non-certified KN95 masks should never be used as an alternative to N95s, they can serve as a "surgical mask" alternative, states Infection Control Consulting Services Founder Phenelle Segal, RN, CIC, FAPIC.

Such sentiment was reflected in the ECRI news release, with Michael Argentieri, vice president for technology and safety for the organization, quoted as stating, "KN95 masks that don't meet U.S. regulatory standards still generally provide more respiratory protection than surgical or cloth masks and can be used in certain clinical settings."

ECRI also noted its researchers found that many non-certified masks with head and neck straps, as opposed to masks with ear loops, better conform to and seal against the wearer's face, which helps ensure air being breathed is filtered.