Don't Worry About Us - We'll Be Fine Without the N95

[Blue]

http://afludiary.blogspot.com/

I am so disgusted at this group right now. I would like to see the evidence for this decision.

We are the human resources that make it possible to care for all of these patients, but we might as well be boxes of gloves or disposable tissues...

There is now a move afoot to lower the recommendation from using the more expensive (and widely assumed to be more protective) N95 respirators to using surgical masks (which are more plentiful) in a healthcare setting.



The same surgical masks we?ve been told for years provided `little or no protection? against the influenza virus.


This recommendation comes from the CDC?s Healthcare Infection Control Practices Advisory Committee (HICPAC).

[morningperson]

Re: Don't Worry About Us - We'll Be Fine Without the N95

Has HICPAC lost its mind?????

[Blue]

Re: Don't Worry About Us - We'll Be Fine Without the N95

They aren't doing patient care, and figure we will run out of masks by then anyway...

And then, they will rescue us with the vaccine. So for the first time, more than 40% of us might be willing to get the vax.

I don't know what they are thinking. We won't have any antibodies for awhile yet anyway.

Using the face masks, most of us won't need the vax. We will already be immunized by people coughing in our faces like they already do.

[silvergirl]

Re: Don't Worry About Us - We'll Be Fine Without the N95

BYOM-bring your own masks to work....sick...they really don't care do they?

[silvergirl]

Re: Don't Worry About Us - We'll Be Fine Without the N95

BYOM-bring your own masks to work....sick...they really don't care do they?
So much for"we are prepared for a pandemic or catastrophe of magnificent proportion." No PPE? NO WORKEE

[NurseNalts]

Re: Don't Worry About Us - We'll Be Fine Without the N95

Here's the link to CDC recommendations for Droplet Precautions

http://www.cdc.gov/ncidod/dhqp/gl_isolation_droplet.html

II.B.2. Droplet Precautions Droplet Precautions are intended to prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions as described in I.B.3.b. Because these pathogens do not remain infectious over long distances in a healthcare facility, special air handling and ventilation are not required to prevent droplet transmission. Infectious agents for which Droplet Precautions are indicated are found in Appendix A of the HICPAC/CDC Isolation guideline and include B. pertussis, influenza virus, adenovirus, rhinovirus, N. meningitides, and group A streptococcus (for the first 24 hours of antimicrobial therapy). A single patient room is preferred for patients who require Droplet Precautions. When a single-patient room is not available, consultation with infection control personnel is recommended to assess the various risks associated with other patient placement options (e.g., cohorting, keeping the patient with an existing roommate). Spatial separation of patients by > 3 feet and drawing the curtain between patient beds is especially important for patients in multi-bed rooms with infections transmitted by the droplet route. Healthcare personnel wear a mask (a respirator is not necessary) for close contact with infectious patient; the mask is generally donned upon room entry. Patients on Droplet Precautions who must be transported outside of the room should wear a mask if tolerated and follow Respiratory Hygiene/Cough Etiquette.


Here's specifics on Airborne-Transmission Precautions:
III.B.3. Airborne Precautions Airborne Precautions prevent transmission of infectious agents that remain infectious over long distances when suspended in the air (e.g., rubeola virus [measles], varicella virus [chickenpox], Mycobacterium. tuberculosis, and possibly SARS-CoV) as described in I.B.3.c and Appendix A of the HICPAC/CDC Isolation Guideline. The preferred placement for patients who require Airborne Precautions is in an airborne infection isolation room (AIIR). An AIIR is a single-patient room that is equipped with special air handling and ventilation capacity that meet the American Institute of Architects/Facility Guidelines Institute (AIA/FGI) standards for AIIRs (i.e., monitored negative pressure relative to the surrounding area, 12 air exchanges per hour for new construction and renovation and 6 air exchanges per hour for existing facilities, air exhausted directly to the outside or recirculated through HEPA filtration before return). Some states require the availability of such rooms in hospitals, emergency departments, and nursing homes that care for patients with M. tuberculosis. A respiratory protection program that includes education about use of respirators, fit-testing, and user seal checks is required in any facility with AIIRs. In settings where Airborne Precautions cannot be implemented due to limited engineering resources (e.g., physician offices), masking the patient, placing the patient in a private room (e.g., office examination room) with the door closed, and providing N95 or higher level respirators or masks if respirators are not available for healthcare personnel will reduce the likelihood of airborne transmission until the patient is either transferred to a facility with an AIIR or returned to the home environment, as deemed medically appropriate. Healthcare personnel caring for patients on Airborne Precautions wear a mask or respirator, depending on the disease-specific recommendations (Respiratory Protection II.E.4, and Appendix A of the HICPAC/CDC Isolation Guideline), that is donned prior to room entry. Whenever possible, non-immune HCWs should not care for patients with vaccine-preventable airborne diseases (e.g., measles, chickenpox, and smallpox).


PLEASE NOTE THE RECOMMENDATIONS FOR N95's directly from the CDC website, and note comment on HCW's who are non-immune to vaccine preventable airborne diseases are NOT recommended to care for infected patients. SOOOOOOOO, is H1N1 considered potentially airborne???? Is it lethal enough in serious cases to protect those caring for the sick,or caring for YOUR loved ones, our going home to care for their OWN families???

BYOM or walk. You can't care for others if you don't protect yourself, FIRST!!!

[Blue]

Re: Don't Worry About Us - We'll Be Fine Without the N95

I know what they have been saying, but now they are changing their minds, and our masks by October? Dang! So what will labor say next week? Will it make a difference?

APIC is pleased, isn't that just dandy...

Not to worry, if you have to suction, then you can use an N95. Better document that, though.

http://www.apic.org/Content/NavigationMenu/GovernmentAdvocacy/PublicPolicyLibrary/HICPAC_H1N1_Guideline.pdf

The Working Group recommendations were based on the results of a
systematic review on respiratory protection devices for Influenza A (H1N1) performed
by the Center for Evidence-Based Practice at the University of Pennsylvania Health
System in June 2009. The guidance development process continues with a CDC meeting
to hear the views of labor organizations on July 28. On August 11-14, 2009, the Institute
of Medicine (IOM) will convene an expert panel on personal protective equipment for
healthcare personnel in the workplace against H1N1. The guidance development process
is expected to be completed by October 1, 2009. APIC is pleased that the Working Group
recommendations are consistent with an APIC-endorsed position paper.

As some of you are aware, a number of state health departments, after recognizing that
the Novel H1N1 influenza was similar to the seasonal influenza, advised healthcare
organizations within their jurisdictions that standard and droplet precautions should be
followed for patients with Novel H1N1 rather than airborne infection isolation. After a
systematic review of the transmission of airborne infections, the H1N1 Working Group
arrived at the following recommendations for minimum isolation precautions:
? Healthcare personnel should wear a surgical mask when caring for patients with
suspected or confirmed cases.
? An N95 respirator is recommended for select procedures that are potentially
aerosol-generating (e.g. bronchoscopy, intubation, CPR, open airway suctioning,
and sputum induction).
? Healthcare personnel should adhere to standard and droplet precautions for 7 days
after the onset of illness or until symptoms resolve, whichever is longer.

[High Risk]

Re: Don't Worry About Us - We'll Be Fine Without the N95

Oh My, this is awful guidance. If the plan was never to protect numbers of HCWs, the middle of the pandemic is certainly not the time to practice a swine flu party mentality with the HCWs and with their unknowing patients. Can't this country and all industrialized nations, and some others produce enough N-95 masks to protect emergency personnel and HCWs? Apparently not. I just hope most of you work in a good state at a savvy hospital.

[NurseNalts]

Re: Don't Worry About Us - We'll Be Fine Without the N95

"I know what they have been saying, but now they are changing their minds, and our masks by October? Dang! So what will labor say next week? Will it make a difference?

APIC is pleased, isn't that just dandy...

Not to worry, if you have to suction, then you can use an N95. Better document that, though."

*****************
I'm on your side. My point is that they (CDC) are changing their tune, their own website clearly supports n95 masks if a disease is known to be airborne, and with the aerosol potential of H1N1 and the fact that if you haven't already gotten it, or your are vaccinated x2 with good immune response - you ARE going to get it!

If the issue is about supply and cost, what kind of cost is it to have staff out sick, or staff out caring for their sick families? And what kind of cost is it to society when the caregivers can't properly and safely care for their patients?The hospital has obligation to provide protection.

If masks aren't provided, then why not practice without gloves, goggles or safe needles for that matter? Nursing is a career, a job, yes we may be in it by some special "calling", but this is not some martyrdom. We serve others for the greater good, but we cannot sacrifice our health, or even lives or that of our childrens because some big health conglomerate thinks we are dispensable! Nurses can refuse to work in unsafe situations. We should do our part, be a loud voice to our employers before a greater impact from the pandemic, and if proper PPE's are not provided, you have to protect yourself first in order to be of any help to anyone else.

.

[Lizw]

Re: Don't Worry About Us - We'll Be Fine Without the N95

PLEASE NOTE THE RECOMMENDATIONS FOR N95's directly from the CDC website, and note comment on HCW's who are non-immune to vaccine preventable airborne diseases are NOT recommended to care for infected patients. SOOOOOOOO, is H1N1 considered potentially airborne???? Is it lethal enough in serious cases to protect those caring for the sick,or caring for YOUR loved ones, our going home to care for their OWN families???

BYOM or walk. You can't care for others if you don't protect yourself, FIRST!!!

What an intelligent way to encourage health care workers to come to work in a pandemic. It's like telling firefighters they won't be provided with turn-out gear any more, but they have to come to work anyway.

[Flufreak]

Re: Don't Worry About Us - We'll Be Fine Without the N95

Our health care facility's influenza surge plan states that workers must continue to work ( 12 hour shifts with mandatory overtime, all leave and vacations cancelled ), even if not vaccinated and the hospital runs out of anti-viral medications , until they become symptomatic, and as soon as they are not symptomatic. Running out of masks is not addressed.

[Blue]

Re: Don't Worry About Us - We'll Be Fine Without the N95

*

****************
I'm on your side.

I know you are, NurseNalts. You are a colleague.

Lord protect us all.

[AlaskaDenise]

Re: Don't Worry About Us - We'll Be Fine Without the N95

........ surge plan states that workers must continue to work ....... until they become symptomatic,..........

So HCW will become spreaders during they infectious pre-symptomatic period?

I thought hospitals were supposed to cure illness not start it.

.

[littlebird]

Re: Don't Worry About Us - We'll Be Fine Without the N95



Now now... these masks are expensive. We can't just hand them out to EVERY Tom, Dick, and Health Care worker.