Nurses file Cal-OSHA complaint over A/H1N1 mask issue

[Shiloh]

Source: http://news.prnewswire.com/DisplayR...STORY=/www/story/07-14-2009/0005059854&EDATE=

Nurses File Cal-OSHA Complaint After Hospital Refuses to Supply Swine Flu Masks for Units with Infected Patients




Sutter Solano Creates Potential Danger to Patients and Conditions That Could Further Spread Swine-Flu Pandemic with Refusal to Safeguard RNs

OAKLAND, Calif., July 14 /PRNewswire/ -- RNs from the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) have filed an urgent plea with the state of California to step in and force Sutter Solano Hospital to provide nurses with proper safety equipment when they care for patients infected with the H1N1 "swine flu" virus. The nurses fear that the unsafe procedures at the hospital create a danger of infection for every patient at the facility, as well as for the surrounding community.

The plea comes as nurses are actively caring for hospital patients infected with the virus, and with up to 10 RNs from the facility experiencing severe respiratory illness in recent weeks that their physicians have called "probably" the swine flu, leaving them physically unable to work.

The nurses requested assistance from the California Division of Occupational Health and Safety just days after the World Health Organization re-classified H1N1 as an "unstoppable" Level 6 pandemic, with the number of confirmed cases worldwide approaching 100,000, and 170 confirmed deaths in the United States alone.

Sutter Solano has purchased so few of the proper N95 masks that most nurses working with patients are unable to procure an adequate supply of disposable masks. Last week, the union raised their concerns with management. On Friday, the hospital supplied new masks that did not properly fit, making them useless for stopping the virus. Management responded by ordering the nurses to wear a contact mask on top of the ill-fitting N95 masks but the nurses raised concerns because doing so can increase carbon dioxide retention in the mask wearer. Earlier that week, management had given nurses a single mask in a plastic bag, with instructions to re-use it repeatedly, rendering the mask useless for infection control purposes. Compounding these problems, some rooms with infected patients lack appropriate HEPA filters, and proper isolation protocol is not being followed, with visitors moving in and out of contact with infected patients.

"Nurses will be on the front line of the fight against the H1N1 virus. However, if hospitals refuse to take basic safety steps to protect them from exposure, then infected RNs will be physically unable to continue working and may well become a vector for further infection. We nurses are shocked that hospital management is exposing us to this risk. It endangers every other person we come into contact with--our patients, our family, even management. This is not a time for finger-pointing, this is the time for Sutter Solano management to do their job and provide nurses with basic safety protections," said Sherry Ramsey, a RN at Sutter Solano.

Hospital management has claimed that there is a national shortage of the appropriate masks, a charge not verifiable in any way: neither the Centers for Disease Control nor the mask's manufacturers have reported any shortage, and other hospitals are able to provide their nurses with this safety protection.

"Sutter Health is an outlier with their refusal to protect nurses against the H1N1 virus. They must immediately move to safeguard these nurses, because we have a very busy and deadly flu season coming up, and hospitals must meet safety standards," said Deborah Burger, RN, a diabetes case management nurse and co-President of CNA/NNOC.

A study published in October 2009 by the Journal of Occupational and Environmental Hygiene found that face-seal leakage, such as that caused by the use of ill-fitting masks, is a key reason for mask failure, and allowing the penetration of viral particles. The article, "Performance of an N95 Filtering Facepiece Particulate Respirator and a Surgical Mask During Human Breathing: Two Pathways for Particle Penetration," by Sergey A. Grinshpun et. al., reports that, "The number of particles penetrating through the faceseal leakage of the tested respirator/mask far exceeded the number of those penetrating through the filter medium."

CNA/NNOC is the largest and fastest-growing organization of RNs in the U.S. with 86,000 members in all 50 states.


SOURCE California Nurses Association/National Nurses Organizing Committee

 

[Desolation_anonymous]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

Good for them.

Sadly, living in the bay area (and working on Oakland) Sutter's attitude is not alone. kaiser shut down flu clinics over a month ago. when I had a bad respiratory infection with bronchitis, and I was wearing a mask when I went to the hospital, they told me to take my mask off because it was just scaring people.

Haven't seen doctors or nurses with masks for months.

 

[tropical]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

Good for them.

Sadly, living in the bay area (and working on Oakland) Sutter's attitude is not alone. kaiser shut down flu clinics over a month ago. when I had a bad respiratory infection with bronchitis, and I was wearing a mask when I went to the hospital, they told me to take my mask off because it was just scaring people.

Haven't seen doctors or nurses with masks for months.

Precisely the wrong behaviour many times seen from health personnel (at developed countries also), a freaky wrong staff behavior.
A shame for infectious shielding procedures.

Obviously those hospital managers did not "managing" well, when they obviously knows well that an chimerized pandemic is on the stage.

Probably the health state of emergency contemplated sanctions for such obvious creators of hospital pandemic infections future spreaders and possible victims.

 

[peter m]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

Source: http://news.prnewswire.com/DisplayR...STORY=/www/story/07-14-2009/0005059854&EDATE=

Nurses File Cal-OSHA Complaint After Hospital Refuses to Supply Swine Flu Masks for Units with Infected Patients

"Sutter Solano Creates Potential Danger to Patients and Conditions That Could Further Spread Swine-Flu Pandemic with Refusal to Safeguard RNs
Sutter Solano has purchased so few of the proper N95 masks that most nurses working with patients are unable to procure an adequate supply of disposable masks. Last week, the union raised their concerns with management. On Friday, the hospital supplied new masks that did not properly fit, making them useless for stopping the virus. Management responded by ordering the nurses to wear a contact mask on top of the ill-fitting N95 masks but the nurses raised concerns because doing so can increase carbon dioxide retention in the mask wearer. Earlier that week, management had given nurses a single mask in a plastic bag, with instructions to re-use it repeatedly, rendering the mask useless for infection control purposes. Compounding these problems, some rooms with infected patients lack appropriate HEPA filters, and proper isolation protocol is not being followed, with visitors moving in and out of contact with infected patients."

Appears to be a supply chain problem with hospitals running just in time inventory practices, only ordering supplies when needed and often not ordering enough. hospitals are like many other corporations in that they will not keep a large enough supply as it is too espensive and hospitals run tight budgets. Not only that but they often order incorrect items, and this results in major foul ups. I have been in the supply chain business and have had to run supplies to hospitals all over S Cal and LA region, often in very short notce, and often the hosp need those supplies in an hr or 2 from time of ordering.
This fall we will see major supply problems as hospitals will need items at very short notice to deal with this pandemic, and delivery route specialists to run them in. I am in that business and it is very high stress as those doctors need that kidney or anti-viral delivered quick, and i mean quick. It could well be a life and death matter for the patient. That is the nature of supply chain distribution logistics for medical supply delivery.

 

[peter m]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

There will also be an increase in the no of companies doing pickup & dropoffs of patients and transporting them to local clinics/hospitals for treatment, and this will increase dramatically as the Sw flu picks up full speed this fall and roars full blast this winter here in Scal, which is when the flu usually hits hardest.
(Oct-feb are the peak months for seasonable flu in S Cal and i assume the Sw flu will hit at about the same time. Perhaps in two waves: a mid fall wave and a late winter wave.

This type of work(patient transport) is low paying and usually part-time and good for retirees and maybe students but you do need some delivery exprience skiils and a clean DMV record as these patient transport companies do not want to pay excessive insurance and bonds for drivers with marred dmv records.
Might be an opportunity for some out of work desperate Californians , of which we have over two million now, and 3-4 million if u include total U-6 UE rate.

 

[AlaskaDenise]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

a quick check of Amazon.com shows only 1 of 50 suppliers was out of stock.

.

 

[tropical]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

I agree Peter.

Now it is time to the managers to ask more money from whatsoever, even budgeted sources, if the market holes and banks were foraged by fresh money worldwide, it could be done with the ER/hospitals also.

When the things will slip out of hands, it will be late to ask/aspect anything.

 

[peter m]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

Hospitals could order large supplies of those N95 masks in quanities enough for a major pandemic outbreak but they like everyone else do not know how bad the outbreak will be this fall. They could end up with an oversupply which ties up dollars in idled inventory. No business i know of keeps an oversupply of anything. They order it as they need it. This is the nature of modern just-in-time inventory.
If that Oakland Hosp HAD A sudden upsurge of patients and needed a large supply of N95 masks quickly(assuming they ordered correctly , which they didn't in this case) they could do rush ordering via same day or next day express but that is too,too expensive, and remember, Hospitals are run like businesses like any other corporation, at least at the upper-tier administrative management level. They need to manage costs. That is our Modern-day managed health care, at least in the private sector.
Also, CA Gov't-subsidized medical cash aid/infusions are taking a hit from a deteriorated economy and shrinking CA Gov't revenues(Ca tax revenues fell 25% from a year ago). One OC major hospital chain just announced 150 layoffs today. Out of control budgets, shrinking revenues, increasingly rising nos. of uninsured patients, all affect ability of the medical profession to operate effectively.
Only a few hospitals in rich areas OF LA /CA such as Cedar Sinai & and UCLA /Westwood Medical centers have good financial resources and good revenue streams available to provide top notch service. But they are few and far between and serve a relatively small part of LA, the tiny wealthy LA Westside enclave(home of the rich and famous!) which is <5 % of the LA County area and population. 90% of Ca hospitals are running in the red and this will affect quality & levels of hospital care statewide ,at every level.

 

[tropical]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

They can shut down all the hospitals worldwide - that will cut the expencies to 0% (the "economy" could loose the spared at the markets again), but they don't - why?

By the same above logic, it could be provide the respirators and gloves for the hospital staff.

The gloves must be already frequently changed because of hospital inspections, and the respirators could lasts 5 years, time schedule enaugh wide to use all of them even if there will be no more pandemic flu.

Without matched vaccines, by sticking and breathing spreading germs inner the hospitals, from and to the patients, is not a small matter.

 

[Tonka]

Re:Reuse of nurses' masks sparks dispute

Re:Reuse of nurses' masks sparks dispute

http://www.contracostatimes.com/solanocounty/ci_12867096

Reuse of nurses' masks sparks dispute
By Shauntel Lowe
VALLEJO TIMES-HERALD
Posted: 07/18/2009 01:34:50 PM PDT
Updated: 07/18/2009 07:07:08 PM PDT


A complaint filed last week by nurses who say they may have contracted swine flu at work could give birth to new standards about what level of protection employers owe their employees.

Investigators from the state Division of Occupational Safety and Health are now trying to determine what constitutes a "use" of the specialty masks designed to protect against pandemic illness, like swine flu.

The nurses from Sutter Solano Medical Center allege hospital management is jeopardizing their health by asking them to reuse the 3M N95 masks.

About 10 nurses say they have developed respiratory illness over the past few weeks as they treat patients with either confirmed or suspected cases of swine flu. The virus has been blamed for one Solano County death.

But what does it mean to "reuse" the masks? Is it entering the room of one sick patient and moving to another without swapping for a new one? Or is it only a reuse when the mask has gotten wet or otherwise damaged?

It depends on who you ask.

"We're not in a position to say a hard-and-fast rule on any of that right now," Cal-OSHA Senior Safety Engineer Deborah Gold said.

Since the nurses, with the backing of the California Nurses Association, filed their complaint with Cal-OSHA late Sunday night, Cal-OSHA investigators have visited the hospital to evaluate the nurses' claims.

Gold said the investigation could take between three and four months, though if any major issues
are discovered investigators will move to enact changes right away.

While hospital officials have said they feel using a single mask throughout an entire shift, barring any overt contamination, is sufficient, some nurses say they should be swapping them every time they go in and out of a sick patient's room.

The federal Food and Drug Administration, Centers for Disease Control and Prevention, and the state and federal divisions of Occupational Safety and Health all have varying standards for mask use.

Gold said investigators are in the next few months going to try to find a more clear standard.

The N95 masks are required to prevent at least 90 percent of tiny particles from passing through the filter to wearers, Gold said.

They are recommended for use against illnesses like swine flu and tuberculosis, but do not provide 100 percent protection, she said.

A document on the manufacturer 3M's Web site reads, " ... the respirator cannot eliminate the breathing in of all germs in the air and does not eliminate the possibility of contracting infection, illness or disease."

Reach staff writer Shauntel Lowe at slowe@thnewsnet.com.

 

[tropical]

Re: Nurses file Cal-OSHA complaint over A/H1N1 mask issue

#10:
""We're not in a position to say a hard-and-fast rule on any of that right now," Cal-OSHA Senior Safety Engineer Deborah Gold said."
"swapped"

Masks in such special environments can't be allowed to swap when going out, and than reuse it, as in TV movies (it was frustrating to see on TV/movies those health staff swap up and down the masks without any decontamination and reusing them; also sliping the gloves by taking it from the outside cover, or taking cofee and so on with the same contaminated gloves).

These respirator masks have fabric usage guideliness (once time usage before throwing) which must be implemented.

Buy N100 instead N95, to rise the security of non contamination.

If the stocks are tiny, between restock, a provisory sparing try could be the one of put first the respirator, than cover the respirator by an surgical mask which will absorb the main droplets flushings, which instead will contaminate the respirator mask.

By the above, mostly of the sticky droplets will remain on the outer surgical mask, which must be take off and thrown every time the staff exit the contaminated room, or area.
That way, maybe - in an emergency with low masks numbers - the inner respirator mask could be carefully deposed by new gloves (not the contaminated), and then reused, if it's time usage schedule is not vanish (example: 4 hours).

If the above is not acceptable, squeeze the hospital administrators to buy enaugh masks to avert contaminations during all of the pandemic,
or manage all the patients in special builded wards with less staff number entering,
or produce more and faster vacc. to be administered to the staff, and the chronic patients.