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Impact on quantitative fit-test results after application of prophylactic hydrocolloid dressing under N95 respirators

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  24 June 2021

Irene Ng Open the ORCID record for Irene Ng [Opens in a new window] ,
Benjamin Kave ,
Fiona Begg ,
Sarah Sage ,
Reny Segal  and
Daryl L. Williams
Irene Ng*
Affiliation:
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia University of Melbourne, Parkville, Victoria, Australia
Benjamin Kave
Affiliation:
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia
Fiona Begg
Affiliation:
Health and Safety, People and Culture, Royal Melbourne Hospital, Parkville, Australia
Sarah Sage
Affiliation:
Wound Management, Royal Melbourne Hospital, Parkville, Australia
Reny Segal
Affiliation:
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia University of Melbourne, Parkville, Victoria, Australia
Daryl L. Williams
Affiliation:
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia University of Melbourne, Parkville, Victoria, Australia
*
Author for correspondence: Dr. Irene Ng, E-mail: Irene.Ng@mh.org.au
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Abstract

Objective:

Discomfort and device-related pressure injury (DRPI) caused by N95 filtering facepiece respirators (FFRs) are common. The use of prophylactic hydrocolloid dressings is one of the strategies that may improve comfort and reduce DRPI. In this study, we investigated the impact of these dressings on N95 respirator fit.

Methods:

We performed a repeat quantitative fit testing through the Respiratory Protection Program on 134 healthcare workers (HCWs), who applied hydrocolloid dressings on the bridge of their nose under the N95 FFRs that they passed the initial fit test with, but reported discomfort with the FFR.

Results:

With the hydrocolloid dressings in place, the fit-test pass rate for the semirigid cup style (3M 1860) was 94% (108 of 115); for the the vertical flat-fold style (BYD), the pass rate was 85% (44 of 52); for the duckbill style (BSN medical ProShield and Halyard Fluidshield), the pass rate was 81% (87 of 108); and for the 3-panel flat-fold style (3M Aura) N95 FFRs, the pass rate was 100% (3 of 3). There was a statistically significant reduction in the overall fit factors for both the vertical flat-fold and duckbill type N95 respirators after the application of hydrocolloid dressings.

Conclusions:

Hydrocolloid dressings are likely to disturb the mask seal for nonrigid-style N95 FFRs, particularly the vertical flat-fold style and the duckbill style N95 FFRs. Given the risk of mask seal disturbance of N95 respirators as shown in this study, we advocate that any HCW requiring the use of prophylactic dressings should undergo repeat quantitative fit testing with the dressing in place prior to using the dressing and mask in combination.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 8 , August 2022 , pp. 993 - 996
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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