OHNs at the Forefront of Workplace Respiratory Protection

Photo: N95 Respirator Mask
N95 Respirator Masks protect against airborne infectious agents. They are certified by NIOSH.
Photo: Surgical Mask
Surgical Masks are not designed to fit tightly to the face; they do not effectively filter small particles

Occupational health nurses (OHNs) are key players in the field of respiratory protection. As the largest single group of professionals involved in delivering health care at the workplace, OHNs are at the front line of assisting approximately five million U.S. workers who are required to use respirators on the job. 1, 2

A new pilot study led by Debbie Taormina and Barbara Burgel confirmed 87 percent of OHNs have a respiratory protection program at their work site. They recruited forty OHNs for the pilot study, which was co-conducted with the American Association of Occupational Health Nurses (AAOHN) Northern California chapter.

Taormina developed a web-based survey to collect data on OHNs and their comfort level with key components of respiratory protection programs. The survey included a 12 item competency assessment and gathered information related to OHN experience, training, type of industry, how respondents motivated employees to adopt respiratory protection, and workplace roles and responsibilities.

The survey found OHNs were most comfortable with employee medical evaluations of respiratory fitness. Overall, comfort with respiratory protection and years of experience were significantly linked.

The majority of survey respondents confirmed their work site offered respiratory fit testing. Qualitative fit testing, which complies with the OSHA respiratory protection standard, was conducted by 40% of the sample. Fit testing assesses the effectiveness of a respirator’s facial seal against a variety of irritants.

Results of the study also identified gaps in OHN education. “Twenty percent of participants reported no to slight comfort in explaining the difference between a surgical mask and N95 respirator,” reported Taormina, who graduated in June 2012 from the University of California, San Francisco, School of Nursing as an Adult Nurse Practitioner with a focus in Occupational and Environmental Health. “Many OHNs were also not comfortable with the inspection, cleaning, and repair of respiratory equipment, nor with writing the policies and programs for respiratory protection.”

The study stemmed from recommendations made by the Institute of Medicine Committee on the Respiratory Protection Curriculum for Occupational Health Nursing Programs on how to improve the education and training of OHNs. Feedback from this pilot study helped inform a national-level study, reports Taormina, who is now a nurse practitioner at the Stanford University Occupational Health Center.

Photo: Debbie Taormina
Debbie Taormina at the NIOSH National Personal Protective Technology Laboratory Program Stakeholder Meeting

Following the successful pilot, she was invited to participate in the AAOHN Respiratory Protection Education Competencies and Training project. “Our goal is to address the next part of the Institute of Medicine recommendations by identifying strategies to advance respiratory protection educational competencies across all levels of nursing,” says Taormina.

Barbara Burgel, professor of Nursing at the UCSF graduate program in Occupational and Environmental Health Nursing, noted the important contributions made by Taormina to this ongoing national initiative. “Debbie brought her years of OHN experience, in addition to her own expertise in respiratory protection, to this project.”

Results of the pilot were disseminated in a poster presentation at the March 2012 NIOSH National Personal Protective Technology Laboratory Stakeholder Meeting on “Personal Protective Equipment Selection, Use, and Expectations” held in Pittsburgh, PA. They were also presented in a program in May 2012 sponsored by the California El Camino Real Association of Occupational Health Nurses.

1World Health Organization website, “The Role of the Occupational Health Nurse in Workplace Health Management.” http://www.who.int/occupational_health/publications/eurnursing/en.
2United States Department of Labor Occupational Safety and Health Administration website. Safety and Health Topics. Respiratory Protection. http://www.osha.gov/SLTC/respiratoryprotection.

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