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N95 Use and Draft Communication Algorithm

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October 23, 2009

N95 Use

In accordance with the Public Health Agency of Canada (July 28, 2009) document, Interim Guidance: Infection prevention and control measures for Health Care Workers in Acute Care Facilities, Infection Prevention and Control at Fraser Health has posted the Personal Protective Equipment Recommendations including N95 use on our website:  http://www.fraserhealth.ca/professionals/resources/h1n1/

We want to ensure that all staff who require an N95 based on Infection Control protocols have one and use it to ensure staff safety

N95 use is only intended for the procedures outlined in the infection control guidelines:

  • non-invasive positive pressure ventilation (BIPAP, CPAP)
  • respiratory/airway suctioning
  • high-frequency oscillatory ventilation
  • bronchoscopy procedure
  • chest physiotherapy 
  • endotracheal intubation
  • tracheostomy care
  • diagnostic sputum induction
  • autopsy of lung tissue 
  • aerosolized or nebulized medication administration


  • Administrative Controls and restrictions on facilities ordering N95 have been in place for several months to ensure adequacy of supply through the entire Pandemic Surge
  • Currently, two boxes of each of the three N95 models can be filled per order (120 N95 masks per order).
  • This is a fairly substantial quantity provided per order and will meet the needs, unless there is a very large number of patients/residents on Aerosol Generating Medical Procedures (AGMP), or other airborne spread illnesses are present.
  • Requests placed by departments for quantities in excess of the two boxes of each N95 model per order will be individually reviewed by the supply chain personnel to determine if the situation in that department requires an increase in supply.

DRAFT Communication Algorithm

A.  Creation of new or revised communication materials

  1. Coordinator, Pandemic Influenza / Public Health Emergency Management sends materials to Pandemic Information Approval Team, for response within the requested timeline:
    a)    48-hr standard turnaround
    b)    24-hr high-priority turnaround
    c)    Emergency turnaround time negotiated at time of request

    (All members of Pandemic Information Approval Team are responsible for consulting within their teams for feedback.)

  2. Approval team will consist of the following Pandemic Influenza Management Committee Members:
    Chief Medical Officer or Designate, Executive Director or Designate, Acute Care Director, Workplace Health Director, Infection Control Director. (Other specialty areas may be involved in the approval process as needed owing to the content matter under review.)

B.    Central distribution of communication materials related to flu/pandemic

  1. The Coordinator, Pandemic Influenza will distribute all material related to flu/pandemic, including Communicable Disease, Infection Control and Workplace Health information.
  2. All materials are sent to the following distribution lists to ensure maximum coverage within the organization

.FH Prevention Communicable Disease Team
.FHA Communications
.FHA Directors Forum
.FHA Infection Control Department
.FHA Lab – Dept of Lab Medicine/Pathology
.Health Protection – CCFL Managers
.Health Protection – EHS Managers

.FHA Medical Directors
.FHA Medical Health Officers
.FHA Medical Staff Assistants
.FHA Prevention Admin. Leadership Team
.FHA Prevention Managers
.FHA Prevention Supervisors
.PHA FHA Pharmacists
.Workplace Health

 

 


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