1. Written Program with Policies and Procedures

NIOSH Documents

Hospital Respiratory Protection Program Toolkit
This toolkit was developed to assist hospitals in developing and implementing effective respiratory protection programs, with an emphasis on preventing the transmission of aerosol transmissible diseases (ATDs) to healthcare personnel.

Healthcare personnel are paid and unpaid persons who provide patient care in a healthcare setting or support the delivery of healthcare by providing clerical, dietary, housekeeping, engineering, security, or maintenance services. Healthcare personnel may potentially be exposed to ATD pathogens. Aerosols are particles or droplets suspended in air. ATDs are diseases transmitted when infectious agents, which are suspended or present in particles or droplets, contact the mucous membranes or are inhaled.

Implementing Hospital Respiratory Protection Programs: Strategies from the Field
Protecting workers from exposure to all types of respiratory hazards is an important issue for hospitals and other healthcare organizations. In order to address this often overlooked danger, The Joint Commission and Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL) have collaborated to develop a new educational monograph designed to assist hospitals in implementing their respiratory protection programs (RPPs).

Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare
This document recommends practices for extended use and limited reuse of NIOSH-certified N95 filtering facepiece respirators (commonly called “N95 respirators”). The recommendations are intended for use by professionals who manage respiratory protection programs in healthcare institutions to protect health care workers from job-related risks of exposure to infectious respiratory illnesses.

Infographics

Institute of Medicine (IOM) Reports

Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers
During an influenza pandemic, healthcare workers will be on the front lines delivering care to patients and preventing further spread of the disease. Protecting the more than 13 million healthcare workers in the United States from illness or from infecting their families or the patients in their care is critical to limiting morbidity and mortality and preventing progression of a pandemic. As the nation prepares for pandemic influenza, multiple avenues for protecting the health of the public are being carefully considered, ranging from rapid development of appropriate vaccines to quarantine plans should the need arise for their implementation. One vital aspect of pandemic influenza planning is the use of personal protective equipment (PPE) - the respirators, gowns, gloves, face shields, eye protection, and other equipment that will be used by healthcare workers and others in their day-to-day patient care responsibilities.

Reusability of Facemasks During an Influenza Pandemic: Facing the Flu
In the event of an influenza pandemic, public health officials will need to resort to multiple measures to reduce the impact. If effective vaccines and anti-viral medications do not exist or are not available in adequate quantities during a pandemic situation, respirators and medical masks could help prevent or slow influenza transmission.

Journal Articles

Considerations for recommending extended use and limited reuse of filtering facepiece respirators in healthcare settings
Fisher-EM; Shaffer-RE, J Occup Environ Hyg 2014 Aug; 11(8):D115-D128

Reaerosolization of MS2 bacteriophage from an N95 filtering facepiece respirator by simulated coughing
Fisher-EM; Richardson-AW; Harpest-SD; Hofacre-KC; Shaffer-RE, Ann Occup Hyg 2012 Apr 56(3):315-325