To minimise the Hawthorne effect, 10 staff were not informed of the purpose of the study until after the completion of the observations. Audits of this type form part of routine infection, prevention and control practice. All participants were selected at random. Permission to conduct the ward area observation was obtained from the ward manager. Verbal consent was gained for participation on the questionnaire and the controlled audit. Participation in one part of the audit did not exclude participation in another part of the audit and as such there is some overlap of participants between the groups. Participants in each section of the audit were selected at random from the personnel on the ward at the time the audit was carried out. The audit comprised of staff members working on acute wards (designated COVID-19 and standard wards) across two hospital sites within a health board in South Wales in December 2020. Observation of mask fit and mask etiquette in the clinical area (30 participants). The aim of our audit was to review the fit of FRSMs supplied to patient-facing workers in the NHS and through re-audit, assess for improvements in fit with FRSMs worn with a plastic strap (intervention A) and with FFP3 masks (intervention B).Ī three-part audit of mask fitting designed to obtain triangulation of results in relation to mask fit, comprising:Ĭontrolled observation of mask fit (30 participants observed over a total of 600 minutes) In this paper, we investigate the issue of mask fitting as one critical component of these measures.

2,7,8,9 Focussing on all aspects of the preventative measures deployed is crucial in reducing risk. 4 Risks include PPE malfunction, failure to use PPE and incorrect use of PPE. Healthcare workers (HCWs) are at greatly increased risk of infection with COVID19. 6 A previous report by O'Dowd et al noted a poor fit factor with FRSMs, suggesting potential compromise in protective efficacy. 2,6 Furthermore, they stipulate that ‘FRSMs should not be touched once put on or allowed to dangle around the neck’. The UK Infection Prevention and Control (IPC) national guidelines states ‘the masks must be well-fitting and fit for purpose, fully covering the mouth and nose’ 6 as otherwise their effectiveness is reduced. Most suppliers have a ‘one size fits all’ approach. The level of efficiency offered by a mask depends on a number of factors including filtration efficiency, material used and fit, which varies considerably with design. The masks are tested for bacterial filtration efficiency, breathability, splash resistance, microbial cleanliness (bioburden) and biocompatibility. 6 They are constructed to a standard that specifies construction, design, performance requirements and test methods (EN14683:2019). 2,4,6 The UK Government recommends them for use during contact with any patient regardless of their COVID-19 status. 1,2,4,5įluid-repellent surgical masks (FRSMs) are designed to be worn over the mouth and nose to protect the mucous membranes from splashes and infectious droplets. 1–3 As worldwide cases of COVID-19 are currently over 120 million and deaths surpass 2.7 million, it is vital to break the chain of infection wherever possible as each transmission event has the potential to generate a new chain of infections. Fomite transmission from contaminated personal protective equipment (PPE) is of potential concern and important in the healthcare setting. 1 The relative contribution of fomite spread is also uncertain but it is likely responsible for at least some transmission. Whether predominately via respiratory droplet or aerosol (a matter of conjecture), transmission can occur through routine social contact during tidal breathing, speaking and coughing.

SARS-CoV-2 is primarily transmitted through close contact with an infected individual. First detected in December 2019, it subsequently spread rapidly, leading to the declaration of a pandemic by WHO in March 2020. SARS-CoV-2 is the novel coronavirus that causes coronavirus disease 2019 (COVID-19).

Fluid mask training