Infection Control & Hospital Epidemiology
conundrums, such as RP for fungal infections, surgical smoke, and contingency planning for shortages, including reprocess- ing. Research is underway on improved respirator designs that address user discomfort and clinical assessment challenges.10
To our knowledge, this is the first attempt to identify clinical
issues in which clarification of RP guidance might be needed from a wide range of stakeholders. Nevertheless, our study has several limitations. We cannot assume that the results are generalizable or that the issues are comprehensive, and we may have missed existing guidance pertaining to clinical conundrums. Our findings are consistent with those of Peterson et al.4 in that
hospital staff were often unclear about which type of RP was needed and about when and how to use it. Challenges related to respirator discomfort (eg, heat, diminished visual field, and com- munication difficulties) are similar to findings from previous research regarding respirator tolerability.3 Finding answers to clinical conundrums, operational program-
matic gaps, and practice gaps should be addressed through future research, education, and policy initiatives. Addressing these issues is the first and necessary step to improved RP. The health and safety of healthcare workers and patients depends on it.
Author ORCIDs. Barbara I. Braun, 0000-0002-7098-6800
Acknowledgments. We are sincerely grateful to those individuals who con- tributed responses and issues to this study, either via e-mail, phone interview, or online submission.
Financial support. This work was supported by the Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL contract no. 200-2016-M-90738).
Conflicts of interest. All authors report no conflicts of interest related to this article.
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8. Yokoe DS,AndersonDJ,Berenholtz SM, et al. Introductionto “Acompendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.” Infect Control Hosp Epidemiol 2014;35:S1–S5.
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