HS5506/HS1206 : In the Healthcare Settings, N95 Respirators and Surgical Masks are Parts of the Essential Personal Protective Equipment (PPE): Diploma in nursing Assignment, Ngee Ann Polytechnic, Singapore

Compare one of the following sets of clinical skills:

• Hand hygiene – Medical handwash and antiseptic hand rub

• Temperature measurement – oral and tympanic routes

• Blood Pressure measurement – manual and electronic

Discuss the similarities and differences of the 2 clinical skills with regards to the following attributes:-

1. Clinical indications

2. Safety

3. Effectiveness/accuracy

4. Complexity of skill

5. Special considerations, if any

Sample Report:

In healthcare settings, N95 respirators and surgical masks are parts of the essential personal protective equipment (PPE). They help to minimise the risk of transmissions of infectious agents among patients and healthcare providers. The COVID-19 Systematic Urgent Group Effect (SURGE) (2020) reported that the use of face masks and N95 respirators resulted in a large reduction in the risk of infection.

In order to ensure that they are effective, proper donning and doffing of PPE is critical or it may result in contamination and spread of infections (Centers for Disease Control & Prevention (CDC), 2021). This assignment will discuss the similarities and differences between N95 respirators and surgical masks, which will create an awareness of their appropriate usage to achieve their maximum effectiveness.

Both types of masks are made for single-use and should be discarded after patient encounters or once it gets soiled. To minimise cross-contamination, hand hygiene must be complied with before donning and after doffing of the masks. However, they are different in relation to indications and techniques to achieve their effectiveness.

N95 respirators are used in airborne precautions and protect the wearer from exposure to small particle aerosols (0.1 to 0.3 microns) and large droplets such as SARS (CDC,2021). Mowery (2020) compared 29 alternative masks and found that a properly fitted N95 respirator with face shield is the most effective and offered a fitted filtration efficiency (FFE) of 99.6%.

However, it requires the wearer to undergo a fit test in order to find the correct size so that a good mask seal is established and minimise leakage around the edges of the respirators. When properly fitted, it filters at least 95% of airborne particles. The fit test should be conducted at least 1 year to ensure that the mask size and type fit the wearer (3M, 2021). The wearer must diligently perform the fit check to ensure a good seal against the skin after each donning. Improper fit and donning may give a false sense of security and put the wearer at risk to exposure.

Surgical masks are used to protect the wearer and patients in situations where the healthcare personnel care for patients under droplet precautions or respiratory emissions such as flu or cough or at higher risk of getting splashes of body fluids (Health Science Authority (HSA), 2021). Ideally, the surgical mask should consist of 3 layers of flat or pleated non-woven fabric, with a bacterial filtration efficiency of 95% or higher (HSA, 2021).

The surgical mask is easy to don on and it is snuggly fitted on skin compared to N95 respirators, hence leakage can occur around the edge of the mask when the wearer inhales. Therefore, it does not provide the wearer with a reliable level of protection from inhaling smaller airborne particles and is not considered respiratory protection. The surgical mask does not require any fit test, however, the wearer must know how to differentiate the correct facing of the mask or else, it will not provide any protection when worn.

In conclusion, the N95 respirators are indicated in airborne precautions while surgical masks may be used in droplet precautions. To ensure effectiveness, the wearers must observe the proper handling of these two PPE, for example, a tight seal of an N95 respirator and snug fit of a surgical mask on the wearer’s face respectively.