key: cord-0899390-p0xjet04 authors: Fabre, Valeria; Cosgrove, Sara E.; Catalfumo, Francis; Trexler, Polly; Curless, Melanie; Maragakis, Lisa L.; Rock, Clare title: N95 respirator reuse during the COVID-19 pandemic: Healthcare worker perceptions and attitudes date: 2020-11-26 journal: Infection control and hospital epidemiology DOI: 10.1017/ice.2020.1348 sha: 0b735ca922e18d8157a06fe173837050332d91fa doc_id: 899390 cord_uid: p0xjet04 nan The survey was completed by 294 HCWs (294 of 890, a 33% response rate); 78% were female; and respondents had a median age of 35 years (range, 22-70). Respondents' roles included nurse (40%), advanced practitioner (28%), attending/resident physician (23%), and other (9%). Clinical department affiliations included medicine (40%), emergency medicine (29%), surgery (18%), anesthesia (6%), and other (7%). Overall, 53% of participants indicated that they felt comfortable with N95 reuse, and 46% used the same N95 for >14 days. However, 75% expressed discontent with N95 reuse as a PPE-conservation strategy (Table 1) . Physician, compared with nonphysicians, were more likely to indicate support of N95 reuse (35% vs 21%; P < .05); however, they appeared to have reused their N95s less than HCWs in other roles. Also, 66% of respondents stated that they used their N95 3-5 times per work day, and 10% indicated >5 uses per day. Nurses were less likely than other HCWs to report wearing their N95 for shorter periods after donning: 31% of nurses wore the N95 <1 hour per donning compared to 69% of nonnurses (P = .01). For those who replaced their N95s (n = 153 of 224, 68%), commonly cited reasons were mask soilage (24%), head strap breakages (15%), loss of seal (8.5%), or >1 reason (23%). Physicians were less likely to consistently perform a user safety seal check at time of reuse compared to other roles (44% vs 62%; P = .04). Although a seal check is recommended at every N95 donning to identify air leakage from a gap between the wearer's face and N95, 29% respondents never performed a seal check or were unaware of what a seal check is. At 5 months into the COVID-19 pandemic, HCWs caring for hospitalized patients were discontent with the need for continued N95 conservation measures. Despite such reservations, most have continued to comply with N95 reuse recommendation. Although 57% of respondents reused the N95 multiple times over a prolonged period, reuse varied by role, with physicians performing fewer donnings and wearing the N95 for fewer hours than nonphysicians. The finding that 29% of respondents were not aware of or did not consistently perform a user seal check before donning indicates an area for improvement. Study limitations include selection bias because HCWs who were not enthusiastic about N95 reuse strategy may have felt more motivated to respond. Our study has limited generalizability because the survey was administered at a single academic hospital. Given the extensive N95 reuse and discontent with the practice reported by HCWs in the setting of N95 shortages, studies are urgently needed to evaluate important safety issues related to N95 conservation strategies, such as the safe number of N95 reuses before failure. Critical supply shortages-the need for ventilators and personal protective equipment during the COVID-19 pandemic COVID-19 and the N95 respirator shortage: closing the gap Availability of personal protective equipment and infection prevention supplies during the first month of the COVID-19 pandemic: a national study by the APIC COVID-19 task force Stewardship of personal protective equipment (PPE): an important pandemic resource for PPE preservation and education The level of collapse we are allowed: comparison of different response scales in safety attitudes questionnaire Acknowledgments. We thank George Jones and Alejandra Salinas for their technical assistance with developing the electronic questionnaire in Qualtrics.Financial support. This study was funded by the Centers for Disease Control and Prevention through a COVID-19 supplement to grant no. 6 U01CK000554-02-02. All authors report no conflict of interest relevant to this article.