Wearing of fit-tested respirators is a requirement for students attending clinical placements in Queensland Health facilities where there is a high risk of exposure to an airborne infectious agent.
Do I need to wear a P2/N95 respirator while on clinical placement?
There is no simple “yes” or “no” answer to this question, and the answer may vary between HHSs at different times.
The requirement to use a respirator relates to the risk of infection with an airborne transmitted disease. Some students already routinely wear appropriately fit tested respirators while on clinical placement, due to the locations they are attending and the patients they are seeing.
When there is a widespread risk of airborne transmitted disease, such as in the case of COVID-19, either parts or whole Hospital and Health Services may require the use of respirators for some or all of their staff and students attending clinical placements in those locations.
With rapidly changing community transmission of COVID-19, education providers are encouraged to maintain a close relationship with Hospital and Health Services to determine the personal protective requirements of students attending facilities, understanding that these requirements may change as local risk levels heighten or decrease.
Is Queensland Health assisting education providers with the purchase of testing devices and consumables for fit testing?
Queensland Health’s role is to provide the overarching governance framework regarding the requirements surrounding testing and reporting for student and patient safety. Queensland Health is not responsible for the purchase of fit testing equipment or consumables, or costs associated with private fit testing companies. Queensland Health can assist in advising education providers of the types of respirators generally available across Hospital and Health Services. At times where capacity permits, Queensland Health facilities may make in-house fit testing available to students.
What is the difference between fit testing and fit checking?
Fit testing is a validated method to determine whether a specific make, model, and size of respirator achieves an adequate seal on an individual’s face. Fit testing is to be performed by an appropriately trained person, and is undertaken annually and when there is a significant change in the user’s facial characteristics that could alter the seal of the respirator.
Fit checking is the minimum standard required each time a P2/N95 respirator is put on to ensure it is applied properly. Fit checking must be performed each time a respirator is used. It ensures the respirator fits the user’s face with an effective seal.
How often does a fit test need to be carried out?
Fit testing is to be undertaken annually and when there is a significant change in the wearer’s facial characteristics that could alter the facial seal of the respirator (e.g. significant change in body weight, facial surgery, growth of facial hair).
What standard of fit testing is required?
Australian/New Zealand Standard 1715:2009 describes two types of facial fit test that may be used. Fit testing must occur in line with this Australian and New Zealand Standard.
Why are different respirators used in different Hospital and Health Services?
Supply chain limitations do not allow the sheer volume of respirator availability that would be required to have the same respirator in all Queensland Health locations.
Queensland Health stocks several makes, models, and sizes of respirators. However, there is continuing supply chain disruption occurring across the world that can put pressure on the availability of any of the currently stocked respirators at a particular time. For this reason, Queensland Health recommends that all students that require fit testing are fit tested to at least two different masks so there is a back-up if one mask becomes unavailable. Additionally, it is recommended that education providers have regular communication with Hospital and Health Service clinical placement coordinators to confirm which respirators are in stock at the Hospital and Health Service; confirm if the respirator in stock is one to which the student has been fit tested; and confirm if the particular respirator will be made available to students at the time of their placement.
What happens if a student fails a fit test?
Education providers are asked to continue to test the student on subsequent respirator(s) until a successful fit is found.
Fit testing can be repeated on previous stock with different testing officers, or when new stock is made available.
Workplace Health and Safety Queensland does not accept or recognise any fit test, regardless of the outcome, which:
- occurred whilst the wearer had facial hair in the area where the respirator seals to the face; or
- which incorporates the use of beard covering techniques.
Queensland Health will not be accepting a student without a passed fit test when it is required.
What evidence of fit test will be required by Queensland Health?
Fit testing must be conducted in accordance with Australian/New Zealand Standard 1715:2009. Evidence of fit test outcome may be provided from either a Hospital and Health Service, an outsourced company, or on official education provider letterhead if the testing was conducted internally and must include:
- name of student
- date fit test performed
- make, model, and size of respirators that were successfully fitted and outcome of fit test.
Students who fail to produce this record may not be able to proceed with the clinical placement.
The Queensland Health guidance document Fit Testing of particulate filter respirators in respiratory protection programs – Implementation Guidance [PDF 440.58 KB] is provided for reference. Please note that this document was developed for the Queensland Health workforce, so reference to workforce may not always have application for students.
Does the student need to provide the results of the fit test to the placement contact and/or Supervisor?
Yes. The student must retain evidence of their fit test validation with them (can be a photocopy or photographic evidence). Students who fail to produce this evidence may not be able to proceed with the clinical placement.
Who records student fit test results?
As with any pre-placement compliance requirement, a reference to the completion of a fit test should be retained by the education provider. The detail of the record held is to be determined by the education provider to accord with relevant record-keeping requirements.
If the fit-test has been completed by the education provider, records will need to be retained to comply with testing parameters and the Australian/New Zealand Standard 1715:2009.
Who do I contact if I have a question about my fit test?
Please use the following as a guide in relation to directing your questions:
- Students should contact the organisation that conducted the fit test, in the first instance, if they have questions regarding the fit test outcome or process.
- Students should contact their education provider if they have questions regarding their fit test compliance with Queensland Health requirements.
- Education providers should contact the Clinical Placements Team for all questions regarding students and pre-placement requirements.