Few participants (1.3%) had prior experience using an EHMR. Overall, 87% of participants had at least 1 year of experience wearing a respiratory protective device 9.7% of participants in the EHMR group vs 27.6% in the N95 group had no prior experience. The majority of participants were women (77%), with a mean age of 38 years. Of 193 health care personnel randomized, 153 (79%) participated in the study (124 in the EHMR group and 29 in the N95 group) ( Table 1). Analyses were conducted using SPSS, version 25. Additional details are available in the protocol ( Supplement 2). No sample size calculation was performed.
Mean differences for time to completion of fit testing between groups was calculated using t tests, differences in the number of attempts to achieve proper fit were calculated using χ 2 tests, and ANOVA with post hoc and 2-sided pairwise comparisons were used to compare EHMR performance scores by attempts with α = .05.
A total score for each area consisted of a sum of 4 or 6 individual performance indicators (3 points each) ranging from 12 or 18, with a possible overall score of 78 points. Trainers scored participants based on the degree of assistance needed to complete each step (1 indicated physical assistance 2, verbal assistance 3, no assistance). The EHMR group was assessed 3 times consecutively for 26 performance indicators in the following 6 key areas: (1) inspection, (2) donning, (3) positive-pressure user seal check, (4) negative-pressure user seal check, (5) doffing, and (6) disinfection. Both groups were trained using a 9-minute video. 6 The number of fit testing attempts and testing time were recorded. Fit testing was performed to assess respirator fit to face, checking for leaks, using an Occupational Safety and Health Administration qualitative fit testing process. Written informed consent was obtained at recruitment. The institutional review boards at UTHealth, Baylor College of Medicine, and Emory University approved this study. In 2019, 2 US health care organizations (Emory University and University of Texas Health Science Center at Houston) conducted an outbreak simulation in which health care personnel, who were randomized to EHMR (80%) or N95 (20%) groups, were rapidly fit tested and trained. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.