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ette in Healthcare Sett... Page 1 of 2
CDC - SeasonalInfluenza (Attachment D
Centers for Disease Control and Prevention
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Respiratory Hygiene/ Cough Etiquette in Healthcare
Settings
To prevent the transmission of all respiratory infections in healthcare settings, including
influenza, the following infection control measures should be implemented at the first point of
contact with a potentially infected person. T hey should be incorporated into infection control
practices as one component of Standard Precautions.
1.
Visual Alerts
Post visual alerts (in appropriate languages) at the entrance to outpatient facilities (e.g.,
emergency departments, physician offices, outpatient clinics) instructing patients and persons
who accompany them (e.g., family, friends) to inform healthcare personnel of symptoms of a
respiratory infection when they first register for care and to practice Respiratory
Hygiene/ Cough Etiquette.
• Notice to Patients to Report Flu Symptoms
(http://www.cdc.govIncidodl dhqp/pdf/Infdis/RespiratorvPoster.pdf)
Emphasizes covering coughs and sneezes and the cleaning of hands
• Cover Your Cough (../../protect/covercough.htm)
Tips to prevent the spread of germs from coughing
• Information about Personal Protective Equipment
(http://'Nww.cdc.govInddodl dhqp/ppe.htmn
Demonstrates the sequences for donning and removing personal protective equipment
2.
Respiratory
Hygiene/Cough
Etiquette
The following measures to contain respiratory secretions are recommended for all individuals
with signs and symptoms of a respiratory infection.
• Cover or sneezing;
• Use in the nearest waste receptacle after use;
• Perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water,
alcohol-based hand rub, or antiseptic handwash) after having contact with respiratory
secretions and contaminated objects/materials.
Healthcare facilities should ensure the availability of materials for adhering to Respiratory
Hygiene/Cough Etiquette in waiting areas for patients and visitors.
• Provide tissues and no-touch receptacles for used tissue disposal.
• Provide conveniently located dispensers of alcohol-based hand rub; where sinks are
available, ensure that supplies for hand washing (i.e., soap, disposable towels) are
consistently available.
3. Masking and Separation of Persons with Respiratory Symptoms
During periods of increased respiratory infection activity in the community (e.g., when there is
increased absenteeism in schools and work settings and increased medical office visits by
persons complaining of respiratory illness), offer masks to persons who are coughing. Either
http://www.cdc.govlfluiprofessionaisiinfectioncontrol/resphygiene.htm
1112/2010
CDC - Seasonal Influenza (Flu) - Respiratory Hygiene/Cough Etiquette in Healthcare Sett ... Page 2 of2
procedure masks (i.e., with ear loops) or surgical masks (i.e., with ties) may be used to contain
respiratory secretions (respirators such as N-95 or above are not necessary for this purpose).
When space and chair availability permit, encourage coughing persons to sit at least three feet
away from others in common waiting areas. Some facilities may find it logistically easier to
institute this recommendation year-round.
4. Droplet Precautions
Advise healthcare personnel to observe Droplet Precautions (i.e., wearing a surgical or
procedure mask for close contact), in addition to Standard Precautions, when examining a
patient with symptoms of a respiratory infection, particularly if fever is present. These
precautions should be maintained until it is determined that the cause of symptoms is not an
infectious agent that requires Droplet Precautions http://www.cdc.gov Incidodl dhqp/ppe.html
(http://www.cdc.gov
Incidodl dhqp/ppe.html)
~JOTE: These recommendations
Agents in Hestthcere Settings,
.
are based on the Draft Guideline for Isolation Precautions:
Preventing Transmission
of Infectious
Recommendations
of the Healthcare Infection Control Practices Advisory Committee
(HICP.A.C), CDC.
Page last updated: August 1, 2009
Content source: Centers for Disease Control and Prevention
Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA
30333, USA
800-CDC-INFO (800-232-4636) TIY: (888) 232-6348, 24 Hours/Every [email protected]
http://www.cdc.gov/fluiprofessionalsiInfectioncontrol/resphygiene.htm
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Attachemnt
E
Sample Hazard Assessment Log
Hazard Assessment
DATE
Department
*
**
Contaminants
Exposure Level
(8 hr TWA*)
Log
PEL**
Controls
Summarized from Industrial Hygiene report provided by Responsible Person.
These values were obtained from a survey on average exposures as published in
the American Journal of Industrial Hygiene
----,.
'
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Sample Hazard Evaluation
Process Hazard Evaluation for
DATE
Process
Noted Hazards
Prep-sanding
Ventilation controls on some sanders are in place, but employees continue to be
exposed to respirable wood dust at 2.5 - 7.0 mg/m3 (8 hour time-weightedaverage, or TWA). Half-face piece APRs with PIOO filters and goggles are
required for employees sanding wood pieces. PAPRs will be available for
employees who are unable to wear an APR.
Prep-c leaning
Average methylene chloride exposures measured at 70 ppm based on 8-hour
TW A exposure results for workers cleaning and stripping furniture pieces.
Ventilation controls are planned, but will not be implemented until designs are
completed and a contract has been let for installation of the controls. In the
meantime, employees must wear supplied air hoods with continuous airflow, as
required by the Methylene Chloride Standard 1910.1 052.
Assembly
Ventilation controls on sanders are in place, but employees continue to be
exposed to respirable wood dust at 2.5 - 6.0 mg/m3 (8 hour TWA); half-face '
piece APRs with PlOD filters and goggles are required for employees sanding
wood pieces in the assembly department. PAPRs will be available for
employees who are unable to wear an APR. The substitution for aqueous-based
glues will eliminate exposures to formaldehyde, methylene chloride, and epoxy
resins.
Maintenance
Because of potential IDLH conditions, employees cleaning dip coat tanks must
wear a pressure demand SAR during the performance of this task.
Cleaning Spray Booth
Walls
Employees may voluntarily wear half-face piece APRs with PIOO cartridges.
Although exposure monitoring has shown that exposures are kept within PELs
during this procedure, Company Name will provide respirators to workers
who are concerned about potential exposures
Loading Coating Agents
into Supply Systems
Employees may voluntarily wear half-face piece APRs with organic vapor
cartridges. Although exposure monitoring has shown that exposures are kept
within PELs during this procedure, Company Name will provide respirators
to workers who are concerned about potential exposures
Changing Booth Filters
Employees may voluntarily wear half-face piece APRs with PI 00 cartridges.
Although exposure monitoring has shown that exposures are kept within PELs
during this procedure, Company Name will provide respirators to workers
who are concerned about potential exposures
(Include documentation
of the sampling data that hazard evaluation is based on.
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