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ette in Healthcare Sett... Page 1 of 2 CDC - SeasonalInfluenza (Attachment D Centers for Disease Control and Prevention "'l'''G'lJr '::'In!;,-'~S(.airc~ tor (-~reriible- Heolth ~nf·:::,rrnntj.:)," 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 Jf .•.. '''c'L (.~l ~~A~gQ'!:asy 1112/2010 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 ----,. ' 16 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. 18