Severe PI: Healthcare Guidance: See: Publication 3328-5 (Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers). Pandemic Influenza: Severe PI: Healthcare Q&A 1: This document provides general information regarding OSHA's Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers (OSHA Publication 3328) and links to additional resources. Page numbers are given for sections of the longer document that address the question asked. Question 1: Is an influenza pandemic expected to occur? Many scientists believe that since no pandemic has occurred since 1968, it is only a matter of time before another pandemic occurs. It is difficult to predict when the next influenza pandemic will occur or how severe it will be. Wherever and whenever a pandemic starts, everyone around the world is at risk. Question 2: How will I know when an influenza pandemic has started? The World Health Organization (WHO) maintains a global surveillance system of circulating influenza strains and a Global Influenza Preparedness Plan. Once a new influenza A virus develops the capacity for efficient and sustained human-to-human transmission in the general population (Phase 6), the WHO declares that an influenza pandemic is in progress (this is known as the "Pandemic Period"). In the event of a pandemic, the U.S. Department of Health and Human Services (HHS)/Centers for Disease Control and Prevention (CDC) will coordinate support and intelligence with U.S. public health departments regarding the pandemic situation in the U.S. and in foreign countries. Question 3: What are some recommended precautions for the protection of healthcare workers during an influenza pandemic? Given that the exact transmission pattern or patterns will not be known until after the pandemic influenza virus emerges, transmission-based infection control strategies may have to be modified to include additional selections of engineering controls, personal protective equipment (PPE), administrative controls, and/or safe work practices. The following precautions are advisable until more information is known about the transmission of any future pandemic influenza virus. Environmental/Engineering Controls: The appropriate use of engineering controls and other control efforts will require frequent analysis of pandemic influenza transmission patterns in designated wards, in the facility, and in the community. If possible, and when practical, use of an airborne infection isolation room may be considered when conducting aerosol-generating procedures. Airborne infection isolation rooms receive numerous air changes per hour and are under negative pressure, so that the direction of the air flow is from the outside adjacent space (e.g., the corridor) into the room. The air in an airborne infection isolation room is preferably exhausted to the outside, but may be recirculated provided that the return air is filtered through a high-efficiency particulate air (HEPA) filter. Cohorting: If single rooms are not available, patients infected with the same organisms can be cohorted (share rooms). Management of cohort areas should incorporate the following: (a) Whenever possible, healthcare workers assigned to cohorted patient care units should be experienced healthcare workers and should not "float" or be assigned to other patient care areas. (b) The number of persons entering the cohorted area should be limited to the minimum number necessary for patient care and support. (c) Limit patient transport by having portable x-ray equipment available in cohort areas. Administrative Controls/Work Practices: Hand Hygiene: To reduce the risk of becoming infected with influenza, healthcare workers working with influenza patients should follow rigorous hand hygiene measures: (a) When hands are visibly dirty or contaminated with respiratory secretions, wash hands with soap (either non-antimicrobial or antimicrobial) and water. (b) If hands are not visibly soiled, use an alcohol-based hand rub for routinely decontaminating hands in all clinical situations including contact, whether gloved or ungloved, with an influenza patient. (c) Hand hygiene before and after patient contact, and after removing gloves and other PPE. Facility Hygiene To protect healthcare workers, standard practices for handling and reprocessing used patient care equipment, including medical devices, should be followed. (a) Healthcare workers should wear gloves when handling and transporting used patient care equipment. (b) Healthcare workers should wipe heavily soiled equipment with a U.S. Environmental Protection Agency (EPA)-approved hospital disinfectant before removing it from the patient's room and follow current recommendations for cleaning and disinfection or sterilization of reusable patient care equipment. (c) Healthcare workers should wipe external surfaces of portable equipment (e.g., for performing x-rays and other procedures) in the patient's room with an EPA-approved hospital disinfectant upon removal from the patient's room. Healthcare workers should use precautions when cleaning the rooms of pandemic influenza patients or of influenza patients who have been discharged or transferred. Cleaning and Disinfection of Patient-Occupied Rooms: (1) Wear gloves in accordance with facility policies for environmental cleaning. (2) Wear a surgical mask in accordance with droplet precautions. Use a respirator when airborne precautions are warranted by the circumstances. (3) Gowns are usually not necessary for routine cleaning of an influenza patient's room. However, a gown must be worn when cleaning a patient's room if soiling of the employee's clothes or uniform with blood or other potentially infectious materials may occur. (4) Wear face and eye protection if cleaning within 6 feet of a coughing patient. Infection control professionals have traditionally used a range of 3-6 feet to reflect the distance from a patient that potentially infectious particles could travel. Recent reviews of the scientific literature suggest that the data on what constitutes "close contact" is not definitive. For pandemic influenza planning purposes, and in order to be more protective, DOL and HHS experts now recommend that close contact be considered a distance of less than 6 feet. (5) Keep areas within 6 feet of the patient free of unnecessary supplies and equipment to facilitate daily cleaning. (6) Use any EPA-registered hospital detergent-disinfectant. (7) Give special attention to frequently touched surfaces (e.g., bedrails, bedside and over-bed tables, TV controls, call buttons, telephones, lavatory surfaces including safety/pull-up bars, doorknobs, commodes, and ventilator surfaces) in addition to floors and other horizontal surfaces. Cleaning and Disinfection after Patient Discharge or Transfer: (a) Follow standard facility procedures for post-discharge cleaning of an isolation room. (b) Clean and disinfect all surfaces that were in contact with the patient or might have become contaminated during patient care. See more from topic source: https://www.osha.gov/html/a-z-index.html