Severe PI: Healthcare Q&A 2: Respiratory Hygiene/Cough Etiquette: Educate persons with respiratory illness and coughing or sneezing to: (1) Cover their mouths and noses with a tissue and dispose of used tissues in no-touch waste containers. (2) Use a mask when tolerated, especially during periods of increased respiratory infection activity in the community. (3) Perform hand hygiene after contact with respiratory secretions and contaminated objects or materials (e.g., handwashing with soap and water, alcohol-based hand rub, or antiseptic handwash). (4) Stand or sit at least 6 feet from other persons, if possible. For additional information, see: Respiratory Hygiene/Cough Etiquette in Healthcare Settings. Precautions during Specimen Collection and Transport: Healthcare workers who collect or transport clinical specimens should consistently adhere to recommended infection control precautions to minimize their exposure. Potentially infectious specimens should be placed in leakproof specimen bags for transport, labeled or color coded for transport and handled by personnel who are familiar with safe handling practices and spill cleanup procedures. Healthcare workers who collect specimens from pandemic-influenza infected patients should also wear PPE as described for employees performing direct patient care. Precautions during Patient Transport within Healthcare Facilities: Influenza-infected patients' respiratory secretions are the principle source of infectious material in healthcare settings. Maintaining source control of patient secretions will limit the opportunities for nosocomial (in hospital) transmission. (a) Surgical and procedure masks are appropriate for use by pandemic influenza-infected patients to contain respiratory droplets and should be worn by suspected or confirmed pandemic influenza-infected patients during transport or when care is necessary outside of the isolation room area. (b) Limit the movement and transport of patients from the isolation room/area for essential purposes only. Inform the receiving area/facility as soon as possible, prior to the patient's arrival, of the patient's diagnosis and of the precautions that are indicated. Use mobile diagnostic services (e.g., mobile X-ray and CT scan) when available. (c) If transport outside the isolation room is required, the patient should wear a surgical mask and perform hand hygiene after contact with respiratory secretions. (d) If the patient cannot tolerate a mask (e.g., due to the patient's age or deteriorating respiratory status), instruct the patient (or parent of pediatric patient) to cover the nose and mouth with a tissue during coughing and sneezing, or use the most practical alternative to contain respiratory secretions. If possible, instruct the patient to perform hand hygiene after respiratory hygiene. (e) Identify appropriate paths, separated from the main traffic routes as much as possible, for entry and movement of pandemic influenza patients in the facility, and determine how these pathways will be controlled (e.g., dedicated pandemic influenza corridors and elevators). (f) If there is patient contact with surfaces, these surfaces should be cleaned and disinfected. (g) Healthcare workers transporting unmasked patients with suspected or confirmed pandemic influenza-infected patients should wear an N95 or higher NIOSH-certified respirator. Staff Education and Training: It is incumbent upon healthcare employers to educate employees about the hazards to which they are exposed and to provide reasonable means by which to abate those hazards. Personal Protective Equipment (PPE): Gloves: HHS recommends the use of gloves made of latex, vinyl, nitrile, or other synthetic materials as appropriate, when there is contact with blood and other bodily fluids, including respiratory secretions. (a) There is no need to double-glove. (b) Gloves should be removed and discarded after patient care. (c) Gloves should not be washed or reused. (d) Hand hygiene should be done after glove removal. Gowns: Healthcare workers should wear an isolation gown when it is anticipated that soiling of clothes or uniform with blood or other bodily fluids, including respiratory secretions, may occur. HHS states that most routine pandemic influenza patient encounters do not necessitate the use of gowns. Examples of when a gown may be needed include procedures such as intubation or when closely holding a pediatric patient. (1) Isolation gowns can be disposable and made of synthetic material or reusable and made of washable cloth. (2) Gowns should be the appropriate size to fully cover the areas requiring protection. (3) After patient care is performed, the gown should be removed and placed in a laundry receptacle or waste container, as appropriate. Hand hygiene should follow. See more from topic source: https://www.osha.gov/html/a-z-index.html