Respiratory Infection Control Measures for Occupationally-Acquired
Infections
Aims to control the work-related spread of selected pathogens to and from healthcare
personnel, including work restrictions and postexposure prophylaxis.
Direct contact transmission occurs when there is physical contact between an infected
person and a susceptible person. (The microbes that cause healthcare-associated infections
(HAIs) can be transmitted on the hands of healthcare personnel )
Indirect contact transmission occurs when there is no direct human-to-human contact.
Contact occurs from a reservoir to contaminated surfaces or objects, or to vectors such as
mosquitoes, flies, mites, fleas, ticks, rodents or dogs.
Environmental Surfaces Can Look Clean but… • Bacteria can survive for days on
patient care equipment and other surfaces like bed rails, IV pumps, blankets ,patient
equipment .
Aerosol Generating Procedures:
Some procedures performed on patients are more likely to generate higher concentrations
of infectious respiratory aerosols than coughing, sneezing, talking, or breathing. These
aerosol generating procedures (AGPs) potentially put healthcare personnel and others at an
increased risk for pathogen exposure and infection.
Commonly performed medical procedures that are often considered AGPs, or that might
create uncontrolled respiratory secretions, include:
• open suctioning of airways
• sputum induction
• cardiopulmonary resuscitation
• endotracheal intubation and extubation
• non-invasive ventilation (e.g., BiPAP, CPAP)
• bronchoscopy
• manual ventilation
• nebulizer administration
• high flow O2 delivery
- Standard infection control precautions may be insufficient to prevent cross transmission
of specific infectious agents and additional precautions called “transmission based
precautions” (TBP) may be required when caring for patients with known / suspected
infection or colonization.
Infection control measures :
1-Hand hygiene is one of the MOST important ,critical way to prevent the spread of
infection, can prevent up to 50% avoidable infections acquired during health care delivery
2- Develop and implement systems for appropriate infection control measures,
including isolation precautions, PPE) of potentially infectious persons at initial points
of patient encounter in outpatient settings (e.g., triage areas, emergency departments,
outpatient clinics, physician offices) and at the time of admission to hospitals and long-
term care facilities (LTCF).
3-Use respiratory hygiene and cough etiquette to reduce the transmission of respiratory
infections within the facility.
4- Prompt patients and visitors with symptoms of respiratory infection to contain their
respiratory secretions and perform hand hygiene after contact with respiratory secretions
by providing tissues, masks, hand hygiene supplies and instructional signage or handouts
at points of entry and throughout the facility
5-When space permits, separate patients with respiratory symptoms from others as
soon as possible (e.g., during triage or upon entry into the facility)
6-Ensure that healthcare personnel either receive immunizations or have documented
evidence of immunity against vaccine-preventable diseases as recommended by the CDC,
CDC’s Advisory Committee on Immunization Practices (ACIP) and required by federal,
state or local authorities.
7- Implement a system for healthcare personnel and sick leave policies when
reporting signs, symptoms, of acute infectious illness (e.g. fever, cough, diarrhea,
vomiting, or draining skin lesions) and diagnosed illnesses that may represent a
risk to their patients and coworkers to their supervisor or healthcare facility staff
who are responsible for occupational health
8- Adhere to federal and state standards and directives applicable to protecting
healthcare workers against transmission of infectious agents including OSHA’s
Bloodborne Pathogens Standard, Personal Protective Equipment Standard,
Respiratory Protection standard and TB compliance directive.
Patient considerations
1- All patient placement decisions and assessment of infection risk (including isolation
requirements) must be clearly documented in the patient notes and provided in patient
handovers with other healthcare/care providers.
2-The clinical judgement and expertise of the staff involved in a patient’s management and
the infection prevention and control team (IPCT) should be sought, particularly for the
application of TBPs, eg, isolation prioritization, when single rooms are in short supply.
3-Infectious patients should be separated from other patients while awaiting assessment
and during care management by at least 3 feet (1m).
4-Residents should remain in their bedroom while considered infectious and the door
should remain closed (if unable to isolate this should be documented).
5-Avoid unnecessary transfer of residents within/between care areas.
6-If transfer from a primary care facility to hospital is required, ambulance services should
be informed of the infectious status of the patient. Patient confidentiality must be
maintained.