Prevention of Health Care Related Influenza

Workers who perform direct patient care, aerosol-generating procedures, specimen analysis, and other patient support, like dietary and housekeeping services are at risk for contracting the seasonal Flu. These workers have a right to a safe workplace and a duty to take precautions at work that reduce their risk of exposure to the flu virus. Precautions include using a combination of safe work practices and personal protective equipment (PPE) to reduce your exposures.

• Get vaccinated! Vaccination is the most important way to prevent the spread of the flu.
• Stay at home if you are sick. CDC recommends that workers who have a fever and respiratory symptoms stay at home until 24 hours after their fever ends (100 degrees Fahrenheit [37.8 degrees Celsius] or lower), without the use of medication. Not everyone who has the flu will have a fever. Other symptoms could include a runny nose, body aches, headache, tiredness, diarrhea, or vomiting. Note that CDC has special instructions for workers returning to work in areas with patients whose immune systems are severely weakened.
• Keep frequently touched common surfaces (e.g., telephones, computer equipment, etc.) clean.
• Try not to use a coworker's phone, desk, office, computer, or other work tools and equipment. If you must use a coworker’s equipment, consider cleaning it first with a disinfectant.
• Stay in shape. Eat a healthy diet. Get plenty of rest, exercise, and relaxation.
• If you are in a high risk category for flu complications (e.g., pregnant women, persons with asthma, etc.) talk with your employer about alternative work assignments.
• Participate in all training offered by your employer. Make sure that you understand your exposure risk, your facility's policies and procedures for isolation precautions, use of workplace controls, work practices, and PPE protection during aerosol-generating procedures, and potential complications of the flu.

Additional Precautions for Healthcare Activities

Your employer should use a combination of workplace engineering controls, work practices, and personal protective equipment listed below to reduce your exposure to the flu. Engineering controls adapt workplace conditions and practices to reduce exposure. Engineering controls should be used first.

PPE is the least effective way to reduce exposure. PPE should be used only when close contact cannot be eliminated any other way. Follow your employer's procedures for implementing these controls and use the protective equipment provided to reduce your exposure risk at work.

Engineering Controls and other Workplace Control Measures

• Modify patient intake, triage, and other service areas to increase space between workers, coworkers, and patients (e.g., install sneeze guards or partitions).
  
• If available, use airborne infection isolation rooms (AIIRs), for aerosol-generating procedures and limit the number of people present during the procedure.
  
• Isolate and group flu patients according to your facility’s procedures.
  
• Use the appropriate Biosafety Level, in laboratories, when handling specimens from flu patients.
  
• Limit patient transport. Conduct exams and procedures at the bedside, instead of transporting the patient to other areas of the facility. Place a surgical mask on the patient, if tolerated, when they are being transported out of the room.
  
• Use closed suctioning systems to suction a patient’s airways and use high quality filters on the expiratory port of ventilators, when available.

Safe Work Practices

• Screen incoming patients and separate those with flu-like symptoms.
  
• Limit the staff entering patient isolation rooms to only those necessary for patient care.
  
• Restrict visits for patients in isolation.
  
• Use proper respiratory and cough etiquette and encourage hand washing by patients and visitors.
  
  • Cover your coughs and sneezes with a tissue or cough and sneeze into your upper sleeve(s). Dispose of tissues in a "no touch" wastebasket.
  • Clean your hands after coughing, sneezing, or blowing your nose.
  • Avoid touching your nose, mouth, and eyes.
    
• Wash your hands with soap and water for at least 20 seconds before and after contact with patients, after using PPE, and after touching contaminated surfaces; use an alcohol-based hand rub if soap and water are not available.
• When using soap and water, rub soapy hands together for at least 20 seconds, rinse hands with water, and dry completely.
  
• If soap and water are not available, use of an alcohol-based hand rub is helpful as an interim measure until hand washing is possible. When using an alcohol-based hand rub, apply liquid to palm of hand, cover all surfaces of the hands with the liquid, and rub hands together until dry.
  
• Check yourself for symptoms of the flu.
  
• Follow standard cleaning and disinfection methods

Personal Protective Equipment (PPE)

Use an appropriate mask when entering a flu patient's room. A surgical mask is not a respirator. It will not protect you during aerosol-generating procedures, which may create very fine aerosol sprays. A surgical mask can only be used to protect workers from contact with the large droplets made by patients when they cough, sneeze, talk or breathe.

• Use a respirator during aerosol-generating procedures; a fit tested N95 disposable respirator or better is needed.
• Use gloves, gowns, and eye protection for any tasks that might cause contamination or create splashes.
• Put on and take off protective equipment in the correct order to prevent contamination.
  • CDC Poster
    • Sequence for Donning and Doffing Personal Protective Equipment (PPE). Shows correct way to put on and take off PPE. The posters come in two different formats; a one-page format with smaller text and a two-page format with larger text.

Healthcare employers must use all reasonable controls to protect employees and volunteers by reducing the transmission of the seasonal flu virus:

• Promote, annual flu vaccination
• Make annual flu vaccine readily accessible to all employees and volunteers,
• Require employees and volunteers to stay at home when ill
• Require hand hygiene and cough etiquette
• Use airborne infection isolation rooms
• Ensure proper airflow control in patient rooms, procedure rooms, and examination rooms
• Limit the transport of infectious patients within the healthcare facility
• Limit the number of healthcare staff in contact with flu patients.
• Providing proper quantity and quality of personal protective equipment (PPE) (gloves, gowns, surgical masks, respirators) to healthcare staff
• Ensuring appropriate use, disposal or decontamination of PPE and equipment.

Reference

Department of Labor. Seasonal Flu - Employer Guidance Reducing Healthcare Workers' Exposures to Seasonal Flu Virus | Occupational Safety and Health Administration. (n.d.). Retrieved September 25, 2021, from https://www.osha.gov/seasonal-flu/healthcare-employers.

Department of Labor. Seasonal Flu - Worker Guidance Precautions for Healthcare Workers during Flu Season| Occupational Safety and Health Administration. (n.d.). Retrieved September 25, 2021, from https://www.osha.gov/seasonal-flu/healthcare-employers.

© RnCeus.com