patient safety & quality
By J . Hudson Garrett Jr ., PhD , MSN , MPH , MBA , FNP-BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , MSL-BC , CPPS , CPHQ , NREMT , CADS , FACDONA , FAAPM , FNAP
Strategies to Reduce the Transmission of Respiratory Infections During a Pandemic
With the ongoing COVID-19 pandemic , healthcare professionals and facilities must maintain vigilance in the prevention of common and seasonal transmissible respiratory infections such as Influenza , rhinovirus and RSV . Respiratory infections are primarily spread via infectious respiratory droplets that enter the human body through mucous membranes or via indirect contract with contaminated environmental surfaces or the hands of healthcare personnel . These droplets can survive on environmental surfaces such as overbed tables , wheelchairs , IV poles , call light / TV remotes , bedrails , and other surfaces for varying timeframes from hours to days in some cases depending upon the specific microorganism .
Basic infection prevention and control measures such as hand hygiene , cleaning and disinfection of the clinical environment of care , and proper respiratory etiquette practices , will greatly reduce the spread of these infections in both healthcare and community settings . Certain patient populations , such as those with chronic comorbidities as chronic obstructive pulmonary disease , hypertension , type 2 diabetes , and congestive heart failure , are typically at increased risk for developing severe complications such as pneumonia and sepsis from respiratory infections . It is critically important for healthcare facilities to take extra precautions to protect these vulnerable patient populations that have high-risk healthcare conditions .
The Centers for Disease Control and Prevention ( CDC ) guidance provides several core recommendations which will reduce the potential transmission of both COVID-19 as well as other common transmissible respiratory infections .
●Cough Etiquette : Covering your cough or sneeze with your elbow or a tissue will reduce the spread of infectious respiratory droplets into the air which could expose others in the immediate vicinity to these droplets . The CDC has several educational campaigns that can assist healthcare facilities with reminding patients , visitors , and healthcare personnel about these basic respiratory protection and infection control .
●Hand Hygiene : Hand hygiene may be performed with either soap and water or an alcohol-based handrub with an alcohol concentration between 60 percent to 90 percent . It is also important that any alcohol-based handrubs be properly cleared through the Food and Drug Administration ( FDA ) to ensure both safety and efficacy . Alcohol-based handrubs are highly effective against a wide variety of bacteria and viruses and are an important element for both patients and healthcare personnel to break the chain of infection transmission . Hand hygiene remains the single most important infection prevention intervention that is in our arsenal as healthcare providers .
●Disinfection : Disinfection of high-touch surfaces with an Environmental Protection Agency ( EPA ) -registered disinfectant greatly reduces the presence of viable virus on environmental surfaces and medical devices . The EPA has published a new
List N which identifies all EPA-registered disinfectants that are deemed effective against
SARS-CoV-2 virus on hard , non-porous surfaces . Disinfectants used should be broad-spectrum and have a low overall contact time to ensure that room turnover is not compromised . They should also be compatible with commonly used healthcare surfaces and devices to ensure that degradation of the clinical environment does not occur due to incompatibility between the disinfectant and the actual healthcare environment itself . Due to product supply challenges , disinfectants may be available in a variety of different formats including ready-to-use wipes , liquids , sprays , or also distributed through novel technologies .
●Face Coverings or Masks : The CDC continues to recommend the use of a universal face coverings for the general community and the use of FDA-cleared masks for healthcare providers to create universal source control when addressing potential spread of COVID-19 infection . In the healthcare settings , healthcare providers should wear FDA-cleared medical masks and follow their institutional policies and procedures for the appropriate use of personal protective equipment .
●Universal Screening : Screening of both healthcare providers and also patients / visitor for potential infectious respiratory diseases . This screening includes temperature , symptoms of common respiratory infections , travel history , and recent exposure history ( usually within the last 14 days ). This screening should be conducted each time a patient / visitor or healthcare provider enters the healthcare facility .
●Social Distancing : Remaining at a distance of 6 feet or greater will help reduce the potential dispersal of contaminated droplets from one person to another particularly with COVID-19 infection , but also can be helpful with common respiratory infections . More importantly , if a healthcare provider is ill , they should not report to work and stay home to avoid exposing their colleagues and patients to potential infection .
●Vaccines : Certain vaccines , such as the annual Influenza vaccine , are not only effective at mitigating the potential spread of common respiratory infections , but also in many instances can reduce the potential severity of illness in affected patients or healthcare personnel . The CDC publishes annual guidance on appropriate vaccines for both healthcare personnel as well as patients that should be used to guide best practices for infection prevention and control .
While the COVID-19 pandemic is now entering a new phase with vaccine availability , healthcare personnel and facilities must continue to adhere to the CDC ’ s recommended infection control practices to prevent the transmission of these respiratory infections . This involves a comprehensive approach that addresses risks of patients , visitors , and healthcare personnel together to reduce potential spread of these infections . While vaccines are playing a larger role in the reduction of common respiratory infections , core infection control practices remain the mainstay for reducing transmission , improving outcomes , and ensuring the continuity of clinical operations during both pandemic and normal seasonal respiratory infection periods .
J . Hudson Garrett Jr ., PhD , MSN , MPH , MBA , FNP-BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , MSL-BC , CPPS , CPHQ , NREMT , CADS , FACDONA , FAAPM , FNAP , is president and CEO of Community Health Associates , LLC .