crafted the guidance , it goes to the hundreds and thousands of hospitals and care providers across the entire country ,” confirms Hilary M . Babcock , MD , MPH , the liaison between HICPAC and the Society for Healthcare Epidemiology of America ( SHEA ), a member of the isolation guideline workgroup , an infectious diseases specialist and the chief quality officer at BJC HealthCare . “ And then they must develop policies and procedures based on them to keep our patients and employees safe . So , if we ’ re not clear , that lack of clarity has ripple effects that are significant . For some people who watched the proceedings , it may seem like nitpicking , or it may seem like we are in the weeds , but we know how people will be using this guidance , so we want to be as clear as we possibly can to ensure that the intent of the guidance is reflected properly .”
There are several key updates in the pre-final 2024 guideline , including :
• Clearer and more concise language and formatting , to better align with adult learning principles . Instead of using roman numerals and long narratives , the workgroup suggested that the general needs for PPE and its value be described more plainly . Doing so would also make the section more usable to healthcare workers , reducing its length significantly from the current 207 pages , and avoiding repetition of content maintained in other guidelines .
• Using more protective practices and PPE to address new and emerging pathogens of concern . Among the proposed new categories for transmission-based precautions , Special Air Precautions recommends the use of NIOSH-approved fit-tested N95 ( or higher-level ) respirators as the default option during care of patients with pandemic or emerging respiratory viruses . Other recommended categories to prevent transmission by air include Routine Air , which would have healthcare personnel wear a surgical or isolation mask for endemic respiratory pathogens , with eye protection added when indicated , and Extended Air Precautions , which would be used when providing care to patients with pathogens that can spread efficiently across long distances and over extended times .
In the pre-final draft guideline , the section Use of Transmission-Based Precautions to Prevent Transmission through the Air makes the following recommendations :
u Routine Air Precautions : a . A mask is worn by HCP on room entry , and eye protection is used based on Standard Precautions . ( Standard Practice ) b . Private rooms are preferred ; if not available , then cohort .
( Standard Practice ) c . Rooms should be appropriately ventilated , but an AIIR is not routinely needed . ( Standard Practice ) d . Source control masking should be used by the patient when they leave their room ( e . g ., for transport to a procedure ). ( Standard Practice )
➋ Special Air Precautions : a . A NIOSH-approved ® fit-tested N95 ( or higher-level ) respirator