CDC and OSHA: Use hierarchy of controls to protect HCWs
In its updated guidance on infection control measures and 2009 H1N1 influenza virus, the Centers for Disease Control and Prevention urges health care facilities to use a hierarchy of controls and provides examples of measures they should take. The U.S. Occupational Safety and Health Administration also stated that inspectors will look for a range of protective measures. Here are examples provided by CDC:
Elimination of sources of infection
Postponing elective visits and procedures for patients with suspected or confirmed influenza until they are no longer infectious.
Denying healthcare facility entry to those wishing to visit patients if the visitors have suspected or confirmed influenza.
Minimizing outpatient and emergency department visits for patients with mild influenza-like illness who do not have risk factors for complications.
Keeping personnel at home while they are ill to reduce the risk of spreading influenza.
Engineering controls
Installing partitions (e.g., transparent panels/windows/desk enclosures) in triage areas as physical barriers to shield staff from respiratory droplets.
Using local exhaust ventilation (e.g., hoods, tents, or booths) for aerosol-generating procedures.
Using hoods for the performance of laboratory manipulations that generate infectious aerosols.
Using ventilation controls in ambulances.
Installing hands-free soap and water dispensers, and receptacles for garbage and linens to minimize environmental contact.
Conducting aerosol-generating procedures in an airborne infection isolation room (AIIR) to prevent the spread of aerosols to other parts of the facility.
Using closed suctioning systems for airways suction in intubated patients.
Using high-efficiency particulate filters on mechanical and bag ventilators.
Ensuring effective general ventilation and thorough environmental surface hygiene.
Administrative controls
Vaccinating as much of the health care work force as possible (once vaccine is available).
Identifying and isolating patients with known or suspected influenza infections.
Implementing respiratory hygiene/cough etiquette programs.
Setting up triage stations, managing patient flow, and assigning dedicated staff to minimize the number of health care personnel exposed to those with suspected or confirmed influenza.
Setting up triage stations, managing patient flow, and assigning dedicated staff to minimize the number of health care personnel exposed to those with suspected or confirmed influenza.
Setting up triage stations, managing patient flow, and assigning dedicated staff to minimize the number of health care personnel exposed to those with suspected or confirmed influenza.
Screening personnel and visitors for signs and symptoms of infection at clinic or hospital entrances or badging stations and responding appropriately if they are present.
Adhering to appropriate isolation precautions
Limiting the number of persons present in patient rooms and during aerosol-generating procedures
Arranging seating to allow 6 feet between chairs or between families when possible.
Ensuring compliance with hand hygiene, respiratory hygiene, and cough etiquette.
Making tissues, facemasks, and hand sanitizer available in waiting areas and other locations.
Establishing protocols for cleaning of frequently touched surfaces throughout the facility (elevator buttons, work surfaces, etc.).
Locating signage in appropriate language and at the appropriate reading level in areas to alert staff and visitors of the need for specific precautions.
Placing facemasks on patients, when tolerated, at facility access points (e.g., emergency rooms) or when patients are outside their rooms (e.g., diagnostic testing).
Placing facemasks on patients during transport, when tolerated; limiting transport to that which is medically necessary; and minimizing delays and waiting times during transport.
Personal protective equipment
Wearing appropriate gloves, gowns, facemasks, respirators, eye protection, and other PPE.
In its updated guidance on infection control measures and 2009 H1N1 influenza virus, the Centers for Disease Control and Prevention urges health care facilities to use a hierarchy of controls and provides examples of measures they should take.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content