1 Novel Influenza A H1N1 Outbreak: The Florida Response Infection Control Considerations: Focus on Personal Protective Equipment

2 Workplaces may require workers to have contact with people who are known or suspected to be infected with the Influenza A H1N1 virus. Institute work practices to reduce the risk of infection and to protect your workers. The diversity among healthcare workers and their workplaces makes preparation and response to a pandemic influenza especially challenging.

3 Infection Control Considerations: Focus on Personal Protective Equipment OSHA – General Guidance CDC – Specific Guidance for:  Caring for Patients in Healthcare Settings  Obstetric Settings  Laboratory Workers  Post-Mortem Care and Autopsy Procedures  Correctional and Detention Facilities  Homeless and Emergency Shelters

4 Infection Control Considerations: Focus on Personal Protective Equipment SHEA Position Statement  Interim Guidance on Infection Control Precautions for Novel Swine-Origin Influenza A H1N1 in Healthcare Facilities  Endorsed by APIC and IDSA HICPAC Review of Interim Guidance  Working Group, Stakeholders, IOM expert panel  Process complete October 1, 2009

5 Infection Control Considerations: Focus on Personal Protective Equipment Patient Controls  Respiratory etiquette  Use of masks  Antivirals  Vaccination (when available) Environmental Controls  Ventilation  Sanitation  Waste management

6 Infection Control Considerations: Focus on Personal Protective Equipment Administrative Controls  Staffing considerations  Triage, isolation, or cohorting  Active surveillance  Disposable or dedicated supplies and equipment  Infection Control Precautions Use of Personal Protective Equipment Transmission of H1N1 – Droplet or Airborne?

7 Infection Control Considerations: Focus on Personal Protective Equipment Infection Control Precautions  Standard – basic level for care of all patients Hand Hygiene Other PPE, if exposure anticipated  Contact – diseases easily transmitted by direct patient contact or by indirect contact with items Standard Precautions Gloves and Gowns Eye Protection – if splashes anticipated Private room – if available

8 Infection Control Considerations: Focus on Personal Protective Equipment Infection Control Precautions  Droplet – working within 6 feet of a patient who is coughing or sneezing or during procedures that result in dispelling droplets into the air. Standard Precautions - plus Surgical Mask  Airborne – protect against airborne droplet nuclei that may remain suspended in the air for a long time. Standard Precautions - plus Personal Fit Tested N-95 or PAPR Respirator Negative Pressure Isolation Room

9 Infection Control Considerations: Focus on Personal Protective Equipment Written program in accordance with OSHA Programs and fit test procedures: Staff should be medically cleared, fit-tested, and trained for respirator use Florida Guidance – under consideration to move towards use of surgical mask for routine patient care