Optimizing Barrier Protection During a
Pandemic Event Caused by Influenza A

Infection Control Measures for Influenza A According to the Centers for Disease Control and Prevention (CDC), influenza A is transmitted via droplets, meaning person-to-person, direct contact, or via aerosol (sneezing, coughing, talking, etc.). Therefore, droplet precautions, in addition to standard precautions, should be implemented.35 Due to the high mortality rate that could be linked to a pandemic situation, WHO recommends that airborne precautions be adhered to when caring for any suspected case of influenza A.36 AIRBORNE PRECAUTIONS Place the patient in a private room with negative air-pressure ventilation. Negative pressure rooms are specially designed to prevent the flow of air from the room into corridors and common areas where susceptible persons may be exposed. This is accomplished through fans and vents that direct the airflow outside the building and/or through HEPA filters. Use external air exhaust or high-efficiency particulate air filters if the air is recirculated. Keep the door to the room closed. When a private room is not available, place the patient in a room with a patient who has an active infection with the same microorganism, unless otherwise contraindicated. Use an N-95 respirator mask. DROPLET PRECAUTIONS Droplet precautions are intended to minimize the risk of droplet transmission of the infectious agents. Droplet transmission involves contact of the conjunctivae or mucous membranes of the nose or mouth of a susceptible person with large-particle droplets (larger than 5µm in size) containing microorganisms generated from a person who has a clinical disease or who is a carrier of the microorganism. Transmission via large-particle droplets requires close contact between source and recipient, because droplets do not remain suspended in the air and generally travel only short distances, usually three feet or less, through the air. PATIENT PLACEMENT The patient should be placed in a private room. If a private room is not an option, the patient should be placed in a room with a patient(s) who also have an active infection with the same microorganism but with no other infection. If either of these situations cannot be achieved, it will be necessary to provide at least three feet between the infected patient and other patients and/or visitors. Special air handling and ventilation are not necessary. The door may remain open. PATIENT TRANSPORT The patient should only be transported from their room for necessary purposes. If transport or movement is essential, reduce patient spreading of droplets by masking the patient, if this is possible. HANDWASHING Handwashing is the number one way to reduce the spread of this disease or any other disease.Wash hands immediately after gloves are removed, between patient contacts, and when otherwise indicated to avoid transfer of microorganisms to other patients or environments. GLOVES Wear gloves when touching blood, bodily fluids, secretions, excretions, and contaminated items. Put on clean gloves just before touching mucous membranes and/or non-intact skin. Change gloves between tasks and procedures on the same patient after contact with material that may contain a high concentration of microorganisms. Remove gloves promptly after use, before touching noncontaminated items and environmental surfaces, and before going to another patient. Wash your hands immediately to avoid transfer of microorganisms to other patients or environments. MASKS, EYE PROTECTION, FACE SHIELDS Wear a standard surgical mask and eye protection or a face shield to protect mucous membranes of the eyes, nose, and mouth during procedures and activities that are likely to generate splashes or sprays. A mask should be worn when working within three feet of the patient. Wearing a mask upon entering the room of a patient with droplet precautions is wise, as this will diminish any inadvertent exposure. GOWNS Protect skin and prevent soiling of clothing during procedures and patient-care activities that are likely to generate splashes or sprays of blood, bodily fluids, secretions, or excretions by wearing a clean, non-sterile gown. Make sure that the gown is appropriate for the activity and amount of fluid likely to be encountered. HANDLING ITEMS YOU USE FOR EACH PATIENT Handle used patient-care equipment soiled with blood, bodily fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other patients and environments. Reusable equipment should never be used for the care of another patient until it has been cleaned and reprocessed appropriately. Discard singleuse items properly. This will prevent the possibility of transfering microorganisms to other patients and environments. It is extremely important that patients and healthcare workers are educated on how to prevent the spread of influenza. The CDC has presented a few tips to remember: Routine hand hygiene is necessary after contact with respiratory secretions and contaminated objects/materials.Washing your hands frequently is essential during the flu season. Educate patients to cover their noses/mouths when coughing or sneezing, and always use tissues to confine respiratory secretions and dispose of them properly, in the nearest waste receptacle, after they are finished. Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick as well. If at all possible, stay home from work when you are sick. Avoid touching your eyes, nose, or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Even without a pandemic event occurring, healthcare professionals must apply proper infection control practices in all circumstances. These scientific concerns should be taken seriously, as it is our role to minimize the spread of pathogens and help maintain a healthy and safe environment for our patients and ourselves.

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