Novel Influenza A H1N1 Outbreak: The Florida Response

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

2. Infection Control Considerations: Focus on Personal Protective Equipment • 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: www.osha.gov/SLTC/etools/respiratory • 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