ASC Spotlight - Q2 2019 - 45

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COUGH ETIQUETTE

Respiratory Hygiene/Cough Etiquette
in Healthcare Settings
Repurposed from the Centers for Disease Control and Prevention (CDC)

To prevent the transmission of all respiratory infections in healthcare
settings, including influenza, the following infection control measures
should be implemented at the first point of contact with a potentially
infected person. They should be incorporated into infection control
practices as one component of Standard Precautions.
1. Visual Alerts
Post visual alerts (in appropriate languages)
at the entrance to outpatient facilities (e.g.,
emergency departments, physician offices,
outpatient clinics) instructing patients and
persons who accompany them (e.g., family,
friends) to inform healthcare personnel of
symptoms of a respiratory infection when
they first register for care and to practice
Respiratory Hygiene/Cough Etiquette.

2. Respiratory Hygiene/Cough
Etiquette
The following measures to contain
respiratory secretions are recommended for
all individuals with signs and symptoms of
a respiratory infection.

* Cover your mouth and nose with a tissue
when coughing or sneezing;
* Place in the nearest waste receptacle to
dispose of the tissue after use;

* Perform hand hygiene (e.g., hand
washing with non-antimicrobial soap
and water, alcohol-based hand rub,
or antiseptic handwash) after having
contact with respiratory secretions and
contaminated objects/materials.
Healthcare facilities should ensure the
availability of materials for adhering to
Respiratory Hygiene/Cough Etiquette in
waiting areas for patients and visitors.

* Provide tissues and no-touch receptacles
for used tissue disposal.
* Provide conveniently located dispensers
of alcohol-based hand rub; where sinks
are available, ensure that supplies for
hand washing (i.e., soap, disposable
towels) are consistently available.

3. Masking and Separation
of Persons with Respiratory
Symptoms
During periods of increased
respiratory infection activity
in the community (e.g., when
there is increased absenteeism
in schools and work settings
and increased medical office
visits by persons complaining
of respiratory illness), offer
masks to persons who are
coughing. Either procedure
masks (i.e., with ear loops)
or surgical masks (i.e., with
ties) may be used to contain
respiratory secretions
(respirators such as N-95 or
above are not necessary for
this purpose). When space
and chair availability permit,
encourage coughing persons
to sit at least three feet away
from others in common waiting areas. Some
facilities may find it logistically easier to
institute this recommendation year-round.

4. Droplet Precautions
Advise healthcare personnel to observe
Droplet Precautions (i.e., wearing a surgical
or procedure mask for close contact), in
addition to Standard Precautions, when
examining a patient with symptoms of a
respiratory infection, particularly if fever
is present. These precautions should be
maintained until it is determined that the
cause of symptoms is not an infectious agent
that requires Droplet Precautions.

NOTE: These recommendations are based on the Draft Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in
Healthcare Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC), CDC.

19MS4306

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ASC Spotlight - Q2 2019

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