Strategies for Universal Respiratory Etiquette

• Provide surgical masks to all patients with symptoms of a respiratory illness. Provide instructions on the proper use and disposal of masks.
• For patients who cannot wear a surgical mask, provide tissues and instructions on when to use them (i.e., when coughing, sneezing, or controlling nasal secretions), how and where to dispose of them, and the importance of hand hygiene after handling this material.
• Provide hand-hygiene materials in waiting room areas and encourage patients with respiratory symptoms to perform hand hygiene.
• Designate an area in waiting rooms where patients with respiratory symptoms can be segregated (ideally by at least 3 feet) from other patients who do not have respiratory symptoms.
• As soon as possible, place patients with respiratory symptoms in a private room or cubicle for further evaluation.
• Implement use of surgical or procedure masks by health care personnel during the evaluation of patients with respiratory symptoms.
• Consider the installation of Plexiglas barriers at the point of triage or registration to protect health care personnel from contact with respiratory droplets.
• If no barriers are present, instruct registration and triage staff to remain at least 3 feet from unmasked patients and to consider wearing surgical masks during respiratory infection season.
• Continue to use droplet precautions to manage patients with respiratory systems until it is determined that the cause of symptoms is not an infectious agent that requires precautions beyond standard precautions.

Source: Centers for Disease Control and Prevention, Atlanta. Web: www.cdc.gov/ncidod/sars/guidance/C/pdf/c.pdf.