Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines

Patricia Rios; Amruta Radhakrishnan; Sonia M. Thomas; Nazia Darvesh; Sharon E. Straus; Andrea C. Tricco

Higher infection concern. Surfaces that have been in contact with the patient's oral secretions or other excretions and cannot be readily disinfected pose a bigger concern. This is because, although the infection risk is still likely to be extremely low on these surfaces, there is a greater probability that the virus has remained viable. Such surfaces include the following: Breathing circuits (including ventilator accessories and any portions of the breathing circuit inside ventilators), suction devices and systems, or any other devices that are exposed to the patient's oral secretions (including contaminated condensate), urine, feces, and other excretions HEPA filtration systems, which are installed systems or portable systems (i.e., mobile high-efficiency-filter air cleaners [MHEFACs]) used to control room air contamination levels and ensure negative pressure in isolation rooms Any handheld items or other items that can be found in beds, including nurse call buttons, remote controls for televisions, pillow speakers, blood pressure cuffs, and telemetry transmitters Highest infection concern. The highest level of concern is posed by entering the room of a SARS patient without appropriate personal protective equipment (PPE). This is because of the close proximity to the patient, the potential risk of exposure to droplet secretions from coughs and sneezes, exposure to contaminated surfaces, and possible exposure associated with aerosol-generating procedures. Keep in mind that even the highest level of risk is not an insurmountable concern as long as servicing personnel take the protective steps listed in the next section.