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

Patients suspected or confirmed to have influenza should be cared for in single rooms if possible. Perform a risk assessment to determine patient placement and/or suitability for cohorting when single rooms are limited or if in a LTC setting. Patients who are known to have influenza should be cohorted with suitable roommates. If cohorting is not possible and a cubicle or designated bedspace is used in a shared room, privacy curtains should be drawn between beds. Infection control signage should be placed at the room entrance indicating Droplet and Contact Precautions required upon entry to the room. 8 . Patient Flow/Activities Patients with ILI 5 should be restricted to their room until symptoms have resolved. Participation in group activities should be restricted while the patient is symptomatic. Movement/transport of patients with suspected or confirmed influenza should be restricted to essential diagnostic and therapeutic tests only. Transfer within facilities should be avoided unless medically indicated. If transport is necessary, transport services and personnel in the receiving area should be advised of the required precautions for the patient being transported. Patients with influenza who leave their room for medical reasons (i.e., essential diagnostic and therapeutic tests) should wear a mask and adhere to respiratory hygiene. 9 . Personal Protective Equipment (PPE) a) PPE in addition to Routine Practices • Facial protection (masks and eye protection, face shields, mask with visor attachment) should be worn when within 2 metres of a patient with suspected or confirmed influenza. • In acute care settings, gloves should be worn when entering the room of a patient with suspected or confirmed influenza. • In LTC settings, gloves should be worn for direct personal care with the patient or if direct contact with frequently touched environmental surfaces is anticipated. • A long-sleeved gown should be worn if it is anticipated that clothing or forearms will be in direct contact with the patient or with environmental surfaces or objects in the patient care environment. • Remove all PPE just before leaving the patient's room and discard in a hands-free waste or linen receptacle within the room. • Hand hygiene should be performed after removing gloves and gown, before removing facial protection, and after leaving the room. Note: In a shared room/cohort setting, facial protection may be worn for the care of successive patients. b) Aerosol generating medical procedures (AGMPs) • AGMPs should only be performed on patients with confirmed or suspected influenza if medically necessary.