Hospital Infection
Control Guidance for Severe Acute Respiratory Syndrome (SARS)
Revised
28 March 2003
Outpatient/triage setting
- Those presenting to health
care facilities who require assessment for SARS should be rapidly diverted
by triage nurses to a separate area to minimize transmission to others
- Those patients should be given a N 95 mask
to wear
- Staff involved in the triage process
should wear a N 95 mask and wash hands before and after contact with any
patient, after activities likely to cause contamination and after removing
gloves
- Wherever possible, patients under
investigation for SARS should be separated from the probable cases.
Inpatient setting
Care for probable SARS cases (see Case Definitions for
Surveillance of Severe Acute Respiratory Syndrome (SARS)
- Probable SARS cases should
be isolated and accommodated as follows in descending order of preference:
- negative pressure rooms with the door
closed
- single rooms with their own bathroom
facilities
- cohort placement in an area with an
independent air supply, exhaust system and bathroom facilities
- Turning off air conditioning and opening
windows for good ventilation is recommended if an independent air supply
is unfeasible. Please ensure that if windows are opened they are away from
public places
- WHO advises strict adherence to the
barrier nursing of patients with SARS, using precautions for airborne,
droplet and contact transmission
- All staff, including ancilliary staff
should be trained in the infection control measures required for the care
of such a patient
- If possible, identify a member of the
staff who will have the sole role of observing the practice of others and
provide feedback on infection control
- Disposable equipment should be used
wherever possible in the treatment and care of patients with SARS and
disposed of appropriately. If devices are to be reused, they should be
sterilized in accordance with manufacturers’ instructions. Surfaces should
be cleaned with broad spectrum disinfectants of proven antiviral activity
- Movement of patients outside of the
isolation unit should be avoided. If moved the patients should wear a N 95
mask
- Visitors, if allowed by the health care
facility should be kept to a minimum. They should be issued with personal
protective equipment (PPE) and supervised
- All non-essential staff (including
students) should not be allowed on the unit/ward
- Handwashing is crucial: therefore access
to clean water is essential
Hands should be washed before and after contact with any patient, after
activities likely to cause contamination and after removing gloves
- Alcohol-based skin disinfectants could be
used if there is no obvious organic material contamination
- Particular attention should be paid to
interventions such as the use of nebulisers, chest physiotherapy,
bronchoscopy or gastroscopy; any intervention which may disrupt the
respiratory tract
- PPE should be worn by all staff and
visitors accessing the isolation unit
- The PPE worn in this situation should be:
N95 mask as a minimum
Single pair of gloves
Goggles
Disposable gown
Apron
Footwear that can be decontaminated
- All sharps should be dealt with promptly
and safely
- Linen from the patients should be prepared
on site for the laundry staff. Appropriate PPE should be worn in this
preparation and the linen should be put into biohazard bags
- The room should be cleaned by staff
wearing PPE using a broad spectrum disinfectant of proven antiviral
activity
- Specific advice concerning air
conditioning units will be available soon