1. Influenza Presentation for Health Care Workers Part 3 of 3
We are glad you can join us for a presentation on influenza geared toward health care workers working in facility settings. This presentation has been updated for the season.
Season

2. Influenza Outbreak Control Measures
Hand Hygiene
Signage during an outbreak
Personal Protective Equipment (PPE)
Room Placement
Patient/Resident Care Equipment
Cleaning and Disinfection of surfaces and equipment

3. Hand hygiene plays a very important role in limiting the spread of influenza.
The hands of health care providers are the most common vehicle for the transmission of microorganisms from resident-to-resident, from resident to equipment and the environment, and from the environment to the resident.
In LTCHs, health care associated infections have a significant impact on residents’ health and quality of life. Adherence to hand hygiene recommendations is the single most important practice for preventing the transmission of pathogens and directly contributes to resident safety.
Reference:
Ministry of Health and Long Term Care. (2016). A Guide to the Control of Respiratory Infection Outbreaks in Long-Term Care Homes, pg.41.
Clean Your Hands!!!

4. Hand Hygiene Method #1 Wash with Soap and Water
Reference:
Just Clean Your Hands, PHO

5. Hand Hygiene Method #2 Use Hand Sanitizer
Reference:
Just Clean Your Hands, PHO

6. Reference:
Just Clean Your Hands, PHO

7. Outbreak Signage Outbreak Notification Signs
To be posted at all facility entrances and affected unit/area
Additional Precaution Sign (Droplet/Contact)
To be posted at the entrance to the resident’s room or bed space
PPE Poster
To be posted close to the PPE supplies (e.g., entrance to the resident’s room)
Hand Hygiene Signage
To be posted next to handwashing sinks and hand sanitizer stations
References:
Ministry of Health and Long-Term Care (2016). A guide to the control of respiratory infection outbreaks in long-term care homes
Public Health Ontario (2012). Routine practices and additional precautions: In all health care settings (November, 2012)

8. Routine practices + Droplet/Contact Precautions
PPE for Influenza
Routine practices + Droplet/Contact Precautions
1. Surgical mask
to be worn when within 2 meters of a resident with suspected or confirmed influenza
to be changed when it becomes wet or contaminated by secretions
Mask to be worn by resident when leaving the room
Appropriate mask use:
- it should securely cover the mouth and nose
- do not touch mask while wearing it
- wash hands after removing the mask
- disposable mask is for single-use only; not for re-use (PHO, 2012)
References:
PHO (2012). Routine practices and additional precautions: In all health care settings (3rd ed.). Retrieved from

9. PPE for Influenza 2. Gloves
to be worn when providing direct personal care
gloves are task-specific and single-use for that task
Appropriate glove use:
- select glove appropriate to task
- ensure glove fits the size of your hand (not overly tight or loose)
- hands must be washed prior to wearing and after removal
- gloves are for single-use only; do not wash or re-use (PHO, 2012)
References:
PHO (2012). Routine practices and additional precautions: In all health care settings (3rd ed.). Retrieved from

10. PPE for Influenza
3. Gown
to be worn when there will be direct contact with the resident
4. Eye protection
to be worn when within 2 meters of a resident with suspected or confirmed influenza
eye glasses are not an acceptable eye protection
Appropriate gown use:
- gown must be properly worn; tied at the top and around the waist
- gown is for single-use only
- gown must be changed after each resident care (PHO, 2012)
Appropriate use of eye protection:
- to be worn when within 2 metres of a resident with suspected or confirmed influenza
- may be disposable or re-usable (must be cleaned and disinfected prior to re-use)
- to be removed immediately after the task (PHO, 2012; Public Health Agency of Canada, 2010)
References:
PHO (2012). Routine practices and additional precautions: In all health care settings (3rd ed.). Retrieved from

11. Additional Points on PPE
The facility must stock sufficient PPE for all staff
If goggles are reused – they must be cleaned and disinfected between use
Stock clean goggles on the PPE cart outside the room
Have a container for used goggles inside the room
Staff must have unrestricted access to PPE
Inappropriate use of PPE may lead to:
Compromised quality of care provided to the resident
Increased waste and cost
Shortage of PPE → increase of infection rate
Reference:
Public Health Ontario (2012). Routine practices and additional precautions: In all health care settings (November, 2012), pgs.10-11

12. Room Placement for Residents with Influenza
Single room preferred:
If room is shared, cohort with appropriate roommates
Ensure privacy curtain is drawn between beds
Ill residents are to remain in their room:
For 5 days after onset of symptoms or until symptoms have resolved (whichever is shorter)
(Respiratory Outbreak Control Measures – York Region, 2014)
Keep residents in their room as long as it does not cause undue stress or agitation and can be done without applying restraints
Reference:
Respiratory Outbreak Control Measures – Information Package for Institutions, York Region Community and Health Services, January 2014.

13. Resident Care Equipment
Use disposable equipment when possible
Dedicate equipment to ill resident when possible
Shared equipment must be cleaned and disinfected between residents
Follow manufacturer’s guidelines on proper cleaning and disinfection procedures for equipment
Policies should clearly state who is responsible for cleaning equipment
Reference:
Ministry of Health and Long-Term Care (2016). A guide to the control of respiratory infection outbreaks in long-term care homes
PHO (2012). Best practices for environmental cleaning for prevention and control of infections: In all health care settings (May, 2012), pg.156

14. Cleaning and Disinfection of Environmental Surfaces
Use higher level disinfectants in outbreak situations (e.g., 5,000ppm bleach solution)
Always follow a two-step process: clean then disinfect
Increase frequency of cleaning and disinfection in outbreak affected areas
Pay special attention to frequently touched surfaces such as door handles, bed rails, and light switches
References:
Public Health Ontario (2013). Best practices for cleaning, disinfection and sterilization of medical equipment/devices: In all health care settings (3rd ed.).
Public Health Ontario (2012). Best practices for environmental cleaning for prevention and control of infections: In all health care settings (2nd ed.).

15. This is available on our website for download and printing (and better viewing).

16. In Summary…
The best prevention against the flu is getting the annual flu shot
You are protecting yourself, patients/residents, and others by getting your annual flu shot
Follow proper hand hygiene practices and wear PPE (when appropriate) to prevent the spread of influenza (and other infections)
Stay off work when ill and seek medical attention if needed

17. Additional Information
Visit our website: or
Call Public Health:
General Questions:
- York Region Health Connection:
Vaccine Related Questions:
, ext.73452

18. Additional Information
Ontario Respiratory Virus Bulletin:
Canadian Flu Watch:
National Advisory Committee on Immunization (NACI):
Just Clean Your Hands:
Video: The Flu – don’t pass it on!
Video: The Sneeze