Respiratory/Cough Etiquette
Respiratory and cough hygiene is designed to minimize the risk of cross-transmission of respiratory illness (pathogens). The following guidelines apply to all staff and patients.
Staff should promote respiratory and cough hygiene, helping those who need assistance with this, for example, providing patients with tissues, plastic bags for used tissues, and hand hygiene facilities as necessary. The following guidelines are to be followed:
Cover the nose and mouth with a disposable tissue when sneezing, coughing, wiping, and blowing the nose. If a disposable tissue is unavailable, use your elbow to cover your nose and mouth when coughing or sneezing.
Patients with respiratory illness symptoms should be encouraged to wear a surgical face mask when clinically safe and tolerated by the wearer.
Dispose of used tissues and face masks promptly into a waste bin.
In the absence of disposable tissues and hand hygiene facilities only, individuals should cough or sneeze into their elbow/sleeve.
Wash hands with non-antimicrobial liquid soap and warm water after coughing, sneezing, using tissues, or after contact with respiratory secretions or objects contaminated by these secretions.
Where running water is unavailable or hand hygiene facilities are lacking, staff may use hand wipes followed by ABHR, then wash their hands at the first available opportunity.
Keep contaminated hands away from the eyes, nose, and mouth.
Introduction
LifeCare Therapy Services, as an outpatient rehabilitation provider in Broward County, Florida, delivers physical, occupational, and speech therapy in both clinic and home-based settings. This program integrates OSHA-compliant Bloodborne Pathogen (BBP) training with CDC-based Standard Precautions, tailored to the unique challenges of outpatient and home-based therapy. Our policies and the associated training address regulatory requirements, infection transmission, practical application scenarios, and documentation, ensuring that all staff are equipped to protect themselves and their patients across diverse environments.
Regulatory Context
OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030)
The OSHA Bloodborne Pathogens Standard applies to all persons with reasonably anticipated occupational exposure to blood or other potentially infectious materials (OPIM), including therapists providing direct patient care in both clinic and home settings. Key definitions include:
Bloodborne Pathogens: Microorganisms in human blood that can cause disease (e.g., HBV, HCV, HIV).
Occupational Exposure: Anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM.
Personal Protective Equipment (PPE): Specialized clothing or equipment for protection against hazards.
Engineering Controls: Devices that isolate or remove hazards (e.g., sharps containers, needleless systems).
Work Practice Controls: Procedures that reduce exposure risk by altering how tasks are performed (e.g., no recapping of needles).
Employers must establish a written Exposure Control Plan (ECP), provide initial and annual training, offer Hepatitis B vaccination, and ensure post-exposure evaluation and follow-up.
CDC Standard Precautions and Outpatient Guidance
CDC’s Standard Precautions are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status, in any healthcare setting—including outpatient clinics and home care. These include:
•Hand hygiene
•Use of PPE based on anticipated exposure
•Respiratory hygiene/cough etiquette
•Safe injection practices
•Environmental cleaning and disinfection
•Safe handling of laundry and waste
CDC’s Guide to Infection Prevention for Outpatient Settings outlines the minimum expectations for safe care, emphasizing the importance of consistent application across all therapy environments.