Influenza (Flu)

Infection Prevention and Control: Long-Term Care

Standard Precautions

Remind all staff to follow Standard Precautions in the care of all residents all of the time. See Standard Precautions

Wear gloves if hand contact with blood and/or bodily fluids including respiratory secretions or potentially contaminated surfaces is anticipated.
Wear a gown if soiling of clothes or contamination of skin with a resident’s respiratory secretions is anticipated.
Change gloves and gowns after each resident encounter and perform hand hygiene.
Clean hands before and after touching the resident, after touching the resident’s environment, or after touching the resident’s blood and/or bodily fluids including respiratory secretions, whether or not gloves are worn.
When hands are visibly soiled or contaminated, wash hands with soap and water. If hands are not visibly soiled, an alcohol-based hand rub can be used.

When caring for residents with influenza-like illness:

Follow Standard Precautions AND Droplet Precautions (surgical mask and eye protection as indicated by Standard Precautions)
Droplet Precautions should be followed for seven days after the onset of the resident’s influenza-like illness.
Place resident into a private room. If a private room is not available, place (cohort) residents with influenza-like illness with other residents having the same symptoms.
Wear a surgical mask when entering the resident’s room or when having close contact with the resident.
Remove the mask when leaving the resident’s room, dispose of the mask in a waste container, and perform hand hygiene.
If resident movement or transport is necessary, have the resident wear a surgical mask, if possible.
When residents are transferred to another facility, notify the receiving facility of a suspected/confirmed influenza outbreak in your facility.
Prior to residents being transferred into your facility, notify the transferring facility that you have a suspected/confirmed influenza outbreak.

Assure that all new residents have received influenza vaccination prior to transfer

Respiratory Protection

Respiratory Protection should be used while performing aerosol-generating procedures (e.g. Bronchoscopy, open suctioning of airway secretions, sputum induction, resuscitation involving emergency intubation or cardiac pulmonary resuscitation, endotracheal intubation and extubation and autopsy.)

Respiratory protection includes:

Fit-tested disposable N95 respirator
- Prior fit-testing that must be repeated annually and fit-check / seal-check prior to each use
OR Powered air purifying respirator (PAPR)
- Follow facility protocols and procedures for decontamination of PAPR
PLUS Standard Precautions
PLUS eye protection (goggles/face shield)

Specimen collection

Droplet Precautions should be used by the healthcare workers obtaining a clinical specimen (includes nasopharyngeal swab, nasal wash, throat swab); if splashes are anticipated, then eye protection should be considered.

Environmental Cleaning and Disinfection

Routine cleaning and disinfection strategies should be used.
- Increase the frequency of cleaning in common areas throughout the facility.
- Immediately clean/disinfect areas that become visibly soiled.
Follow regular laundering procedures and polices for patients with influenza-like illness.
- As usual, follow Standard Precautions (e.g. gown, gloves) when handling soiled linen.