Infection prevention and control: Guideline for speech pathologists, Version 1,2020.

5.0

5.4 Routine Management of the Physical Environment Maintaining environmental hygiene is important in preventing or minimising the transmission of infectious agents in the clinical or practice setting. The transmission of an infectious agent can occur from the environment to clients directly (i.e. contact with contaminated equipment) or in- directly (i.e. contaminated hands from equipment or the environment and then touch a client). See Section 7.0 for further information on environmental cleaning. Air handling The use of mechanical or natural ventilation for infection prevention and control is based on needs, availability and cost to provide the best control to counteract the risk. Consider if heating, ventilation or air-conditioning systems require adjustment of air pressure, flow control or filtration; ventilation rates, airflow patterns and humidity. 9 Ventilation • The amount and quality of outdoor air provided into a room 48. • Dilutes pollutants originating in an internal space with clean air. • Commonly designed around the expected number of individuals in a room and is calculated by litres/second for each occupant (l/s/p) 49 . • Can occur mechanically, naturally (via open doors and windows) or hybrid (mixed- mode). • Can be used for containment, odour control and climate regulation (temperature and relative humidity). 50 Air Exchange • Not dependent on the number of individuals in the room. It is calculated by the quantity of outside air that is provided per time, normalised to the volume of the room. 49 Droplet precautions • Special air handling and ventilation are not required to prevent droplet transmission, as these agents do not remain infectious over long distances. 51 • Increase precautions to airborne for the duration of the procedure (at minimum) when conducting an AGP and/or engaging in aerosol generating behaviours. Airborne precautions • Use a single room (negative pressure and/or ventilated) with the door closed or a physically separated closed area or spaced >3m from other clients. 52 • Consider an outside alternative for undertaking clinical tasks with the client (as appropriate) if the door cannot be closed (e.g., in the school setting where doors to clinical areas need to remain open for child safety and protection measures). • Leave the room free for a period of time to allow aerosols to settle if an AGP or an aerosol generating behaviour occurred. The adequate time to leave a room between clients is dependent on the ventilation rate of the room or clinical area and should be determined accordingly. 53 To calculate the number of air changes per hour consult the Centers for Disease Control and Prevention (CDC) website (https://www.cdc.gov/ infectioncontrol/guidelines/environmental/index.html). 54 If it is not possible to determine the time needed, a minimum of 30 minutes is required. 12 Blood and body spills Infection prevention and control requires prompt removal of blood and body substance (e.g., vomit) spills, followed by cleaning and disinfection of the contaminated area. Be familiar with

42

Infection Prevention and Control - Guideline for Speech Pathologists | Version 1, 2020