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Respiratory Hygiene/Cough Etiquette

Health workers and visitors should observe respiratory hygiene and cough etiquette to minimise the risk of cross-infection from persons with potentially undiagnosed respiratory infections. In addition, health workers with respiratory illnesses should avoid providing direct patient contact.

The guidance applies to all personnel entering a healthcare setting with signs of respiratory illness, including cough, rhinorrhea, or increased production of respiratory secretions. Visual alerts should be posted at the entrance to healthcare facilities instructing people with respiratory symptoms to practice respiratory/cough etiquette (LINK TO POSTER). In addition, place hand hygiene supplies, tissues, masks, and no-touch waste bins in waiting areas. The instructions include:

  • Cover the nose and mouth with a disposable tissue when sneezing, coughing, wiping, and blowing the nose. If a disposable tissue is unavailable, cough or sneeze into your upper sleeve.
  • Dispose of all used tissues promptly into a waste bin.
  • Keep contaminated hands away from the eyes, nose and mouth.
  • Wash hands with non-antimicrobial soap and warm water after coughing, sneezing, using tissues, or after contact with respiratory secretions or objects contaminated by these secretions.
  • If hand washing facilities are unavailable, staff may use hand wipes and perform hand hygiene using an Alcohol-based hand rub on physically clean hands.

Literature Review: Standard Infection Precautions Literature Review Cough etiquette. NHS National Health Service Scotland: 13 September 2021.