PHHP 18 - A Joint Collaboration to Update and Standardize Statewide Precaution Signs

Background: Standardized precautions signs are used by healthcare facilities (HCFs) across the state to communicate infection precautions to healthcare workers (HCWs), patients and visitors. Standard precaution (SP) signs communicate basic infection prevention measures. Transmission based precaution (TBP) signs communicate the mode of transmission of pathogens and required Personal Protective Equipment (PPE). The state hospital association, state department of health, and infection preventionists across the state collaborated in a working committee (WC) to update and standardized precaution signs. This study describes research and analysis conducted to inform the work.

Methods: Feedback was collected from front line HCWs for a baseline understanding about their perceptions of existing precaution signs and visitor guidance materials. Input from the HCWs informed questions for a survey emailed to 133 hospitals in the state to collect feedback on the existing signs. An online survey program was used to collect and tabulate the results using descriptive statistics. Some answers were coded using an open-ended method.

Results: Responses revealed COVID-19 aerosol generating procedures (AGP) (87%) and source control learnings (81%) should be addressed in the new signage. Of the current signs, 80% indicated some signs could be consolidated. 75% indicated PPE donning & doffing sequence needed updating. 94% indicated that PPE should be required even if immune for pathogens requiring airborne contact precautions. 68% indicated the PPE images should be more culturally appropriate/gender neutral. 69% indicated that eye protection should be required for all HCWs in droplet precautions.

Conclusions: This study demonstrates the need to update and standardize precaution signs on an ongoing basis to meet changing guidance, technological advances, and updates to best practice guidelines. This study also identifies other considerations that are critical to improve safety and inclusion such as learnings from the COVID-19 pandemic, culturally sensitive icons, and translation into additional languages.