Respiratory Hygiene and Cough Etiquette is designed to contain respiratory secretions and prevent transmission of infection. It includes covering coughs and sneezes, using and disposing of tissues properly, and washing hands. Hospitals should implement these measures, post visual reminders, provide supplies to patients and visitors, and offer masks to those coughing or sneezing, especially during flu season or pandemics. Proper respiratory hygiene and cough etiquette are important for preventing the spread of respiratory illnesses in healthcare settings.

1. Respiratory Hygiene and
Cough Etiquette
Ahmad Thanin

2. Overview
to prevent the transmission of all respiratory
infections in healthcare settings, including influenza,
the following infection control measures should be
implemented at the first point of contact with a
potentially infected person.
They should be incorporated into infection control
practices as one component of Standard
Precautions.

3. Respiratory Hygiene/Cough Etiquette is designed to contain
respiratory secretions and prevent transmission of infection.
It includes:
• Cover the mouth and/or nose with a tissue when coughing or sneezing
• Cough or sneeze into the upper sleeve, not the hands
• Use tissues to contain respiratory secretions
• Place used tissues immediately into a waste bin
• Wash hands with soap and water or use ABHR
• Place signage with instructions for patients and visitors

4. The Importance of Respiratory
Hygiene and Cough Etiquette
Respiratory illnesses and infections can spread from
person to person with ease.
• To prevent the transmission of these infections in hospital settings,
healthcare facilities should never understate or ignore the
importance of respiratory hygiene and cough etiquette.
These facilities need to implement thorough prevention
strategies and furnish patients and visitors with the
supplies they need to keep themselves and others safe.

5. How to encourage proper respiratory hygiene and etiquette
in any hospital
POST VISUAL
REMINDERS
PROVIDE
PATIENTS AND
VISITORS WITH
SUPPLIES
MASKS FOR
PROTECTION

6. Post Visual Reminders
Patients and visitors will have a hard time following hygiene and
etiquette standards if they don't know what those standards are.
The best way to inform them of these standards is to post visual
reminders (in multiple languages) outside of emergency departments,
physician offices, outpatient clinics, and other essential facilities.
These reminders should inform patients and visitors of the most
common symptoms of a respiratory illness (sneezing, coughing, etc.)
and what they should do if they're currently exhibiting one or more of
those symptoms

7. Provide Patients and
Visitors With Supplies
• The most common measures taken to prevent the
spread of respiratory illnesses include covering the
mouth or nose when sneezing and coughing,
properly disposing of used tissues, and thoroughly
washing the hands with non-antimicrobial soap or
an alcohol-based handwash.
• Providing patients with tissues and no-touch
receptacles to toss them in, along with
conveniently placed hand sanitizing stations, will
help reduce the spread of germs exponentially.

8. Masks for Protection
The importance of respiratory hygiene and cough etiquette should
be stressed when the risk of spreading and contracting a respiratory
illness is unusually high, such as during a pandemic or flu season.
During these tumultuous times, hospitals should offer masks
(procedure or surgical) to people who are coughing or sneezing.
•In addition, they should separate the potentially ill from the healthy.
•Ask people who show signs of respiratory illness to remain six or more feet away
from others when in the waiting room.
•And when it comes time to admit them, place them in a room away from the more
vulnerable patients.
Providing patients with exemplary patient care for respiratory issues
is something every hospital must strive for.

10. Basic
protective
measures
against
COVID-19
Wash your hands frequently
• Washing your hands with soap and water or using
alcohol-based hand rub kills viruses that may be on
your hands.
Maintain at least 1 meter distance between
yourself and anyone who is coughing or
sneezing.
• When someone coughs or sneezes, they spray small
liquid droplets from their nose or mouth which may
contain virus.
• If you are too close, you can breathe in the droplets,
including the COVID-19 virus if the person coughing
has the disease.

11. Basic protective measures against COVID-19
• Hands touch many surfaces and can pick up viruses.
• Once contaminated, hands can transfer the virus to your eyes, nose or mouth.
• From there, the virus can enter your body and can make you sick.
Avoid touching eyes, nose and mouth
• This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze.
• Then dispose of the used tissue immediately since the droplets spread virus.
Practice respiratory hygiene.
• Stay home if you feel unwell.
• If you have a fever, cough and difficulty breathing, seek medical attention and call-in advance.
• Follow the directions of your local health authority.
Seek medical care early
• Follow advice given by your healthcare provider, your national and local public health authority or your employer on how to protect
yourself and others from COVID-19.
Stay informed and follow the advice