Initiating respiratory hygiene and cough etiquette stations throughout a multihospital university medical center

ISSUE: In September 2003, the state health department, along with our facility, mandated that we develop a response plan for the possible re-emergence of Severe Acute Respiratory Syndrome (SARS). We convened a multidisciplinary SARS task force, and five team members were given responsibility for writing the plan. During that time, we learned that respiratory hygiene and cough etiquette guidelines were being developed by the Healthcare Infection Control Practices Advisory Committee (HICPAC). There was also a threat of a heavy early flu season, and we needed to provide easy access to hygiene supplies in all hospital and clinic waiting areas and lobbies. PROJECT: The SARS planning group came up with an idea for a “sneeze station” since our policy required that facial tissues, hand sanitizers, waste receptacles, masks, and instructional signage be readily available in all hospital and clinic lobbies and waiting rooms. We took our idea to the director of plant operations and the sneeze station concept was approved. A carpenter was assigned to develop a prototype, and after a few minor revisions by the SARS task force the sneeze station was born. Wall-mounted and rolling floor models were designed to accommodate the various space needs in our facility. It was decided that masks would not be placed on the sneeze stations, but would be available at all reception desks due to concerns of inappropriate use. Our faculty and staff were educated on the respiratory hygiene policy and sneeze stations during the February 2004 mandatory safety fair. RESULTS: As of January 2005, we have placed 180 sneeze stations in our hospitals and clinics as well as in other institutions. When new areas open, one of the first concerns is to make sure they get their sneeze stations. The sneeze stations are continuously being used based on audits of supply usage and through monitoring by the environment of care (EOC) tours. LESSONS LEARNED: The sneeze stations are accepted in the medical center as a valuable part of infection control. There are times when supply cannot keep up with demand because we only have one carpenter assigned to manufacture the sneeze stations. Another lesson learned is that placing the station in a cafeteria may result in it being used as a food disposal instead of for its intended purpose. Overall, the sneeze station has met with great success, and this proves that creative ideas can bring about change.