Infection Control

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The CF Center at RWJMS abides by strict infection control guidelines both inpatient and outpatient programs. These guidelines are set forth by the Cystic Fibrosis Foundation for the protection of all people living with CF while in the medical center. The following guidelines reflect current infection control procedures in clinic, including changes made recently based on the Updated Consensus guidelines from the CF Foundation Spring, 2014.

Outpatient Center

• Contact between CF patients needs to be very limited.  People with CF should stay at least six feet from each other.  Every attempt is made to move patients and families quickly through registration and into a visit room. 
• While in the waiting room, ALL patients will be asked to wear a mask. Masks are available at the registration desk in both the pediatric and adult clinics and should be worn any time you are outside your clinic or hospital room.
• For the pediatric program, we encourage parents to supervise children at all times and we also recommend that children bring their own toys from home rather than playing the with toys in the waiting room. 
• We discourage use of the computer in the waiting room for infection control reasons.
• All staff will gown and glove for your visits. This will include all front end nursing staff and the CF team.
• Staff wash their hands on the way into and out of each patient’s room. 
• The respiratory therapist will gown, glove and mask while assisting patients with PFTs as well as when collecting sputum samples. 
• Patients are also strongly encouraged to stay in the treatment room at all times unless using the bathroom.
• All treatment rooms, triage areas and equipment is wiped down with anti-bacterial wipes after each patient. These wipes are approved for all bacteria, including Pseudomonas and B. Cepacia.  
• MRSA Precautions: Current guidelines require that all patients be placed on contact precautions, Previously, this policy was only for patients colonized with MRSA.
• Pulmonary function testing and sputum cultures will take place in your clinic room rather than moving in and our of the pft lab. The purpose of this is to reduce exposure to bacteria that may remain airborne for up to 30 minutes after testing. If the pft lab is used for any testing, the RT will clean the room and allow 30 minutes between patients.
• Patients will be asked to wear gloves while performing pulmonary function testing.

Note: CF related MRSA is NOT a danger to people in the community.

**B. Cepacia:  Patients who culture Burkholdeia cepacia will continue to be scheduled to come to clinic on a different day than the primary CF clinic day.  Currently, these are the second and fifth Friday of every month in the pediatric program and one Thursday per month in the adult program. Similar infection control policies will be in place on B. Cepacia clinic days.

You may access the full Guidelines at http://www.jstor.org/stable/infeconthospepid.ahead-of-print. 

Hospital Infection Control Policy

All pediatric, adolescent and adult patients with CF will be placed on contact precautions during their stay at BMSCH and RWJUH.  This means the following:

• All patients with Cystic Fibrosis will always be in a private room.
• All hospital staff must gown and glove when entering the room and remove gown and glove and wash hands upon leaving the room.  This includes doctors, residents, nurses, assistants and housekeeping staff.
• All patients with CF should have their own stethoscope and blood pressure cuff in their room.  If you do not, please ask your nurse or medical technician. 
• All patients must wear a mask when leaving the room and will not be allowed to visit another patient with CF in the hospital.
• Patients who wish to leave their rooms must wear a mask and are strongly encouraged to go for walks off the unit.
• Doors to patient rooms should remain closed
• Respiratory therapists must wear masks in addition to gown and glove because they are inducing sputum.
• Whenever possible, CF patients will perform pfts in their hospital rooms rather than coming down to the pft lab.
• No two CF patients will be assigned to the same nurse on a given day
• Family visitors are not limited.  However, family members who are sick are discouraged from visiting. 
• Pediatric and adolescent patients are not allowed in the Child Life room or Teen lounge.  Representatives from the Child Life Department will visit patients frequently and bring various activities, games, etc to rooms.