From ‘droplet’ to ‘respiratory’ precautions: implementation and adherence monitoring in a Swiss tertiary care center, 2023–2025

BACKGROUND: Following updated 2023 guidance from the European Centre for Disease Prevention and Control (ECDC), and in parallel with recommendations from the Swiss Center for Infection Control, a tertiary care centre in Switzerland replaced droplet precautions with 'respiratory precautions' on 1 November 2023. A multifaceted strategy was implemented to facilitate the transition to this updated transmission-based precaution. We aimed to describe the implementation of and adherence to respiratory precautions between November 2023 and March 2025. METHODS: From October 2023 to March 2024, a multifaceted, hospital-wide strategy was implemented to introduce changes in infection control policy with updated respiratory precautions, including standardized training, educational materials, a communication campaign, updated signage and prescription orders. Adherence to the updated respiratory precautions was audited during two periods: January-March 2024 and October 2024-March 2025. RESULTS: A total of 150 training sessions on infection control precautions were conducted for 1967/9410 (21%) healthcare workers and 2913 pocket cards summarizing updated precautions were distributed. Among 793 audits conducted, there was high adherence to recommended patient placement and signage (89-99%). Availability and suitability of placement for FFP2 respirators and eye protection were initially low but improved during the second audit (59% and 36%, respectively). FFP2 use was 76%, while use of eye protection remained low (38%), potentially due to limited availability and suitable placement. CONCLUSIONS: A structured, multifaceted strategy -combining training, audits, and feedback - supported the implementation of a change in respiratory precautions, achieving high adherence overall.