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

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. 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. 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. A structured, multifaceted strategy -combining training, audits, and feedback - supported the implementation of a change in respiratory precautions, achieving high adherence overall.