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February 14, 2017

6 Important Norovirus Tips for Nurses

Image Credit: Alissa Eckert. Provided by CDC/Jessica Allen.

By Kathleen Colduvell, RN, BSN, BA, CBC

Norovirus is a common disease that nurses may come into contact with on a regular basis in a variety of settings. Nursing professionals must understand what norovirus is, its etiology, as well as how to prevent and treat infections.

The Centers for Disease Control and Prevention (CDC) estimate that one in 15 U.S. residents gets sick with norovirus every year, leading to approximately 71,000 hospitalizations and nearly 800 deaths. Symptoms can develop 12 to 48 hours after coming in direct contact with norovirus. Common symptoms of the highly contagious norovirus include vomiting, abdominal pain or cramps, malaise, muscle pain, diarrhea, nausea, and a low-grade fever.

Norovirus, originally known as Norwalk-like virus, typically peaks between the months of December and April. Researchers have linked the spike during these months to people’s close proximity and the increase in person-to-person interaction; furthermore, the holidays bring together families and friends, which increases the likelihood of spreading norovirus.

Norovirus is quite possibly one of the single most dreaded words in nursing and hospital settings. Norovirus is a highly contagious virus that can be spread via an infected individual, contaminated food or water, or by coming in contact with a contaminated surface. Here are a few tips that nurses can follow to help their patients with norovirus and assist in protecting themselves and their families.


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1. Hand Hygiene

The use of proper hand hygiene is singlehandedly the most important advice one can give in helping to prevent the spread of norovirus. It’s crucial to wash hands with soap and water after toileting and changing diapers, as well as before eating, preparing, and handling food. While alcohol-based hand sanitizers such as Purell and Germ-X are widely used, they do not kill or decrease the spread of the virus; these sanitizers are best utilized as one aspect of overall good hand hygiene.

The CDC Hand Washing Guidelines are a great tool for healthcare professionals to review prior to caring for patients with norovirus. It is recommended to lather and rinse for 30 seconds, including under the fingernails. For the pediatric population, it’s suggested to teach children to slowly sing the lyrics to “Row, Row, Row Your Boat” in order to have them wash for the full 30 seconds.

2. Wash Your Scrubs

A good percentage of nurses come home with some type of fluid on their scrubs, whether it’s vomit, urine, or fecal matter; norovirus is spread through fecal matter contamination. With that being said, nurses should always have an extra pair of scrubs in their locker. If you find yourself taking care of a norovirus patient during your shift and are unable to change your clothes prior to going home from the hospital, immediately strip and shower upon entering your house. Sometimes it’s difficult to do this with family obligations or a pet needing your attention, but taking these precautions can help save you and your family from a very painful week of otherwise preventable illness.

It’s imperative to wash any clothes, towels, or sheets that come in contact with vomit or stool immediately; use the hottest water cycle setting on the washing machine, and if at all possible use bleach. If you or a family member are actively infected with norovirus, it is helpful to run an empty cycle with bleach between washes and again once the virus has passed in order to clean out the machine; this will lessen the chances of reinfection. Use gloves to handle soiled sheets, towels, and clothes, and keep them separate from other laundry. It’s worth mentioning that dry cleaning will not kill norovirus germs.


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3. Stop Touching Your Face

This may seem like a silly tip, but the truth is that norovirus must be ingested to contract the disease. Coming in contact with the virus and then touching your mouth, nose, or eyes prior to washing your hands increases the likelihood of contracting norovirus.

4. Stay Hydrated

One of the most common causes of hospitalization is dehydration. Once norovirus is detected there isn’t much one can do but manage the symptoms, but there are ways to prevent further complications and possible hospitalization.

There is no actual cure for norovirus, but symptom management and avoiding complications are key. Sipping water, sports drinks, or juice will replace fluids and essential vitamins, minerals, and electrolytes that are being depleted from the body. Hospital treatment would generally include intravenous fluid replacement. Children should avoid carbonated beverages and sugary fruit juice as it can make diarrhea worse.

5. Clean, Clean, Clean

The last thing that anyone wants to do after being sick is clean, but this can help prevent reinfection or spreading of the virus to others. In 2016, the US Environmental Protection Agency Office of Pesticide Programs released a list of hospital-approved cleaners that are effective in disinfecting against norovirus.

For the home setting, bleach is the one and only cleaner that has proven effective in killing norovirus germs.  The CDC recommends a solution that contains anywhere from 5 to 25 tablespoons of household bleach per gallon of water. Stainless steel requires less bleach, while more porous surfaces such as wooden floors need more. Bleach-based cleaners such as Lysol contain the necessary amount of bleach for those who prefer to purchase a premade cleaner. While handling bleach-based cleaners, use rubber gloves or disposable gloves to protect against both the bleach and any norovirus you may come into contact with.


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6. STAY HOME!

While all of the aforementioned tips can be helpful in preventing norovirus, it’s not a guarantee. If you do contract this awful virus, do everyone a favor and stay home! Symptoms typically last one to three days, but the CDC notes that once a person has contracted norovirus, he or she is most likely contagious for about three days after recovery. Those in the healthcare profession need to be extremely vigilant if norovirus is contracted.

Norovirus attacks everyone; while it isn’t 100% preventable, there are things that healthcare professionals, food workers, and the general public can do to help control its spread. Not only does norovirus wreak havoc on the gastrointestinal tract, it also costs hospitals a great deal of extra money. For example, a 2007 outbreak of norovirus infection at Johns Hopkins Medical Center cost an estimated $650,000 in additional expenses. For everyone’s sake, stay home and rest, keep hydrated, wash your hands, clean with a bleach-based cleaner, and wash that laundry!


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Kathleen Colduvell RN, BSN, BA, CBC graduated with a degree in english and journalism before going back to nursing school. After graduating from Villanova University, she became a Neonatal Intensive Care Nurse. Currently, she works at one of the leading children’s hospitals in the country in the NICU, PICU, and CICU, as well as working as a Certified Breastfeeding Consultant.

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