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Standard Precautionso Associates follow Standard Precautions for the care of ALL patients.o Applies to blood, all body fluids, secretions, excretions (except sweat), mucous membranes, and non-intact skin.o All associates wear the appropriate personal protective equipment (PPE) to prevent contact of their clothes, skin, eyes, or mucous membranes to any substance listed above.
Transmission Based Precautionso These precautions are designed for patients known or suspected to be infected by highly transmissible or epidemiologically important pathogens that require “Standard Precautions plus” to stop their spread in the hospital.o Drug resistant organisms are those with resistant susceptibility to antimicrobials such as, but not limited to: • MRSA – Methicillin Resistant Staph Aureus • VRE – Vancomycin Resistant Enterococcus • ESBL – Extended Spectrum Beta-Lactamaseo Patients that have positive cultures for drug resistant organisms are placed in the appropriate isolation precautions.o Patients with draining wounds/abscesses or foot ulcers are placed in isolation until culture results are obtained.
Transmission Based Precautions• Transmission Based Precautions are broken down into four types. The isolation codes below print to the patient’s armband and display on CPSI screens to alert you to the isolation type: • Airborne Isolation • Droplet Isolation • Contact Isolation • Protective Isolation
Airborne Precautionso Airborne Precautions are designed to reduce the risk of infection that can be spread through the air.o Transmission occurs when tiny droplets or dust containing the infected agent are suspended in the air for long periods.o The agent can float in the air currents of the facility and can be inhaled by or deposited on a susceptible person.
Airborne Precautionso To stop airborne transmission of an infection, the patient should be placed in a specially ventilated room kept under negative pressure.o The air in this room is “changed out” a specific number of times an hour and is exhausted outside. It is not re-circulated in to the hospital. An ultraviolet light remains on in this room. The “isolation” rooms on 3S, 4S, 3N, 4N, ER, CCU, PACU and Pre-Op are designed for airborne isolation.
Airborne Precautionso A special mask - N95 particulate respirator is needed to filter out these particles that are expelled by the patient when they cough, sneeze or talk.o Fit testing for the N95 mask is done in the Associate Health Department annually in the same month as the TB Skin Test.o CDC and OSHA recommends the use of an N95 mask when caring for patients in Airborne Precautions as well as when performing aerosol generating procedures.
Airborne Isolation Precautionso Keep both doors of the anti-room o Limit visitors closed at all times except when entering or exiting the room o Visitors can be fit testedo Keep UV light on at all times o Document precautions at least everyo Wear your appropriately fit tested shift N95 particulate respirator upon entering after you fit check it o Ventilation check daily to assure negative pressureo Patient must be placed in negative pressure isolation room o If negative pressure electronic monitoro Patient must wear a surgical mask is out of range report it immediately to if out of his room and only out of the Engineering room is absolutely necessary
Droplet Precautionso Droplet Precautions are designed to reduce the risk of infection that can be spread when the infected droplet contacts the eyes, nose or mouth of a susceptible person.o These are rather large droplets and only travel a short distance before falling to the ground, usually about three feet.o A regular surgical mask is needed to filter out these particles that are expelled by the patient when they sneeze, cough, or talk.o The mask used for droplet precautions is for one time use and to be disposed of in the patient room. Do not reuse.
Droplet Isolation Precautions o Keep door shut o Wear regular surgical mask if within 3 feet of patient o Place in regular room o Patient must wear a surgical mask when out of his room o Patient is out of room only when necessary o Limit visitors o Document precautions at least every shift
Contact Precautionso Contact Precautions are designed to reduce the transmission risk of epidemiologically important micro-organisms by direct or indirect contact.o Contact involves dry or moist substances and physical transfer of microorganisms to a susceptible person or transfer of the organism from an inanimate object to a susceptible person.o When patient is in contact precautions: • Keep door closed • Upon entering room don gloves and gown if you might have contact with patient or environment • Place in regular room
Contact Isolation Precautionso Patient out of room only when o Wash hands immediately after necessary removing gown and gloves (while still in room) and don’t touch anyo Trash and linen hamper must thing before leaving. Organisms that be in the patient’s room require contact precautions can live for long periods of time outside ofo Use disposable the body and can be transferred to stethoscope, thermometer, and any surface other non-critical itemso Wash hands with antiseptic o Disinfect items that are removed soap i.e.: Calgon Vestal as from patient room to be used plain soap may not wash these elsewhere. organisms off your hands. o Document precautions at least each shift
Protective Isolationo Protective Isolation is designed to reduce the risk of infection in an immuno-compromised patient.o Patients requiring protective isolation can be placed in any room with general hospital ventilation and the door should be kept closed.