ISOLATION PROCEDURE 13:8 Janet J. Nelson RN,CMA
ISOLATION PROCEDURE
13:8
Janet J. Nelson RN,CMA
Define transmission-based isolation & other key words
Identify requirements for ◦ Airborne precautions◦ Droplet precuations◦ Contact precautions◦ Reverse Isolation
Recognize the difference between clean and contaminated during isolation
Objectives:
To prevent the spread of a communicable disease to YOU or to others.
A variety of infection control measures are used for decreasing the risk of transmission of microorganisms.
Included in isolation are:◦ Handwashing and gloving◦ Patient placement◦ Transportation precautions◦ Masks, respiratory protection, eye protection, face shields◦ Gowns and protective apparel◦ Patient care equipment and articles e.g. sharps, bio-bags,
laundry bags, &disposable eating utensils
Why Transmission Based Isolation?
Transmission precautions is Standard Precautions PLUS.◦ Techniques to provide extra protection against
specific disease or pathogens based on how the organism is transmitted.
◦ The severity of the disease◦ And/or if the pathogen is antibiotic resistant or
not
REMEMBER
Direct Contact
Indirect Contact Fomite:
Transmission of Disease
Clean vs Contaminated Contaminated items will
have organisms from patient. HCW does not touch these items unless using PPE.
Clean items have not been exposed to patient.
Different view on:
Is the most important and frequent mode of transmission of nosocomial infections.◦ Direct-contact (direct care to patient)◦ Indirect-contact (contact with contaminated object)
Examples of disease requiring contact Isolation:◦ MRSA (or other multidrug resistant organisim), in a
wound, respiratory, or GI tract◦ E-Coli infection◦ Hepatitis A◦ Impetigo◦ Herpes Simples◦ Staphylococcal infections◦ RSV
Contact Precautions
TYPES OF ISOLATION (TRANSMISSION-BASED
PRECAUTIONS)
~ Contaminated surfaces increase cross-transmission ~
Airborne transmission < 5 microns Stay suspended in air for long periods of
time. The organism can travel from patient by air currents a long distance.
Negative pressure room sucks air outside Use N-95 respirator or PAPR Door always closed
Airborne Precautions
Air-Mate™ High Efficiency
Powered Air Purifying
Respirator (PAPR) (or HEPA)
N95 Respirator
Disease requiring Airborne IsolationGerman measles (Rubella)Varicella (Chickenpox)Tuberculosis (TB)Herpes Zoster
Airborne Isolation
Droplets are generated from the source person primarily during coughing, sneezing and talking (& special procedures e.g. bronchoscopy or suctioning)
The droplets are transmitted a short distance (3 feet) to the hosts mucous membranes (nose,eye,mouth).
Droplets do NOT stay suspended in the air and must not be confused with airborne isolation.
Droplet Precautions
Droplet Precautions Diseases that require Droplet Precautions:
Haemophilus influenzae (HIB) meningitis, pneumonia
Pertussis (whooping cough)
Strept (group A) throat, pneumonia, scarlet fever
Neisseria meningitis or pneumonia
Limit the times the patient must leave his room.
When patient transport is necessary to:◦ Have patient use approtopriate barriers ( e.g.
mask, impervious dressings)◦ Notify the HCW in new area◦ Inform patient of ways he can assist in preventing
the transmission of his infectious microorganism.
Transporting the patient
This is opposite of the other isolations!!
It is to protect the patient from the organisms in the environment. ◦ Immunocompromised
patients◦ Burn patients◦ Patients receiving
chemotherapy or radiation
REVERSED ISOLATION
Sterile gloves, gowns, masks are used by HCW and visitors.
Frequent disinfecting of the room All equipment and supplies are sterile and
at best disinfected before entering room Positive pressure in the room. Filtered, clean
air is brought into the room and allowed to vent out of the room to the surrounding corridors.
Protect the patient
Inside of gown Outside of gown Inside of gloves Outside of mask Waist ties of gown Ties of mask Neck tie of gown Inside of cap
Review: When leaving an isolation unit what is
considered clean/contaminated?
‣ IV Pump ‣ Faucet of sink‣ Outside of gloves
Isolation precautions are burdensome on the HCW and visitors
Facilities policy may vary The emotional impact of isolation for the
patient is enormous.
Conclusion