Appendix 5: Patient Isolation Precautions



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Appendix 5: Patient Isolation Precautions



STANDARD PRECAUTIONS
STANDARD PRECAUTIONS ARE EMPLOYED IN THE CARE OF ALL PATIENTS.


  • Wash hands before and after patient contact.

  • Wear gloves when touching blood, body fluids, secretions, excretions and contaminated items.

  • Wear a mask and eye protection, or a face shield during procedures likely to generate splashes or sprays of blood, body fluids, secretions or excretions

  • Handle used patient-care equipment and linen in a manner that prevents the transfer of microorganisms to people or equipment.

  • Use care when handling sharps and use a mouthpiece or other ventilation device as an alternative to mouth-to-mouth resuscitation when practical.


AIRBORNE INFECTION ISOLATION PRECAUTIONS
Standard Precautions plus:

  • Place the patient in a private room that has monitored negative air pressure, a minimum of six air-changes/hour, and appropriate filtration of air before it is discharged from the room.

  • Wear respiratory protection when entering the room.

  • Limit movement and transport of the patient. Place a mask on the patient if they need to be moved.




  • Conventional Diseases requiring Airborne Precautions with surgical mask:

  • Measles

  • Varicella




  • Conventional Diseases requiring Airborne Precautions with N95 respirator:

  • Pulmonary Tuberculosis

  • Severe Acute Respiratory Syndrome (SARS)




  • Biothreat Diseases requiring Contact and Airborne Precautions with N95 respirator:

  • Smallpox


DROPLET PRECAUTIONS
Standard Precaution plus:

  • Place the patient in a private room or cohort them with someone with the same infection. If not feasible, maintain at least 3 feet between patients.

  • Wear a mask when working within 3 feet of the patient.

  • Limit movement and transport of the patient. Place a mask on the patient if they need to be moved.



  • Conventional Diseases requiring Droplet Precautions:

  • Streptococcus, Group A

  • Influenza

  • Mumps

  • Rubella

  • Diphtheria

  • Pertussis

  • Invasive Haemophilus influenzae and meningococcal disease





  • Biothreat Diseases requiring Droplet precautions:

  • Pneumonic Plague

CONTACT PRECAUTIONS

Standard Precautions plus:



  • Place the patient in a private room or cohort them with someone with the same infection if possible.

  • Wear gloves when entering the room. Change gloves after contact with infective material.

  • Wear a gown when entering the room if contact with patient is anticipated or if the patient has diarrhea, a colostomy or wound drainage not covered by a dressing.

  • Limit the movement or transport of the patient from the room.

  • Ensure that patient-care items, bedside equipment, and frequently touched surfaces receive daily cleaning and disinfecting.

  • Dedicate use of noncritical patient-care equipment (such as stethoscopes) to a single patient, or cohort of patients with the same pathogen. If not feasible, adequate disinfection between patients is necessary.




  • Conventional Diseases requiring Contact Precautions:

  • Clostridium difficile

  • RSV

  • Enteroviruses

  • Enteric infections in the incontinent host

  • Skin infections (lice, scabies)

  • Varicella




  • Biothreat Diseases requiring Contact and Airborne Precautions with N95 respirator and eye shield

For more information refer to the Guideline for Isolation Precautions in Hospitals, Julia S. Garner, RN, MN, and the Hospital Infection Control Practices Advisory Committee.



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