Isolation practices
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This document discusses various isolation precautions used to prevent the spread of infectious diseases in healthcare settings. It describes the goals of isolation as protecting healthcare workers, other patients, visitors, and the environment from pathogens. The key components of isolation precautions are outlined, including standard precautions used for all patient care, and transmission-based precautions for airborne, droplet, and contact infections. Hand hygiene, personal protective equipment, patient placement, transport, cleaning, and other infection control measures are discussed for different isolation scenarios. Reversed isolation used to protect immunocompromised patients from environmental pathogens is also covered.
Isolation practices
- 2. Goal of Isolation (Protection of / from) HCWs Other Patients Environment Visitors (Community) Patient Placement PATIENT Barrier nursing
- 3. Chain of Infection Pathogen Reservoir Portal of Exit Mode of Transmiss ion Portal of Entry Susceptible Host Dr.T.V.Rao MD 3
- 4. Why Isolation?.. because transmission is easier to control than the source / host!
- 6. Our Hands are Threat to LIFE Just Washing can Save Many LIVES Dr.T.V.Rao MD 6
- 7. Handwashing Most important Soap and water OR alcohol based products – when no visible soiliing Length of fingernails ??? When to wash??
- 9. Gloves Gloving Protective barrier ○ To caregivers ○ To patients ○ Between patients / within the same patient When? ○ Anticipated direct contact with non intact skin/body fluids ○ Care of patients colonized with MDRO ○ Handling potentially contaminated patient care equipments/env Failure to change gloves between patient contacts – INFECTION CONTROL HAZARD
- 10. Other Barrier Protection Masks Eye protection Goggles/Face Shields Gowns and protective apparel Why gowns??? When to remove??
- 11. Respiratory protection Face Masks N95 Respirators Loose fitting, not designed to filter out small aerosols Place on coughing patient (source control) HCW should wear mask to protect patient during certain procedures (e.g., surgery) protect HCW ○ droplet precautions ○ Mask + goggles for anticipated spray/splash Tight fitting respirator, designed to filter the air Protects the wearer HCW should wear when concerned about transmission by airborne route
- 14. Patient Care Equipment and Articles Disposal ○ Bags Sharps Reusable devices ○ Critical - Sterilised / Disinfected ○ Non critical – cleaned amd disinfected after use
- 15. Patient placement Private room Patient with highly transmissible or epidemiologically important microorganisms With handwashing and toilet facilities Appropriate room mate sharing – same microorganisms – COHORTING Useful during outbreaks --- eg?? Airborne transmission – room with appropriate air handling and ventilation
- 16. Transport Only for essential purposes With appropriate barriers Precautions in the new area to be transported Informing patients
- 17. Others Linen and Laundary Common sense storage and processing of soiled linen Dishes, Glasses, Cups, and Eating Utensils Hot water and detergents Routine and Terminal cleaning
- 18. Standard Precautions Universal Precautions + Body Substance isolation Principle : All blood, body fluids, secretions, excretions except sweat, non intact skin, and mucous membranes may contain transmissble infectious agents FOR THE CARE OF ALL PATIENTS
- 19. Standard Precautions . Hand washing PPE – gloves,mask,goggles , gown. Proper - handling of soiled patient care equipments, environmental cleaning,disposal of sharps. Respiratory hygiene/cough etiquette Minimal handling of soiled linen.19
- 23. Airborne precautions Patient placement : monitored negative air pressure 6-12 air changes per hour Appropriate discharge of air outdoors Keep the room door closed Respiratory protection N 95 mask while entering the room / discard in trash while leaving the room Patient transport Mask on the patient
- 25. Droplet precautions Neisseria meningitidis Influenza, H1N1 Adenovirus, rhinovirus Pertussis, Mumps Grp A Streptococcus Mycoplasma pneumoniae 25
- 26. Droplet Precautiions Patient placement: Private room If not available, spatial separation of atleast 3 ft Special air handliing and ventilation – not necessary Door may remain open Mask while entering the patient room / discard in trash after leaving the room Masking the patient when transport needed
- 28. Contact precautions RSV Hepatitis -A Antibiotic resistant bacteria MDRO, MRSA,VRE.. Scabies 28
- 29. Contact Precautions Private room Gloves and Handwashing Gown – remove when leaving the room Precautions while transport Dedicate the use of non critical patient care equipment to a single patient (or) clean and disinfect before use for another patient
- 31. 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
- 32. 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
- 33. QUESTIONS ??? When do you practice standard precautions? Among the mask, gown, gloves which do you need the most in contact precautions? What would you do after using USG machine for a patient with MRSA? When a patient is isolated with contact precautions, doctor adjusts the ventilator settings without gloves.. What is your take? What would you do? When a patient with tuberculosis is admitted, what kind of isolation would you do? When there is no private room available for a patient with swine flu what are your options for admission?