Isolation-Precautions - 1 Isolation Precautions and...

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1 Isolation Precautions and Personal Protective Equipment ALERT Don a gown that is impervious to moisture when there is a risk for excess soiling. 6 Wash hands or use an alcohol-based hand rub (ABHR) immediately after removing all personal protective equipment (PPE). 6 Patients in airborne isolation need to be placed in a negative pressure airborne infection isolation room (AIIR). 6 OVERVIEW When a patient has a known or suspected source of colonization or infection, health care personnel must follow specific infection prevention and control practices to reduce the risk of cross-contamination to other patients and health care personnel. Body substances (e.g., feces, urine, mucus, wound drainage) contain potentially infectious organisms. Isolation or barrier precautions include the appropriate use of PPE, such as a gown, mask, eye protection, and gloves. Health care personnel must assess the need for barrier precautions for each planned task and for each patient, regardless of the diagnoses. Increased attention to the prevention of blood-borne pathogens and airborne pathogens, such as tuberculosis (TB), has led to the stressed importance of barrier protection. 3,5 Published guidelines for isolation precautions have made recommendations based on current epidemiologic information regarding disease transmission in health care settings. Although primarily intended for patients in acute care, these recommendations can be applied to patients in subacute care or long-term care facilities. Organizations should modify the recommendations based on their specific needs and as dictated by federal, state, or local regulations. 6 Standard precautions, or tier one precautions, pertain to all patients regardless of the risk or presumed infection status. 6 Standard precautions are the primary strategies for preventing infection transmission and apply to contact with blood, body fluids, nonintact skin, and mucous membranes, as well as equipment or surfaces contaminated with potentially infectious materials. The strategy for respiratory hygiene and cough etiquette applies to any person with signs of respiratory infection (i.e., cough, congestion, rhinorrhea, increased production of respiratory secretions) when entering a health care facility. Key elements of respiratory hygiene education for health care personnel, patients, and visitors include covering the mouth and nose with a tissue when coughing and properly discarding used tissues. The second tier includes transmission-based precautions designed for the care of a patient who is known or suspected to be infected, or colonized, with microorganisms 6 Organisms may be transmitted by contact, droplet, or airborne route or by contact with contaminated surfaces. The three types of transmission-based precautions— airborne, droplet, and contact—may be combined for diseases that have multiple routes of transmission (e.g., chickenpox). 6 Whether used singly or in combination, the precautions should be employed in conjunction with standard precautions.
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