1. INFECTION
PREVENTION
In The Healthcare
Setting
Part 3

2. Transmission Based
Precautions

3. Contact Precautions
Direct or indirect contact with skin or mucous membranes
Indicated for:
Multi-drug Resistant Organisms
Clostridium difficile (C.dif.)
RSV (Respiratory Syncytial Virus)
Scabies
ATTIRE WORN
CONTACT ISOLATION
( In addition to STANDARD PRECAUTIONS )
GLOVES: REQUIRED.
Remove gloves before leaving the room
HANDS: Use antimicrobial soap and water or alcohol gel if hands are not visibly soiled.
GOWNS: REQUIRED when there is a possibility of contact with patients, surfaces, or patient care items.

4. ( In addition to STANDARD PRECAUTIONS )
Droplet Precautions
Mucous membrane to mucous membrane contact with an infectious agent
Indicated for:
MDRO in Sputum
Meningitis
Pertussis
Influenza
ATTIRE WORN
DROPLET ISOLATION
( In addition to STANDARD PRECAUTIONS )
MASK: Mask covering eyes, nose AND mouthREQUIRED when you are within 3 feet of the patient.
GLOVES: REQUIRED if you will touch anything contaminated with respiratory secretions.
GOWN: REQUIRED if clothing will contact contaminated surfaces or respiratory secretions
HANDS: USE ANTIMICROBIAL SOAP & WATER OR ALCOHOL GEL IF HANDS ARE NOT VISIBLY CONTAMINATED.

5. ( In addition to STANDARD PRECAUTIONS )
Airborne Precautions
Infectious Airborne droplets or aerosols into lungs
Indicated for:
Tuberculosis
Varicella Zoster (Chicken Pox)
Measles (Rubeola)
SARS (and Contact Precautions
Avian Flu (and Contact Precautions)
ATTIRE WORN
AIRBORNE ISOLATION
( In addition to STANDARD PRECAUTIONS )
Keep room door(s) closed at all times. Dedicated room and HEPA Filter Unit
REQUIRED MASK: N95 mask REQUIRED BY ALL EMPLOYEES at all times while in room.
Patient must remain in the room unless absolutely necessary.
During transport, place a surgical mask on the patient.
HANDS: USE ANTIMICROBIAL SOAP & WATER OR ALCOHOL GEL IF HANDS NOT VISIBLY CONTAMINATED.

6. Isolation Rooms: Reservoirs for Bacteria
Wear appropriate PPE when entering an isolation room will minimize risk of
exposure to an infectious pathogen.
Removal of PPE upon exiting an isolation room prevents transmission to
others or inanimate objects (door knobs etc.)

7. ABCs of Transporting Patients
PRIOR to transporting a patient, all infectious material must be contained.
This is accomplished by:
Keeping wounds covered
Putting patient in a clean gown
Covering the patient with clean linen
Masking any coughing patients
Practicing proper hand hygiene while
out of room
Appropriate disinfection of equipment
during transportation
PPE during transport should be used ONLY in the event that the above steps are followed and remain ineffective, presenting a risk of exposure.

8. How to get from point A to point B
Contain infectious material (i.e., cover wounds, clean gown to patient, clean bed covers, diaper if having diarrhea).
Discard contaminated protective equipment prior to exiting room.
Perform hand hygiene
Transport to destination
Use hand hygiene
Don necessary protective equipment at destination

9. Before Transporting a Patient, Ask Yourself…
Is all infectious material contained? Does the patient have a clean gown and linen? If not, has the patient been appropriately prepared for transport
ALWAYS PRACTICE A TEAM APPROACH
WHEN PREPARING A PATIENT FOR TRANSPORT

10. ENVIRONMENT OF CARE
ENVIRONMENT OF CARE

11. Patient Care Equipment
Disposable: use once and discard
Single Patient: use item for the entire hospital stay,
discard when visibly soiled
Reusable: items are cleaned and disinfected between each
patient or returned to Central Supply for reprocessing
(depending on item)

12. Cleaning and Disinfection
Cleaning: Removal of all visible soil, blood, body fluid from inanimate objects.
Disinfection: Elimination of many or all pathogenic microorganisms, on inanimate objects
(except spores).

13. Cleaning Reusable Patient Equipment
ITEMS WITH VISIBLE BLOOD OR SOIL
1. Clean by removing visible soil or blood
2. Disinfect after removing visible soil (2 steps)
ITEMS WITH NO VISIBLE BLOOD OR SOIL
Disinfect with manufacturer recommended
disinfectant (1 Step)

14. Disinfectant Use “Contact Time” or “Wet Time”
The length of time a disinfectant must remain on a surface to effectively eliminate pathogens.
Rewet surfaces that dry before the contact time has passed.
5 minutes

15. Proper Segregation of Medical Waste
“A Safety Must”
Why shouldd I care?
It minimizes the potential for the spread of disease from a medical setting to the general public; and
It reduces the overall amount of infectious medical waste produced
helps to protect the environment, and reduces medical facilities’ treatment expenditures

16. Improper Waste Segregation
Sharps waste mixed with
Blood / Body Fluids (Biohazard Waste), container not lined and missing lid
Blood (Biohazard Waste)
mixed with regular trash
Regular trash and Pharmaceutical
Waste in biohazard waste, bag is torn

17. Proper Waste Segregation
WHY?
No medication left in the IV bag
No sharps are attached
No visible Patient Health Information (PHI)
Staff has covered all PHI with an
“Identi-hide” label.
WHY?
Bag is properly tied and not overfilled.

19. Visitors An Important Part of Our Safety Team
Share infection prevention strategies including:
Hand Hygiene
Cough Etiquette
Isolation precautions
Appropriate use of PPE
Delay of visits when sick

20. Take a Proactive Approach to Respiratory Etiquette
Cough in your sleeve.
Offer a coughing patients / visitors
a mask.
Offer patients / visitors tissue.
Offer a patient / visitor hand gel upon arrival on your unit
Encourage hygiene practice in your unit

21. Stay Home When You Are Sick
Working while sick affects everyone
Patients-are at risk of acquisition of a healthcare associated infection
Staff-are at risk of an unnecessary exposure
The sick employee– delays his/her own recovery

22. The CDC recommends that ALL healthcare workers receive the flu vaccine.
Seasonal flu accounts for
approximately 225,000
hospitalizations and up to
50,000 deaths in the United
States each year.
Impossible to predict when
next influenza pandemic may
arise or the severity.

23. HCW Vaccination and Patient Safety
Up to 45% of unvaccinated healthcare workers may acquire
influenza infection.
HCW may have flu virus in their bodies and never develop flu
symptoms, but can infect others.
Flu vaccination will protects patient, co-workers, family, and friends against the flu infection or other complications.
Improves patient outcomes
Decreased absenteeism and cases
of flu among staff.
Takes only minutes – saves lives

24. References
Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, Jane D. Siegel, MD; Emily Rhinehart, RN MPH CIC; Marguerite Jackson, PhD; Linda Chiarello, RN MS; the Healthcare Infection Control Practices Advisory Committee. William A. Rutala, Ph.D., M.P.H., David J. Weber, M.D., M.P.H., and the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2008) Guideline for Disinfection and Sterilization in Healthcare Facilities, Centers for Disease Control and Prevention. Lynne Sehulster, Ph.D., Raymond Y.W. Chinn, M.D., Center for Disease Control and Prevention / Healthcare Infection Control Practices Advisory Committee (HICPAC) (2003), Guidelines for Environmental Infection Control in Health-Care Facilities Centers for Disease Control and Prevention Influenza website CDC Advisory Committee on Immunization Practices (ACIP)