1. Isolation Techniques Fundamentals of Nursing B20 Fundamentals of Nursing B20

2. Isolation Special measures are needed to prevent the spread of communicable diseases, such as measles and tuberculosis. throughout a health care institution. In 1996 the CDC published revised guidelines for isolation.

3. CDC’s 2 Tiered System Tier 1Standard Precautions Standard precautions are used when caring for all clients in any setting regardless of medical diagnosis Includes hand washing in all situations and the use of gloves, masks, eye protection, or gowns as needed. Tier 1Standard Precautions Standard precautions are used when caring for all clients in any setting regardless of medical diagnosis Includes hand washing in all situations and the use of gloves, masks, eye protection, or gowns as needed.

4. Standard Precautions (continued) Personal Protective Equipment including gloves, mask, gown, and eye protection are worn when there is risk of coming in contact with the following: Blood All body fluids, secretions, and excretins Non-intact skin Mucous membranes Personal Protective Equipment including gloves, mask, gown, and eye protection are worn when there is risk of coming in contact with the following: Blood All body fluids, secretions, and excretins Non-intact skin Mucous membranes

5. Tier II- Transmission Categories Airborne Precautions- Droplets < 5 micrometers i.e.- chicken pox, measles, pulmonary or laryngeal TB Private room, negative flow rooms, mask or respiratory protection Droplet Precautions Droplets > 5 micrometers I.e. diptheria, streptoccal pharyngitis, petussis, mumps Private room or clients w/ like diseases, mask Contact Precautions Direct client or environmental contact Can be colonization or infection w/ MRSA, RSV, enteric pathogens such as shigella and clostridium difficle Private room or clients w/ like diseases, gloves, gown Airborne Precautions- Droplets < 5 micrometers i.e.- chicken pox, measles, pulmonary or laryngeal TB Private room, negative flow rooms, mask or respiratory protection Droplet Precautions Droplets > 5 micrometers I.e. diptheria, streptoccal pharyngitis, petussis, mumps Private room or clients w/ like diseases, mask Contact Precautions Direct client or environmental contact Can be colonization or infection w/ MRSA, RSV, enteric pathogens such as shigella and clostridium difficle Private room or clients w/ like diseases, gloves, gown

6. Psychological Implications of Isolation Body image Disturbance Interventions: Teach client and family how to prevent the spread of disease Provide sensory stimuli Deliberately plan time to see the client Body image Disturbance Interventions: Teach client and family how to prevent the spread of disease Provide sensory stimuli Deliberately plan time to see the client

7. Protective Environment Private room is ideal May be able to room together if same microorganism is infecting If possible avoid taking any reuseable article or equipment Use disposable items when possible Private room is ideal May be able to room together if same microorganism is infecting If possible avoid taking any reuseable article or equipment Use disposable items when possible

8. Personal Protective Equipment Gowns Use to prevent soiling of clothes during client contact Masks Used to protect nurse from organisms in client’s respiratory tract Masks should fit snugly over mouth/ nose A mask that becomes moistened is ineffective Change q 1 hour Client wears mask when leaving room for procedure Gloves Cuffs pulled over gown when worn together Eye Protection Gowns Use to prevent soiling of clothes during client contact Masks Used to protect nurse from organisms in client’s respiratory tract Masks should fit snugly over mouth/ nose A mask that becomes moistened is ineffective Change q 1 hour Client wears mask when leaving room for procedure Gloves Cuffs pulled over gown when worn together Eye Protection

9. Delivering Care in an Isolation Room Medication Administration Use precautions to prevent cross-contamination if all equipment used cannot remain in room Blood Pressure Cuff Stethoscope Watch Specimen Collection Removing protective clothing Transporting clients Medication Administration Use precautions to prevent cross-contamination if all equipment used cannot remain in room Blood Pressure Cuff Stethoscope Watch Specimen Collection Removing protective clothing Transporting clients

10. Role of the Infection Control Nurse A nurse specially trained in the control and prevention of infection (pg. 801) Responsibilities include: Advising hospital personnel in infection control matters Monitoring hospital infections/ isolations Staff education Writing and reviewing policies/ procedures A nurse specially trained in the control and prevention of infection (pg. 801) Responsibilities include: Advising hospital personnel in infection control matters Monitoring hospital infections/ isolations Staff education Writing and reviewing policies/ procedures