standard precautions (3)
TRANSCRIPT
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Standard Precautions
& Isolation
Peter T. Redona Jr, RN, RM.
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Isolation Precautions
Isolation refers to measures designed toprevent the spread of infections or potentially
infectious microorganisms to health
personnel, clients, and visitors.
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Disease-Specific Isolation Precautions
Provide precautions for specificdiseases.
These precautions delineate
use of private rooms with specialventilation
having a client share a room with other
clients infected with the sameorganisms,
and gowning to prevent gross soilage of
clothes for specific infectious diseases.
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Universal Precautions
Techniques used with all clients to decreasethe risk of transmitting unidentifiedpathogens.
Obstructs the spread of bloodborne
pathogens, those microorganisms carried inthe bloodand body fluids that are capable ofinfecting other persons with serious and
difficult to treat viral infections, namely,hepatitis B & C virus, and the HIV.
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Body Substance Isolation (BSI)
Employs generic infection control precautionsfor all clients except those with few diseases
transmitted through the air.
The term body substance includes blood,some body fluids, urine, feces, wound
drainage, oral secretions, and any others body
product or tissue.
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Body Substance Isolation (BSI)
Three premises:1. All people have an increased risk for infection
from microorganisms placed on their mucousmembranes and non-intact skin.
2. All people are likely to have potentiallyinfectious microorganisms in all of their moistbody sites and substances.
3. An unknown portion of clients and health care
workers will always be colonized or infected withpotentially infectious microorganisms in theirblood and other moist body sites and substances.
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Standard PrecautionsDesigned for all clients in the hospital
Apply to
Blood
All body fluids, excretions and secretions
Nonintact (broken) skin and mucous membranes. Designed to reduce risk of transmission of
microorganisms from recognized andunrecognized sources.
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Standard Precautions
1. Perform proper hand hygiene after with blood, body fluids, secretions, excretions,
and contaminated objects whether or not gloves are worn.
a. Perform proper hand hygiene immediately after removing gloves.
b. Use nonantimicrobial product for routine hand cleansing.
c. Use an antimicrobial agent or an antiseptic agent for the control of specific
outbreaks of infection.
2. Wear clean gloves when touching blood, body fluids, secretions, excretions, and
contaminated items (i.e. soiled gown).
a. Clean gloves can be unsterile unless their use is intended to prevent the entrance of
microorganisms into the body.b. Remove gloves before touching non-contaminated items and surfaces.
c. Perform hand hygiene immediately after removing gloves.
3. Wear a mask, eye protection, or face shield if splashes or sprays of blood, body
fluids, secretions, or excretions can be expected.
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4. Wear a clean, non-sterile gown if client care is likely to result insplashes or sprays of blood, body fluids, secretions, or excretions.The gown is intended to protect clothing.
a. Remove a soiled gown carefully to avoid the transfer ofmicroorganism to others (i.e., clients or other health care workers.
b. Cleanse hands after removing gown.
5. Handle client care equipment that is soiled with blood, body fluids,secretions, or excretions carefully to prevent the transfer ofmicroorganisms to others and to the environment.
a. Make sure reusable equipment is cleaned and processed correctly.
b. Dispose of single-use equipment correctly.
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6.Handle, transport, and process linen that is soiled
with blood, body fluids, secretions, or excretions
in a manner to prevent contamination of clothing
and the transfer of microorganisms to others and
to the environment.
7. Prevent injuries from used scalpels, needles, or
other equipment, and place in puncture-resistant
containers.
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Transmission-Based Precautions
Airborne Precautions
Use standard precautions as well as the following.
Place client in a private room that has negative air pressure, 6 -12 airchanges per hour, and either discharge of air to the outside or a filtrationsystem for room air.
If a private room is not available, place client with another client who is
infected with the same microorganism. Wear a respiratory device (N95 respirator) when entering the room of a
client who is known or suspected of having primary tuberculosis.
Susceptible people should not enter the room of a client who has rubeola(measles) varicella (chickenpox). If they must enter, they should wear arespirator.
Limit movement of client outside the room to essential purposes. Place asurgical mask on the client during transport.
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Droplet Precautions
Use standard precautions as well as the
following: Place client in a private room
If a private room is not available, place a clientwith another client who is infected with the same
microorganism. Wear a mask if working within 3 feet of the client.
Limit movement of client outside the room toessential purposes. Place a surgical mask during
transport.
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Contact Precautions
Use standard precautions as well as the following
Place client in a private.
If a private room is not available, place client withanother client who is infected with the same
microorganism. Wear gloves as described in standard precautions.
Remove gloves after contact with infectious material.
Remove gloves before leaving clients room
Cleanse hands immediately after removing gloves. Useand antimicrobial agent.
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Contact Precautions
Note: If the client is infected with C. difficile, do not use an alcohol-based hand rub as it may not effective on these spores. Use soap
and water. Wear a gown when entering a room if there is a possibility of
contact with infected surfaces or items, or if the client isincontinent, or has a diarrhea, a colostomy, or wound drainage notcontained by a dressing.
Remove gown in the clients room
Make sure uniform does not contact possible contaminatedsurfaces.
Limit movement of client outside the room
Dedicate the use of non-critical client care equipment to a singleclient or to clients with the same infecting microorganisms.
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Types of Isolation Indications Requirements
1. Strict Isolation -highly transmissible diseases
by direct contact and airborne
routes of transmission.
Private rooms
Gowns, mask, gloves,
handwashing
Double bagged techniques forsoiled articles.
2. Respiratory Isolation - droplet transmission Private rooms
Gowns, mask, gloves,
handwashing.
Patients with the same organism
generally may share room.
Labeled plastic bags are used for
soiled articles.
3. TB isolation /AFB - suspected / active TB Private room with negative
pressure ventilation so the room air
is vented outside
Mask
Handwashing Bronchoscopy and dental
examination generally are
postponed until the patient has
received approximately 2 weeks of
TB medications
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Negative pressure ventilation
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4. Contact Isolation - infectious diseases or multiple
resistant micro organisms that are
spread by close or direct contact.
Private rooms
Gowns, mask, gloves,
handwashing
5. Enteric Precautions - infectious disease transmitted
through direct or indirect contact with
infected feces.
Private room is required if
the patient does not practice
good hygiene measures.
Handwashing
Gloves
Gowns should only be wornonly when handling objects
with contaminated feces.
6. Drainage / Secretions
Precautions.
- patients with wound
drainage/infected wounds.
Gloves
Gowns are indicated if
clothing is likely to becontaminated.
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7. Universal
Blood and Body
FluidsPrecautions
- blood-borne, body fluids
pathogens (blood, semen,
vaginal secretions, CSF,synovial fluid, pleural fluid,
peritoneal fluid, and
pericardial fluid, amniotic
fluid and tissues.
Gloves
Mask and protective
eye gears Gown
Contaminated
needles should not
be recapped
Use puncture
resistant containers
for used needles
and other sharp
items.
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Strict
Isolation
Respiratory
Isolation
Contact
Isolation
Enteric
Precaution
Blood &
Body
fluids
precautio
ns
TB/AFB
isolation
Secretions/
Drainage
Precautions
Diptheria
Zoster
Pneumonia
Varicella
H. Influenza
Measles
Mumps
N. meningitis
Diptheria
Pediculosis
Scabies
Syphilis
Diarrhea
Gastroenteritis
Hepa A
Typhoid Fever
AIDS
Hepa B &
C
TB Burns
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End of Isolation