Isolation and Standard Precautions
Standard precautions, previously called as universal precautions, are a set of basic infection prevention practices that tend to prevent the transmission of infectious diseases from one person to another and should always be practiced when exposure to any blood or body fluids is possible.
This is considered as the most important hygiene measure when it comes to preventing the transmission and spread of infection. It is done through washing hands using water and soap or alcohol-based arm rubs.
It should be done before and after each clinical contact with a patient, before and after eating, after using the toilet, before and after using gloves, after contact with used equipment and immediately following contact with body substances such as blood and any body fluid.
However, it is best to wash with water and soap instead of alcohol-based rubs when the hands are visibly dirty, contaminated, or soiled, after using the restroom and before eating or preparing food.
Personal Protective Equipment
These are certain types of clothing or equipment used as a barrier to protect his/her body from injury and infection.
- Gloves – must be worn if there is a possibility of contact with blood and body fluids, when performing venipuncture, touching mucous membranes, touching non-intact skin, handling contaminated sharps , performing invasive procedures, cleaning body substances spills or any equipment or any contaminated substances.
- Face mask/ face shield/ eye protection – must be worn when performing procedures such as suctioning, intubation and any procedures that require contact with blood or body fluids, or if there is potential for splashing, splattering or spraying of blood or other body substances.
- Gown – worn to protect clothing and skin from contamination with blood and body substances.
- Footwear – must be enclosed and worn to protect feet from injury and contact with sharp objects.
Isolation precautions create barriers between people and germs. They are taken to help prevent the spread of germs in the hospital. The types of transmission-based precaution are: contact precautions which are for diseases spread by direct or indirect contact, droplet precautions practiced for diseases spread by large particles in the air, and airborne precautions used for diseases spread by small particles in the air.
These are practiced for patients/residents infections that can be transmitted by contact with from skin-to-skin, from mucous membranes, feces, vomit, urine, wound drainage, or other body fluids, or by contact with any contaminated equipment.
Diseases requiring this type of precaution are: MDRO organisms (MRSA, VRE, resistant Acinetobacter, ESBL), Rotavirus, RSV, Scabies, Wounds or abscesses with uncontained drainage.
Aside from practicing standard precautions, the nurse must:
- Wear a gown and gloves upon room entry of a patient on contact precautions.
- Use disposable single-use noncritical care equipment such as blood pressure cuffs and stethoscopes.
Used for patients with infection that can be transmitted through droplet, close respiratory and mucous membrane contact with respiratory secretions.
Diseases requiring this type of precaution are: Bacterial meningitis, Seasonal influenza, Pertussis (whooping cough) and Mumps.
In addition to standard precautions, the nurse must:
- Wear a mask upon entering the room of a patient.
- Must provide spatial separation of more than 3 feet and draw the curtain between beds. A private room is preferable.
Used for patients with infections that can be transmitted over long distances through suspended air.
Diseases that require this type of precaution are: Pulmonary or laryngeal Tuberculosis, Chickenpox, Disseminated herpes zoster (shingles), Measles (rubeola) and Pandemic influenza.
Aside from practicing standard precautions, the nurse must also:
- Wear a mask or respirator prior to room entry.
- Place patient/resident in an airborne infection isolation room
Even if with each type of isolation precautions come some unique prevention practices that must be observed, still standard precautions must be the foundation of each of them.