Airborne Precautions

  • Airborne precautions prevent the spread of infectious diseases transmitted by pathogens that are breathed, sneezed, or coughed.
  • Effective airborne precautions require a negative air-pressure room with the door closed to maintain air pressure balance between the isolation room and adjoining anteroom, hallway, or corridor.
  • Negative air pressure must be monitored and air vented to the outside of the building or filtered through high frequency particulate air (HEPA) filtration before recirculation.

Equipment

  • Disposable N95 or HEPA respiration or reusable HEPA respirators or powered air purifying respirator (PAPR).
  • Surgical masks
  • Isolation door card
  • Thermometer
  • Stethoscope
  • Blood pressure cuff
  • Personal protective equipment, as needed

Preparation of Equipment

  • Keep airborne precaution supplies on cart outside isolation room.

Procedures

  1. Situate the patient in a negative-pressure room with door closed. There should be an anteroom if possible.
  2. Put an “airborne precautions” sign on the door to notify anyone entering the room and on the patient’s chart to notify other facility’s policy to determine proper signage.
  3. Keep the patient’s door (and the anteroom door, if appropriate) closed, to maintain negative pressure and contain airborne pathogens.
  4. Monitor negative air pressure
  5. Pick up and put on the respirator.
  6. Adjust the straps for a firm, comfortable fit.
  7. Check the fit and respiratory seal.
  8. Tape an impervious bag to the patient’s bedside for disposal of facial tissues.
  9. Make sure visitors wear respirators while in the room.
  10. Limit the patient’s movement from the room.
  11. Make sure the patient wears a surgical mask over his nose and mouth when he leaves the room.

Disease Requiring Airborne Precautions

DISEASE PRECAUTIONARY PERIOD
Avian Influenza (HSN1) For 14 days after start of symptoms, or until alternative diagnosis is confirmed.
Chickenpox (varicella) Until lesions are crusted and no new lesion appear
Disseminated Herpes Zoster For duration of illness
Localized  Herpes Zoster in immunocompromised patients For duration of illness
Measles (rubeola) For duration of illness
Monkeypox Until lesions are crusted
Pulmonary or laryngeal tuberculosis (TB), confirmed or suspected After patient has started effective therapy, his condition is improving and three consecutive sputum smear collected on different days are negative for TB; or TB is ruled out.
Severe acute respiratory synfrome (SARS) For duration of illness
Smallpox (variola major) For duration of illness and until all scabs fall out
Viral hemorrhagic infections (Ebola, Lassa, Marburg) For duration of illness with severe pulmonary involvement.

 

Nursing Interventions

  1. Before leaving the room, remove gloves and wash your hands
  2. Remove respirator outside the room after closing the door
  3. Discard respirator or clean and store it until next use
  4. To prevent microbial growth, store nondisposable respirators dry, well-ventilated place
  5. Reinforce the explanation of the isolation precautions to the patient and his family.
  6. Staff or visitors with no history of specific disease or no vaccination against it shouldn’t enter the room or provide care.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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