Infection Control Precautions

Airborne Precautions

Airborne Precautions are designed to reduce the risk of airborne transmission of infectious agents. Airborne Precautions apply to clients known or suspected to be infected with pathogens that can be transmitted by the airborne route. In addition to Standard Precautions, use Airborne Precautions, for clients known or suspected to be infected with microorganisms transmitted by airborne droplet nuclei or evaporated droplets containing microorganisms that remain suspended in the air and that can be dispersed widely by air currents within a room or over a long distance. Client Placement: Place the client in an airborne infection isolation room (AIIR), which is a private room that has: 1) monitored negative air pressure in relation to the surrounding areas, 2) 6 to 12 air changes per hour, and 3) appropriate discharge of air outdoors or monitored high- efficiency filtration of room air before the air is circulated to other areas in the hospital. Keep the room door closed and the client in the room. Client should have a private room. When a private room is not available, place the client in a room with a client who has active infection with the same microorganism but with no other infection. Respiratory Protection: Wear respiratory protection (N95 respirator) when entering the room of a client with known or suspected infectious pulmonary tuberculosis. Susceptible persons should not enter the room of clients known or suspected to have measles (rubeola) or varicella (chickenpox) if other immune caregivers are available. If they must enter, they should wear a respirator mask. Client Transport: Limit the movement and transport of the client from the room to essential purposes only. If transport or movement is necessary, place a surgical mask on the client.

Contact Precautions

Contact Precautions are designed to reduce the risk of transmission of microorganisms by direct or indirect contact. Client Placement: Place the client in a private room. When a private room is not available, place the client in a room with a client(s) who has active infection with the same microorganism but with no other infection Gloves and Hand-washing: In addition to wearing gloves as outlined under Standard Precautions, wear gloves (clean, nonsterile gloves are adequate) when entering the room. During the course of providing care for a client, change gloves after having contact with infective material that may contain high concentrations of microorganisms (fecal material and wound drainage). Remove gloves before leaving the client's room and wash hands immediately with an antimicrobial agent or a waterless antiseptic agent. For a client with a C. difficile do not use an alcohol-based, hand rub because it is not effective on C. difficile. Instead use soap and water. After glove removal and handwashing, ensure that hands do not touch potentially contaminated environmental surfaces or items in the client's room to avoid transfer of microorganisms to other clients or environments. Gown: In addition to wearing a gown as outlined under Standard Precautions, wear a gown (a clean, nonsterile gown is adequate) when entering the room if you anticipate that your clothing will have substantial contact with the client, environmental surfaces, or items in the client's room, or if the client is incontinent or has diarrhea, an ileostomy, a colostomy, or wound drainage not contained by a dressing. Remove the gown before leaving the client's environment. After gown removal, ensure that clothing does not contact potentially contaminated environmental surfaces to avoid transfer of microorganisms to other clients or environments. Client Transport: Limit the movement and transport of the client from the room to essential purposes only. If the client is transported out of the room, ensure that precautions are maintained to minimize the risk of transmission of microorganisms to other clients and contamination of environmental surfaces or equipment.

Droplet Precautions

Droplet Precautions are designed to reduce the risk of droplet transmission of infectious agents. Droplet transmission involves contact of the conjunctivae or the mucous membranes of the nose or mouth of a susceptible person Droplets are generated from the source person primarily during coughing, sneezing, or talking and during the performance of certain procedures such as suctioning and bronchoscopy. Transmission via large-particle droplets requires close contact between source and recipient persons, because droplets do not remain suspended in the air and generally travel only short distances, usually 3 ft or less, through the air. Because droplets do not remain suspended in the air, special air handling and ventilation are not required to prevent droplet transmission. Droplet Precautions apply to any client known or suspected to be infected with pathogens that can be transmitted by infectious droplets. In addition to Standard Precautions, use Droplet Precautions, or the equivalent, for a client known or suspected to be infected with microorganisms transmitted by droplets. Client Placement: Place the client in a private room. When a private room is not available, place the client in a room with a client(s) who has active infection with the same microorganism but with no other infection. Mask: In addition to wearing a mask as outlined under Standard Precautions, wear a mask when working within 3 ft of the client. (Logistically, some hospitals may want to implement the wearing of a mask to enter the room.) Client Transport: Limit the movement and transport of the client from the room to essential purposes only. If transport or movement is necessary, place a surgical mask on the client.

Prodromal period:

Begins with the early manifestations of the disease or infection and continues until there are overt clinical symptoms characteristic of the disease.

Client-Care Equipment

Handle used client-care equipment soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other clients and environments. Ensure that reusable equipment is not used for the care of another client until it has been cleaned and reprocessed appropriately. Ensure that single-use items are discarded properly.

Linen

Handle, transport, and process used linen soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures and contamination of clothing and that avoids transfer of microorganisms to other clients and environments.

Standard Precautions

Standard Precautions apply to 1) blood 2) all body fluids, secretions, and excretions except sweat, regardless of whether or not they contain visible blood 3) non-intact skin 4) mucous membranes. Use Standard Precautions, or the equivalent, for the care of all clients.

Needle Disposal

Used needles and any "sharps" are placed directly into puncture-resistant containers. Do not recap or use two hand technique. Sharps with built-in safety features are used when available.

Handwashing

Wash hands after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn. Wash hands immediately after gloves are removed, between client contacts, and when otherwise indicated to avoid transfer of microorganisms to other clients or environments. It may be necessary to wash hands between tasks and procedures on the same client to prevent cross-contamination of different body sites. Use soap and water for routine hand-washing.

Gown

Wear a gown (a clean, non-sterile gown is adequate) to protect skin and to prevent soiling of clothing during procedures and client-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. Remove a soiled gown as promptly as possible, and wash hands to avoid transfer of microorganisms to other clients or environments.

Mask, Eye Protection, Face Shield

Wear a mask and eye protection or a face shield to protect mucous membranes of the eyes, nose, and mouth during procedures and client-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions.

Gloves

Wear gloves (clean, non-sterile gloves are adequate) when touching blood, body fluids, secretions, excretions, and contaminated items. Put on clean gloves just before touching mucous membranes and non-intact skin. Change gloves between tasks and procedures on the same client after contact with material that may contain a high concentration of microorganisms. Remove gloves promptly after use, before touching non-contaminated items and environmental surfaces, and before going to another client, and wash hands immediately to avoid transfer of microorganisms to other clients or environments.

Communicability

period of time in which an infected person is most likely to pass the pathogens to another person

incubation period:

time from exposure to the pathogen until clinical symptoms occur