Infection Control

5 Moments of hand hygiene

1) before touching patient 2) before clean/aseptic procedure 3) after body fluid exposure risk 4) after touching patient 5) after touching patient surroundings

Removing PPE

1. gloves 2. goggles 3. gown 4. mask After completing patient care, prepare to leave the room by collecting items that require removal. Remember that the outside surfaces of your goggles or face shield, mask or respirator, gown, and barrier clothes are contaminated. Except for a respirator mask, remove all PPE at the patient's doorway or in the anteroom. Remove a respirator mask after leaving the patient's room and closing the door. Remove your gloves: Grasp the outside of one glove with your opposite gloved hand, and peel off the glove while turning it inside out. Holding the removed glove in your remaining gloved hand, slide the fingers of your ungloved hand under the remaining glove at the wrist (taking care not to touch the outer surface of the glove), and then peel it off over the first glove. Discard your gloves in an appropriate receptacle. Perform hand hygiene. Remove your goggles or face shield by grasping the ear pieces or headband. Place the equipment in an appropriate receptacle. Remove your gown by untying the neck straps and then the waist ties, pulling the gown away from your neck and shoulders, turning the gown inside out as you remove it, and folding it or rolling in into a bundle. Discard the gown in an appropriate receptacle. Remove your mask or respirator by grasping the bottom tie or elastic and lifting it over your head, grasping the top tie or elastic, and carefully removing the mask or respirator. Discard the equipment in an appropriate receptacle. Perform hand hygiene immediately.

Putting on PPE

1. gown 2. mask 3. goggles 4. gloves Remove your watch and rings if required. Perform hand hygiene. Unfold a gown in front of you. Put on the gown, wrap it around your uniform, and secure it at your neck and then waist. Place the mask snugly over your nose and mouth. Secure the ear loops or tie the strings, as appropriate. If the mask has a metal nose strip, squeeze it to fit. Choose eye protection according to your risk of exposure. Put on appropriate-sized gloves and pull them over the gown cuffs.

Conditions requiring contact precaution

Abcess Major drain Acute viral conjuctivitis Adenovirus (diapered/incontinent) Adenovirus pneumonia Avian influenza Bronchiolitis Burkholderia cepacia pneumonia, patient with cystic fibrosis Campylobacter species gastroenteritis (diapered/ incontinent) Cholera gastroenteritis (diapered/incontinent) Clostridioides difficile Cryptosporidium species gastroenteritis (diapered/incontinent) Diphtheria, cutaneous Escherichia coli gastroenteritis (diapered/incontinent) Enteroviral infection (diapered/incontinent) Furunculosis, staphylococcal Giardia lamblia (diapered/incontinent) Hepatitis A Hepatitis E Herpes simplex, mucocutaneous, disseminated or primary, severe; neonatal Herpes zoster (shingles), disseminated disease (rash affects three or more dermatomes) or localized disease in an immunocompetent or immunocompromised patient Human metapneumovirus Impetigo Monkeypox MDRO Mycobacterium tuberculosis draining extrapulmonary lesion Norovirus gastroenteritis (diapered/incontinent) Parainfluenza virus infection Pediculosis Poliomyelitis Pressure injury; infected major, draining Respiratory syncytial virus infection; infants, young children, and immunocompromised adults Ritter disease Rotavirus gastroenteritis Rubella, congenital syndrome Salmonella (diapered/incontinent) Scabies SARS Shigella (diapered/incontinent) Staphylococcus aureus Streptococcus group A Vaccinia, eczema; fetal, generalized, or progressive Vaccinia blepharitis or conjunctivitis with copious drainage Vibrio parahaemolyticus (diapered/incontinent) Viral hemorrhagic fevers (Ebola, Lassa, Marburg, Crimean-Congo fever viruses) Yersinia enterocolitica (diapered/incontinent)

Precautionary period for contact illness (duration of illness)

Abcess Major drain Acute viral conjuctivitis Adenovirus (diapered/incontinent) Adenovirus pneumonia Bronchiolitis Cryptosporidium species gastroenteritis (diapered/incontinent) Escherichia coli gastroenteritis (diapered/incontinent) Enteroviral infection (diapered/incontinent) Furunculosis, staphylococcal Giardia lamblia (diapered/incontinent) Hepatitis E Herpes zoster (shingles), disseminated disease (rash affects three or more dermatomes) or localized disease in an immunocompetent or immunocompromised Human metapneumovirus Norovirus gastroenteritis (diapered/incontinent) Parainfluenza virus infection Poliomyelitis Pressure injury; infected major, draining Respiratory syncytial virus infection; infants, young children, and immunocompromised adults Ritter disease Rotavirus gastroenteritis Salmonella (diapered/incontinent) SARS Shigella (diapered/incontinent) Staphylococcus aureus Vibrio parahaemolyticus (diapered/incontinent) Viral hemorrhagic fevers (Ebola, Lassa, Marburg, Crimean-Congo fever viruses) Yersinia enterocolitica (diapered/incontinent)

Conditions requiring droplet precaution

Adenovirus infection in infants and young children Diphtheria (pharyngeal) Influenza (seasonal) Haemophilus influenzae type b disease, including epiglottitis, meningitis, pneumonia, and sepsis Neisseria meningitidis disease, including meningitis, pneumonia, and sepsis Mumps Mycoplasma pneumoniae infection Parvovirus B19 (erythema infectiosum) Pertussis (whooping cough) Pneumonic plague Rhinovirus Rubella Severe acute respiratory syndrome Streptococcal group A disease, including pharyngitis (in infants and young children), pneumonia, serious invasive disease, and scarlet fever (in infants and young children) Viral hemorrhagic fevers (Ebola, Lassa, Marburg, and Crimean-Congo fever viruses)

Airborne precautions

Airborne precautions, used in addition to standard precautions, prevent the spread of infectious droplet nuclei, which are small particles (less than 5 micrometers) suspended in the air and dispersed over long distances by air currents. Susceptible individuals can inhale these suspended particles even without having face-to-face contact with the source of the particles.

Reportable diseases (infectious)

Anthrax Arboviral diseases, neuroinvasive and non-neuroinvasive California serogroup virus diseases Chikungunya virus disease Eastern equine encephalitis virus disease Powassan virus disease St. Louis encephalitis virus disease Western equine encephalitis virus disease West Nile virus disease Babesiosis Botulism Foodborne Infant Wound Other Brucellosis Campylobacteriosis Candida auris, clinical Carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE) CP-CRE, Enterobacter species CP-CRE, Escherichia coli (E.coli) CP-CRE, Klebsiella species Chancroid Chlamydia trachomatis infection Cholera Coccidioidomycosis Congenital syphilis Syphilitic stillbirth Coronavirus disease 2019 (COVID-19)4 Cryptosporidiosis Cyclosporiasis Dengue virus infections Dengue Dengue-like illness Severe dengue Diphtheria Ehrlichiosis and anaplasmosis Anaplasma phagocytophilum infection Ehrlichia chaffeensis infection Ehrlichia ewingii infection Undetermined human ehrlichiosis or anaplasmosis Foodborne disease outbreak Giardiasis Gonorrhea Haemophilus influenzae, invasive disease Hansen disease Hantavirus infection, non-Hantavirus pulmonary syndrome Hantavirus pulmonary syndrome Hemolytic uremic syndrome, postdiarrheal Hepatitis A, acute Hepatitis B, acute Hepatitis B, chronic Hepatitis B, perinatal virus infection Hepatitis C, acute Hepatitis C, chronic Hepatitis C, perinatal infection HIV infection (AIDS has been reclassified as HIV stage III) Influenza-associated pediatric mortality Invasive pneumococcal disease Legionellosis Leptospirosis Listeriosis Lyme disease Malaria Measles Meningococcal disease Mumps Novel influenza A virus infections Pertussis Plague Poliomyelitis, paralytic Poliovirus infection, nonparalytic Psittacosis Q fever Q fever, acute Q fever, chronic Rabies, animal Rabies, human Rubella Rubella, congenital syndrome Salmonella Paratyphi infection (Salmonella enterica serotypes Paratyphi A, B [tartrate negative], and C [S. Paratyphi]) Salmonella Typhi infection (Salmonella enterica serotype Typhi) Salmonellosis Severe acute respiratory syndrome-associated coronavirus Shiga toxin-producing Escherichia coli infection Shigellosis Smallpox Spotted fever rickettsiosis Streptococcal toxic shock syndrome Syphilis Syphilis, primary Syphilis, secondary Syphilis, early non-primary, non-secondary Syphilis, unknown duration or late Tetanus Toxic shock syndrome (other than streptococcal) Trichinellosis Tuberculosis Tularemia Vancomycin-intermediate Staphylococcus aureus infection Vancomycin-resistant Staphylococcus aureus infection Varicella (chickenpox) Varicella deaths Vibriosis Viral hemorrhagic fever Crimean-Congo hemorrhagic fever virus Ebola virus Lassa virus Lujo virus Marburg virus New World arenavirus, Guanarito virus New World arenavirus, Junin virus New World arenavirus, Machupo virus New World arenavirus, Sabia virus Waterborne disease outbreak Yellow fever Zika virus disease and Zika virus infection Zika virus disease, congenital Zika virus disease, noncongenital Zika virus infection, congenital Zika virus infection, noncongenital

Conditions requiring airborne precautions

Avian flu Varicella (chickenpox) (also contact) Herpes zoster (also contact) Rubella (measels) Monkeypox (contact) SARS (contact & goggles) Smallpox (contact & vaccine) TB (contact if draining lesion) COVID 19 (contact)

Precautionary period for airborne diseases

Avian flu: 14 days from onset of symptoms Varicella (chickenpox): Lesions crusted, no new lesions Herpes zoster: Duration of illness Rubella (measels): 4 days from onset of rash. Duration of illness if patient's immunocompramised Monkeypox: Until confirmed and smallpox ruled out SARS: Duration of illness, plus 10 days after resolution of fever Smallpox: Until all scabs have crusted and separated. Usually 3-4 weeks TB: Lesion drain needs 3 consecutive negatives. Pulmonary wise needs to clinically improve, be on effective treatment, and test negative 3 separate times for acid-fast bacillus COVID 19: Requires 2 consecutive negative PCR tests (information can change). Non-infectious if CRT >32 BUT keep on droplet & contact precaution

Precautionary period for contact illness

Avian influenza: 14 days from onset of symptoms Burkholderia cepacia pneumonia, patient with cystic fibrosis: Unknown Clostridioides difficile gastroenteritis: 48H after resolve of symptoms or > Diphtheria, cutaneous: 2 cultures (24hrs apart) are negative Hepatitis A: Hospital stay for <3 yo. 2 weeks after onset of symptoms for 3-14yo. 1 week for kids >14yo Herpes simplex, mucocutaneous, disseminated or primary, severe; neonatal: Until lesions are crusted, cultures obtained at 24hr & 36hr are negative Impetigo: 24hrs after effective therapy started MDRO: According to infection control TB extrapulmo lesion: 2 drainage cultures negative Pediculosis: 24hrs from effective therapy started Rubella: Untill age 1 year/nasopharyngeal and urine cultures are repeatedly negative after age 3 months Scabies: 24hrs from effective therapy started SARS: 10 days after fever resolved Streptococcus group A: 24hrs from effective therapy started Vaccinia, eczema; fetal, generalized, or progressive: Until lesions are dried Vaccinia blepharitis or conjunctivitis with copious drainage: Until drainage stops

Reportable diseases (non-infectious)

Cancer Carbon monoxide poisoning Lead, elevated blood levels Lead, elevated blood levels, children (younger than age 16 years) Lead, elevated blood levels, adult (16 years or older) Pesticide-related illness and injury, acute Silicosis

Disinfecting noncritical equipment checklist

Check the equipment manufacturer's recommendations for disinfecting the particular piece of equipment. Gather the necessary equipment. Perform hand hygiene. Put on gloves and, as needed, other personal protective equipment. Inspect the patient care equipment for breaks in integrity; if the integrity is compromised, remove the equipment from use. Disinfect the patient care equipment. B e sure to expose the noncritical item to the disinfectant for the length of time indicated on the product label. If you're using a disinfectant wipe, close the container after removing the wipe. Allow the equipment to air-dry before use. Place reusable cloths in a laundry bag or discard disposable cloths or wipes in an appropriate receptacle. Remove and discard your personal protective equipment. Perform hand hygiene.

Contact precautions

Contact precautions help prevent the transfer of microorganisms that spread through direct or indirect contact with a patient or the patient's environment. Effective contact precautions require a single room, if possible, and the use of gloves and a gown by anyone who has contact with the patient, the patient's support equipment, or items that have come in contact with the patient or the patient's environment. Proper hand hygiene and handling and disposal of articles that have come in contact with the patient and the patient's environment are essential.

Precautionary period for droplet illness

Diphtheria (pharyngeal): Until the patient is no longer taking antibiotics and two cultures taken at least 24 hours apart are negative Influenza (seasonal): For 7 days after onset of signs and symptoms or until 24 hours after fever and respiratory symptoms have resolved, whichever is longer. For the duration of illness in immunocompromised patients. Haemophilus influenzae type b: Until 24 hours after initiation of effective therapy Neisseria meningitidis: Until 24 hours after initiation of effective therapy Mumps: For 5 days after the onset of swelling Parvovirus B19: Duration of hospitalization when chronic disease occurs in immunocompromised patients. For 7 days in patients with transient aplastic crisis or red-cell crisis Pertussis (whooping cough): Until 5 days after initiation of effective therapy Pneumonic plague: Until 48 hours after initiation of effective therapy Rubella: Until 7 days after onset of rash Streptococcal group A disease, including pharyngitis: 24Hrs after starting effective therapy

Droplet precaution

Droplet precautions prevent infectious pathogens from traveling from the respiratory tract of an infected person to the mucous membranes of a susceptible host. These pathogens, carried by respiratory droplets, spread when an infected person coughs, sneezes, or talks or during such procedures as suctioning or endotracheal intubation. A patient who requires droplet precautions should ideally be in a single-patient room. Anyone who has direct contact with the patient or who will be within 3′ (1 M) of the patient should wear a surgical mask that covers the nose and mouth. When exposure to a highly virulent pathogen is likely, wearing a mask when within 6' to 10′ (2 to 3 M) of the patient or upon entering the patient's room offers further protection. ***Pediatric alert: When handling infants or young children who require droplet precautions, you may also need to institute contact precautions and wear gloves and a gown to prevent soiling of clothing from nasal and oral secretions.

Standard precautions checklist

Gather and prepare the equipment and supplies. Perform hand hygiene before and after patient care and before putting on and after removing gloves. Wash your hands immediately if they become contaminated with blood or body fluids. Wear gloves if you could or will come in contact with blood, specimens, tissue, body fluids, secretions, excretions, mucous membranes, broken skin, or contaminated surfaces or objects. Change gloves and perform hand hygiene during patient care, as needed, and between patient contacts. Wear a gown, eye protection, and a mask during procedures that are likely to generate splashing or splattering of blood or body fluids. Wear a mask during lumbar puncture procedures. Follow safe injection practices. Handle used needles and other sharp instruments carefully and dispose of them properly. Use a needleless IV system, whenever possible. Immediately notify your employee health care provider (or designee) of all needlestick or other sharp object injuries, mucosal splashes, and contamination of open wounds or nonintact skin with blood or body fluids. Label all specimens you've collected in the patient's presence. Place them in laboratory biohazard transport bags. Attach laboratory requisition forms, if required. Place contaminated items in a fluid-impervious bag or container labeled BIOHAZARD. Promptly clean blood and body fluids spills. If you have an exudative lesion, avoid direct patient contact until the condition has resolved and your employer health care provider clears you. If you have dermatitis or any broken skin on your hands, avoid situations in which you may have contact with blood and body fluids until the condition has resolved and your employee health care provider has cleared you. Perform hand hygiene and put on gloves, if needed, before properly cleaning and disinfecting or sterilizing reusable equipment. After cleaning and disinfecting, remove and discard your gloves, if worn, and perform hand hygiene. Teach patients, families, and visitors about hand hygiene, respiratory hygiene, and cough etiquette. Document the type of transmission-based precautions needed, if applicable, in addition to standard precautions.

Contact precautions checklist

Gather and prepare the equipment and supplies. Put a CONTACT PRECAUTIONS sign outside the patient's door. Perform hand hygiene. Put on a gown and gloves before entering the room. Instruct visitors to do the same, as required. Confirm the patient's identity. Place the patient in a single room with private toilet facilities and an anteroom, if possible. If necessary and approved by your facility's infection preventionist, place two patients with the same infection in a room together. Explain contact precautions to the patient and family (if appropriate). Change gloves after contact with a contaminated body site, body fluids or excretions, mucous membranes, nonintact skin, or wound dressings; perform hand hygiene before putting on new gloves. Handle all items that have come in contact with the patient as you would for a patient on standard precautions. Limit the patient's movement from the room. If you must move the patient, cover infected areas with clean dressings and notify other staff members of the patient's contact precautions. Teach the patient and family (if appropriate) about infection-prevention measures. Remove and discard your gown and gloves. Perform hand hygiene before leaving the room. Document the procedure.

Droplet precaution checklist

Gather and prepare the equipment and supplies. Put a DROPLET PRECAUTIONS sign by the door. Perform hand hygiene. Put on a gown, if needed. Put on a mask; make sure it fits snugly. Put on gloves, if needed. Confirm the patient's identity. Situate the patient in a single room with private toilet facilities and an anteroom, if possible. Explain droplet precautions to the patient and family (if appropriate). If the patient is wearing a mask for transport, remove and discard it. Instruct the patient to cover the nose and mouth with a facial tissue while coughing or sneezing and then to immediately dispose of the tissue and perform hand hygiene. Provide the patient with a no-touch receptacle, if available. Remove your gloves and gown (if worn) and your mask in the anteroom. If an anteroom isn't available, discard them at the patient's doorway just before leaving the room. Handle the mask by the strings or bands only. Perform hand hygiene. Document the procedure.

Protective Environment checklist

Gather and prepare the equipment and supplies. Review the patient's medical record, and verify the need for a PE. Perform hand hygiene. Put on gloves, a gown, and a mask as indicated. Confirm the patient's identity. Place the patient in the PE room, and explain the PE requirements to the patient and family (if appropriate). Keep the door of the patient's room (and of the anteroom, if applicable) closed at all times. Place a PE precautions sign on the door of the patient's room. Screen the patient's visitors. Ensure daily cleaning of the patient's room. Avoid transporting the patient out of the PE room. If you must take the patient outside the PE room, instruct the patient to wear a regular mask. Also, notify the receiving department that the patient is on PE requirements. Assess the patient daily for signs or symptoms of anxiety or depression while in the PE room. Prohibit fresh flowers in water, dried flowers, and potted plants from being brought into the patient's PE room or area. Remove and discard your gloves and other personal protective equipment. Perform hand hygiene. Document the procedure.

Opening wrapped sterile items

Grasp the sterile item in your nondominant hand. Break the sterilization tape. Open the outermost flap away from your body with your dominant hand. Open the side flaps. Secure all flaps in your nondominant hand. Open the inner flap. Place the item on the sterile field, maintaining sterility. Be sure to place the item at least 1″ (2.5 cm) from the edge of the sterile field.

Opening peel-pack containers or pouches

Grasp the unsealed corner of the wrapper and pull it toward you. Open a peel-pack pouch by grasping each side of the unsealed edge with the thumb side of each hand parallel to the seal and pulling it apart. Hold the sides back so that the wrap covers your hands and exposes the sterile item. Drop light items onto the sterile field without allowing them to slide across the package sides. Give heavy items to a scrubbed person or open them on a separate surface.

Hand hygiene checklist

Hand washing: Remove jewelry, if required. With your arms angled down under the faucet, adjust the water temperature. Wet your hands and wrists and apply soap from a dispenser. Vigorously rub your hands together for at least 20 seconds. Pay special attention to fingernails, cuticles, thumbs, knuckles, and sides of your fingers and hands. Move rings (if worn) up and down your fingers. Avoid splashing water on yourself and the floor. Avoid touching the sink and faucet. Rinse your hands and wrists well. Pat your hands and wrists dry with a paper towel. Turn off the faucets by gripping them with a paper towel. Hand sanitizing: Apply alcohol-based hand rub and cover all surfaces of your hands. Continue rubbing until all of the product has dried.

Root causes of hand hygiene causes

Ineffective placement of dispensers or sinks Failure to accurately or frequently collect or report hand hygiene compliance data Lack of accountability and of just-in-time coaching A safety culture that doesn't stress hand hygiene at all levels Ineffective or insufficient education Full hands that leave health care workers unable to wash Glove wearing, which interferes with the process The perception that hand hygiene isn't needed if gloves are worn Forgetfulness Distractions

Airborne precautions requirements

Negative pressure isolation room. The air is either vented directly to the outside of the building or filtered through high-efficiency particulate air (HEPA) filtration before recirculation. Air pressure is monitored daily. The door to the room should be kept closed to maintain the proper air pressure balance between the isolation room and the adjoining hallway or corridor. All people who enter an airborne infection isolation room must wear respiratory protection, which is provided by a disposable respirator (such as an N95 respirator or a HEPA respirator). Regardless of the type or respiratory protection worn, they should ensure proper a fit to the face each time they wear a respirator by performing a user seal check. When a patient comes to your facility complaining of respiratory symptoms and an airborne infection is suspected, put a surgical mask on the patient's face (if tolerated) and immediately place the patient in a private room with the door closed until an airborne infection isolation room is available.

Opening and putting on sterile gloves

Open the package of gloves, maintaining sterility. Perform hand hygiene. Place the paper glove wrapper on a clean, dry, flat surface. Open the inner package. Use your nondominant hand to grasp the inner surface of the glove for the dominant hand. Insert your dominant hand into the glove, palm side up. Pull down the cuff, touching only the inner surface of the glove. Insert the fingers of your gloved hand into the sterile outer cuff of the other glove. Lift up the glove and insert your nondominant hand into it, allowing the cuff to come uncuffed without touching the skin of your arm. Adjust your fingers. Keep your hands above waist level.

Standard precautions

Part of routine infection control practices, standard precautions include wearing gloves for situations involving known or anticipated contact with blood, body fluids, tissue, mucous membranes, or nonintact skin. If the task or procedure you're performing may result in splashing or splattering of blood or body fluids to the face, you should also wear a mask and goggles or a mask with a face shield. If the task or procedure you're performing may result in splashing or splattering of blood or body fluids to the body, you should also wear a fluid-resistant gown or apron. Additional protective clothing, such as shoe covers, may be appropriate to protect your feet in situations that may expose you to large amounts of blood or body fluids (or both), such as when caring for a trauma patient in an operating room or emergency department.

Opening sterile kits

Remove the outer wrapper. Place the kit on a clean, dry surface. Position the kit so that you can open the farthest flap first. Open the first flap away from you. Open each side flap using the hand on the same side as the flap. Open the innermost flap. Secure the wrapper edges.

Airborne precautions checklist

Review the patient's medical record. Gather and prepare the equipment and supplies. Perform hand hygiene. Confirm the patient's identity. Situate the patient in a single-patient airborne infection isolation room. Explain isolation precautions to the patient and family. Keep the room door closed. If needed, wear respiratory protection when entering the room of a patient with a known or suspected respiratory infection. Check the respirator's seal and function before entering the room. Perform hand hygiene. Enter the patient's room. Remove the patient's mask if the patient is wearing one. Instruct the patient to cover the nose and mouth with a facial tissue while coughing or sneezing. Provide the patient with a no-touch receptacle for used-tissue disposal. Perform hand hygiene. If worn, remove your respirator after leaving the patient's room and closing the door. As appropriate, discard the respirator in an appropriate receptacle or store it for reuse. Perform hand hygiene. Document the procedure.

Important notes of hand hygiene

Teach patients and their families about the importance of hand hygiene in preventing the spread of infection. Keep nails short. Do not wear jewelry on fingers or wrist.

Disinfecting semicritical equipment checklist

Transport the equipment to the decontamination area wearing appropriate personal protective equipment. Gather the necessary equipment. Prepare the detergent or enzymatic cleaner according to the manufacturer's instructions. Perform hand hygiene. Put on personal protective equipment. If composed of more than one piece, disassemble or open the equipment. Rinse the equipment with cold running water. Inspect the equipment surfaces for breaks in integrity that would impair cleaning or disinfection. If you identify a break in integrity, discard the equipment or send it for repair. Meticulously clean the equipment with water and detergent or water and enzymatic cleaner; submerge the equipment in the solution. Use a specially designed soft-bristle brush to clean crevices, lumens, and channels, if necessary. Thoroughly rinse the equipment by immersing it in a basin or sink filled with water. Dry the equipment with a soft, lint-free cloth or allow it to air-dry. Inspect the equipment. Remove and discard your personal protective equipment. Perform hand hygiene. Proceed with high-level disinfection after the equipment is dry.

Pouring sterile solutions

Unwrap and label the sterile bowl and place it on the edge of the sterile field. Visually inspect the solution container; don't use it if it's expired or compromised. Open the sterile solution bottle. Carefully pour the solution into the sterile bowl. Discard any unused solution.

Reportable diseases checklist

Verify that the infectious disease is a reportable disease, if possible. Follow facility protocol for reporting infectious diseases. Institute isolation precautions as appropriate. Perform hand hygiene. Put on personal protective equipment, as needed. Confirm the patient's identity. Provide privacy. Explain the infectious disease reporting requirements to the patient and family (if appropriate). Obtain additional infectious disease-related information from the patient as needed. Complete an electronic or handwritten reportable disease form, if required. Remove and discard your personal protective equipment, if worn. Perform hand hygiene. Document the procedure.

Sterile technique

Verify the order. Review the patient's medical record for a history of allergies to latex or medications. If required, confirm that informed consent has been obtained and that the signed consent form is in the patient's medical record. Gather and prepare the equipment and supplies. Perform hand hygiene. Confirm the patient's identity. Provide privacy. Explain the procedure. Screen for and assess the patient's pain using facility-defined criteria. Treat the patient's pain, as needed and ordered. Remove your rings, watch, and bracelets. Perform hand hygiene. Put on the necessary personal protective equipment.

Precautionary period for droplet illness (duration of illness)

Viral hemorrhagic fevers (Ebola, Lassa, Marburg, and Crimean-Congo fever viruses) Rhinovirus Mycoplasma pneumoniae Adenovirus infection in infants and young children