presented during orientation

1. Ross Ibabao
KJO Hospital
IC Coordinator

2. Learning Objectives
 Discuss chain of infection and different types of
mode of transmission
 Define isolation precautions and describe
different types isolation precautions.
 Describe contact precautions and conditions
under which to use contact precautions.
 Describe conditions under which to use droplet
precautions.
 Describe conditions under which to use airborne
precautions.
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3. Chain of infection
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4. Mode of transmission
 A microorganism may be spread by a single or
multiple routes.
 Contact, direct or indirect
 Droplet
 Airborne
 Vector-borne (usually arthropod) and
 Common environmental sources or vehicles -
includes food-borne and waterborne, medications
e.g., contaminated IV fluids
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5. Contact Transmission
 Direct-contact
 Direct body surface-to-body surface contact and
 Physical transfer of microorganisms between a
susceptible host and an infected or colonized person
 Indirect-contact
 Contact of a susceptible host with a contaminated
intermediate object, usually inanimate, such as
contaminated instruments, needles, or dressings, or
contaminated hands or gloves
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6. Droplet Transmission
 Droplet generation
 coughing,
 sneezing,
 talking,
 procedures such as suctioning and
bronchoscopy
 Droplet deposited on the host’s conjunctivae,
nasal mucosa, or mouth.
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7. Airborne Transmission
 Small-particle residue {5µm or smaller} of
evaporated droplets containing microorganisms
 Suspended in the air for long periods of time
 Dispersed by air currents
 Inhaled by a susceptible host within the same
room or over a longer distance
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8. Definition of Isolation Precautions
Source: Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
 Special precautionary measures, practices, and
procedures used in the care of patients with
contagious or communicable diseases
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9. Fundamentals of Isolation
Precautions
 Handwashing and gloving
 Personal protective equipment's:
 Masks, respiratory protection, eye protection, face shields, gowns
and protective apparel
 Patient-care equipment and articles
 Linen and laundry
 Routine and terminal cleaning
 Patient placement
 Transport of infected patients
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10. 10
Isolation
Precautions
Patient
Transport
Linen & laundry
Patient care equipment
And articles
Routine and
Terminal
Cleaning
PPE
Hand hygiene
Patient
placement
Isolation Precautions

11. Types of Isolation Precautions
 Standard Precautions
 Transmission-based precautions
 Contact precautions
 Airborne precautions
 Droplet precautions
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12. TRANSMISSION-BASED PRECAUTIONS
Patient Placement
 Single patient rooms is
always indicated for patients
placed on airborne
precautions and preferable
for those who require contact
or droplet precautions
 Cohort patients with same
organism.
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13. TRANSMISSION-BASED
PRECAUTIONS
Management of Visitors
 Visitors as sources of healthcare associated infections
– e.g., pertussis, influenza, tuberculosis
 Cough etiquette
 Isolation Logbook
 Use of barrier precautions by visitors
 Educate patients and family members
 Follow signs for isolation precautions
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14. TRANSMISSION-BASED PRECAUTIONS
Contact Precautions
 Infections spread by direct or indirect contact with patients or
patient-care environment
 Limit patient movement
 Private/SINGLE room or cohort with patients with same
infection or diagnosis
 Wear disposable gown and gloves when entering the patient
room
 Remove and discard used disposable gown and gloves inside the
patient room
 Wash hands immediately after leaving the patient room
 Clean patient room daily using a hospital disinfectant, with
attention to frequently touched surfaces
 Use dedicated equipment if possible (e.g., stethoscope)
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15. Contact Precautions cont.
GLOVES
 Use gloves when entering the room.
 Change gloves after contact with infective material.
 Remove gloves before leaving the room.
 Wash hands or use appropriate gel after glove removal.
 Do not touch infective material or surfaces with hands.
 Clean, non-sterile gloves are usually adequate.
GOWN
 Use protective gown when entering the room if
 direct contact with patient or
 potentially contaminated surfaces or
 equipment near patient is anticipated or
 if the patient has diarrhea or
 colostomy or wound drainage that is not covered by a dressing.
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16. Contact Precautions Signage
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17. Droplet Precautions
Reduce the risk of transmission by large particle
droplets (larger than 5 m in size).
Requires close contact between the source person
and the recipient
Droplets usually travel 3 feet or less
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18. Droplet Precautions cont.
 A private/single room or
 Cohort with patient with active infection with same
microorganism
 Use a mask when entering the room and definitely if within
3 feet of patient
 Limit movement and transport of the patient. Use a mask
on the patient if they need to be moved and follow
respiratory hygiene/cough etiquette
 Keep at least 3 feet between infected patient and visitors
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19. Droplet Precautions Signage
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20. Airborne Precautions
Tuberculosis, measles, varicella
Place the patient in an airborne infection isolation room (AIIR)
Pressure should be monitored with visible indicator is
recommended
Use of respiratory protection (e.g., fit tested N95 respirator) or
powered air-purifying respirator (PAPR) when entering the room
Limit movement and transport of the patient. Use a mask on the
patient if they need to be moved
Keep patient room door closed.
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21. Airborne Precautions Signage
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22. Summary
 Isolation precautions is important in all healthcare
settings to prevention transmission of infections
 2 types of isolation precautions
 Usage of each type of precautions
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23. References
 2007 Guideline for isolation precautions: preventing
transmission of infectious agents in healthcare settings:
http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautio
ns.html
 CDC guidelines for isolation precautions in hospitals 1996,
Hospital Infection Control Practices Advisory Committee
(HICPAC):
http://wonder.cdc.gov/wonder/prevguid/p0000419/p0000
419.asp
 Principles of Epidemiology in public health practice, 3rd
edition
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