General isolation policy

TYPES OF ISOLATION
Jamilah saad Alqahtani
CNS,MSN,NS,RGN,BSN, OR Specialist

Brain
storming
jamilah saad Alqahtani
2

Isolation
the process or fact of isolating or
being isolated.
Sociology: Social lack of contact
between persons, groups, or whole
societies
Psychology: The failure of an
individual to maintain contact with
others or genuine communication
where interaction with others
persists
• Isolation (health care),
various measures taken
to prevent contagious
diseases from being
spread
3

OUTLINES
• INTRODUCTRION
• Risk Assessment
• Types of Isolation
• Two TIERS OF PRECAUTIONS
1. Stander Precautions
2. Transmission based precautions
• Standard Requirements of Isolation Room
• Disease requiring contact, Airborne & droplet
precautions
4

Objectives
• At the end of this lecture student will be able to:
1. Define isolation
2. Understand Rational of isolation
3. Differentiate between the two TIERS of
Precaution
4. Know different types of isolation
5. Know Standard Requirements of Isolation
Room
6. Understand Disease requiring contact,
droplet, airborne precautions
5

Introduction
• The separation of infected people in order to
prevent the spread of infectious disease is not
new and is mentioned in islam also the same in
bible. The massage was in order to protect
population. It was decided that no one could
inter the city unlit awaiting period of 40 days
had passed.
6

Cont’
• The advent of the HIV/AID epidemic by the mid
1980s created a panic both amongst the general
public and health care provider. In response, the
term universal precautions for blood and body
fluid was introduced by US CDC for all patients.
This term was ambiguous, leading to universal
confusion in its interpretation. As a result,
inappropriate use of gloves increased
substantially and has contributed to rise in the
incidence of latex allergy amongst HCWs.
7

CONT’
• The term universal precautions has now
been replaced by standard precautions in the
isolation guidelines and these precautions
should be part of the routine care of all patient.
8

Risk assessment
• Needed when ever patient considered for isolation
• The disadvantages must weighted against the
benefits
• The placement of patient into isolation should never
be undertaken as matter of convenience.
• Isolation of patients may not only have a
psychological impact on the patient, but
• Putting patient in isolation ward may have adverse
influence the quality of care by distancing the
patient for care specialties .also some patient have
some culture and religious concerns
•
9

Types of isolation
• Source isolation the aim is to prevent
exogenous infections from infected/colonized
patient to other staff, patients, visitors.
• Protective isolation. The aim is to prevent
transfer of infection from personnel and
inanimate environment to immunosuppressed
patient
10

2 TIERS of Precaution:
1. Standard Precautions
• Universal Blood and Body Fluid
Precautions
2. Transmission based precautions
a. Airborne Precautions
b. Droplet Precautions
c. Contact Precautions
11

The rationale for implementing
standard precautions for the care of
all patients times are:
• Patient may be infectious but show no signs or
symptoms of infection at the time of admission as
s/he may be incubating the infectious disease.
• Patient may be not infectious but show signs or
symptoms of infection as the patient may be an
asymptomatic carrier or colonized with multi
resistant microorganisms.
• Infectious status is often determined by laboratory
test that cannot be completed in time of emergency
• Health care workers should be immunized against
vaccine-preventable diseases both for their own
protection and protection of others
12

Standard Precautions:
1. Hand washing
2. Gloves
3. Mask, eye protection, face shield
4. Gown
5. Patient care equipment
6. Environmental control
7. Linen
8. Occupational health and blood borne
pathogens
13

a. Airborne b. Droplet c. Contact
2. Transmission based
precautions
14

Transmission Based Precautions:
• Standard +
Airborne
• TB, Measles and
Chickenpox
1. Airborne
Precautions
15

Airborne Precautions:
• Single room
• Negative air pressure
• 6-12 air changes per hour
• Appropriate discharge of air outdoors or
monitored high efficiency filtration of room air
before air is circulated to other areas.
• Keep the room door closed and the patient in
the room.
• No single room, place the patient in a room
with a patient who has active infection with the
same microorganisms.
A. PATIENT PLACEMENT:
17

Negative room pressure
• is an isolation technique used in hospitals and
medical centres to prevent CROSS-
CONTAMINATIONS from room to room.[1][2] It
includes a ventilation system that generates
negative pressure to allow air to flow into the
isolation room but not escape from the room, as air
will naturally flow from areas with higher pressure to
areas with lower pressure, thereby preventing
contaminated air from escaping the room. This
technique is used to isolate patients with
airborne contagious diseases such as tuberculosis,
measles, or chickenpox
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• N95 mask
• Susceptible persons should not enter the room
of patients known or suspected to have measles
or varicella (chickenpox)
• If susceptible persons must enter the room of a
patient known or suspected to have measles or
varicella, they should WEAR A MASK.
• Persons immune to MEASLES OR
VARICELLA need not wear a mask.
B. RESPIRATORY PROTECTION
22

• Limit the movement and transport of the
patient
• Minimize patient dispersal of droplet nuclei by
placing a surgical mask on the patient
C. PATIENT TRANSPORT
23

Droplet Precautions:
• Standard Precautions
+ Droplet Precautions
• Influenza, Meningitis,
Whooping Cough and
Mumps
24

• Place the patient in a SINGLE ROOM
• No single room, place patient in a room
who has active infection with the same
microorganisms
• Maintain spatial separation of at least 3
feet between the infected patient
• Special air handling and ventilation are
not necessary and door may remain
open.
A. PATIENT PLACEMENT
25

• Standard Precaution + Mask when working
with three feet of the patient
B. MASK
• Limit the movement and transport of the
patient
• Use mask to patient
C. PATIENT TRANSPORT
26

2- Contact Precautions:
• STANDARD
PRECAUTIONS +
CONTACT
PRECAUTIONS
• (MRSA, Scabies,
skin or wound
infection)
27

Direct contact with
the patient (hand
or skin to skin
contact)
Indirect contact
(touching with
environmental
surfaces or patient
care items in the
patients
environment
Contact
Precautions:
28

Contact Precautions:
• Discharge the patient as soon as possible
• Single room
• Corner bed can be used
A. PATIENT PLACEMENT
29

• Standard precautions + wearing gloves
• Change gloves after having contact with
infective material
• Remove gloves before leaving the
patients environment. Wash hands then
antimicrobial agent.
• After glove removal and hand washing,
ensure that hands do not touch
potentially contaminated environmental
surfaces
B. GLOVES and HANDWASHING
30

• When entering a room if you
anticipate that your clothing will
have substantial contact with the
patient
• Remove before leaving the patients
environment
• Ensure clothing is not
contaminated
C. GOWN
31

• Limit movement and transport of the patient
• Ensure precautions are maintained to prevent
transmission
• Put over gown on patient and cover chair with
extra sheet.
• Disinfect chair after use.
D. PATIENT TRANSPORT
32

• Equipment to a single patient
• Adequately clean and disinfect
before use
• Precautions of spread of MRSA
E. PATIENT CARE EQUIPMENT
33

Standard Requirements of Isolation
Room:
Built in toilet, shower, hand
basin for the patient
Separate basin for staff
Foot operated disposal bin
Individual medical
equipment
Disposable paper hand towel
Antiseptic hand cleanser
All surfaces washable
Doors kept closed
Negative pressure
34

Disease requiring contact precautions:
Conjunctivitis, gonococcal in newborns
Endometritis, group A
Enteric infection
Furunclosis
Herpes simplex
MRSA
Pediculosis
Scabies
Viral hemorrhagic infections (Ebola)
35

Disease requiring droplet precautions:
Diptheria
Influenza
Meningitis
Mumps
Pertusis
Rubella
Scarlet fever
Streptococcal pharyngitis
36

Disease requiring airborne
precautions:
Chicken pox (varicella); Zoster
Measles
Pulmonary TB with + smear
37

LABEL Should appear on
Infected linen – water soluble then RED or
YELLOW bag
HIGH RISK SPECIMEN
• Sealed plastic bag
• Mark as high risk specimen on container and
request form.
• Request form should be clipped not stapled.
38

Summary
• Risk assessment must be considered whenever
patient required for isolation
• Type of isolation are source or protective
• Tires of precautions include stander precaution and
transmission based precaution which based on 3
mode of transmission contact, airborne, or droplets.
• Microorganisms can have multi ways of
transmissions like Ebola virus it include the three
type of isolation should be applied + stander
precaution
39

Reference
• Manual of infection prevention and control thrid
edition 2012 by nizam damani OXFORD
• http://www.cdc.gov/
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General isolation policy

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