Isolation Precautions

Question 1

Nosocomial Infections

Answer 1

An infection that is acquired in the hospital
setting

Healthcare-associated infections (HAIs)

Results in increased cost of care, increase hospital stay,
Increase morbidity, death

Question 2

Nosocomial infection common pathogens

Answer 2

Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, Candida albicans

Question 3

Primary management for nosocomial infections

Answer 3

prevention by following standard precautions

Question 4

Risk factors for developing a nosocomial

infection:

Answer 4

Age – the very old/very young
Immunodeficiency – chronic diseases (CA, COPD, DM, AIDS)
Immunosuppression – chemotherapy, radiation therapy, corticosteroids
Misuse of antibiotics - overprescribing abx or use of broad spectrum abx which kills off pt’s normal flora

Question 5

Those at risk for developing a nosocomial

infection (con’t)

Answer 5

Use of invasive diagnostic & therapeutic procedures
– potentially any line or tube
Agitation – can result in self-extubation or self removal of an invasive line
Surgery – incisions provide access for pathogens
Burns – causes disruption of 1st line of defense (SKIN)
Length of hospitalization – increases the exposure to pathogens

Question 6

CDC recommendations & work restrictions for

personnel w/ infectious disease

Answer 6

In general, stay away (esp. from susceptible/high risk pts) if you have an obvious infection

Question 7

Isolation barriers two tiers

Answer 7

Standard precautions

Transmission based precautions

Question 8

Standard Precautions

Answer 8

Based on the premise that EVERY person is
infected w/ an organism that could be transmitted
Primary strategy of prevention of healthcare- associated transmission of infectious agents
To be followed when providing healthcare services to a patient

Question 9

Standard precautions apply to

Answer 9

Blood
All body secretions, excretions, fluids
Mucous membranes
Damaged skin

Question 10

Standard precautions don’t

Answer 10

Hand hygiene n Personal protective equipment (PPE)
Gloves/Gown/Mouth, noes, eye protection
(masks, goggles, face shields)
Respiratory Hygiene/Cough etiquette
Patient placement
Patient-care equipment and instruments Textiles and laundry

Question 11

Most common mode of pathogenic transmission

Answer 11

Hands

Why hand hygiene is so important

Question 12

Hand hygiene- when

Answer 12

Before/after treatment/procedure
After touching blood, body fluids, secretions,
excretions 
After touching contaminated items 
Immediately after removing 

** Thin layer of H2O based lotion should be applied to prevent chapping

Question 13

Gloves worn when

Answer 13

contact is likely w/ blood, mucous membranes, open skin, intact skin w/ potential contaminants, or any potential infectious material

Question 14

Glove guidelines

Answer 14

Appropriate fit 
Remove using proper technique 
Do not reuse gloves between patients 
On the same patient, change gloves when moving from a contaminated site to clean
site 
Wash hands after removing gloves

Question 15

Transmission based precautions

Answer 15

For care of patients known or suspected to be infected or colonized w/ infectious
pathogens
Used in addition to Standard Precautions to
control transmission
May initially be based on patient symptoms and then modified once diagnosis is ruled
out or confirmed

Question 16

Three categories of transmission based precautions

Answer 16

Airborne precautions
Droplets precautions
Contact precautions

May be combined

Question 17

Airborne Precautions {Airborne Infection Isolation Room (AIIR)}

Answer 17

To reduce risk of transmission of small particles (< 5 microns) that remain viable in air over long distances
Organisms can be spread by air currents and may become inhaled
Special air handling/ventilation required –
negative pressure room

Examples: Chickenpox, measles, tuberculosis

Private room indicated; special mask/respirator
worn when entering room + gown + gloves

Used in addition to Standard Precautions

Question 18

Droplet precautions

Answer 18

To reduce risk of transmission of
pathogens thru respiratory secretions (> 5 microns)

Involved contact with conjunctivae or
mucous membranes of nose/mouth

Droplets generated primarily during
coughing, sneezing or talking or certain
procedures such as suctioning/bronchoscopy

Question 19

Droplet precautions cont

Answer 19

Droplets do not remain suspended in air
and generally travel only short distances
(usually 3 feet or less)

Examples: Mumps, rubella, meningitis

Private room recommended; wear a mask
or face shield or both when working within
3 feet of patient

Used in addition to Standard Precautions

Question 20

Contact precautions

Answer 20

To reduce risk of transmission by direct (skin to skin) or indirect (inanimate object to skin) contact
Examples: Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), Clostridium difficile (C-diff), Escherichia coli

Private room recommended; gown + gloves if
potential contact w/ pt or contaminated object;
may want to wear a mask
Used in addition to Standard Precautions

If equipment is used with patients in isolation,
they should be left in the patient’s room and notbe removed until the infection is resolved.
Thorough cleaning of the equipment is necessary before using the equipment with other patients
Live plants/floral arrangements not permitted in room

Question 21

Protective isolation. - PT

Answer 21

Check labs before treating;

don’t treat if you are feeling sick or have an infection of some sort

Question 22

Other Methods of Prevention

Answer 22

Immunizations
Prophylactic abx therapy
Proper living conditions/sanitation

Question 23

Proper living conditions/sanitation

Answer 23

Disinfect & sanitize
Maintain 1st line of defense – skin care
Pre/post-op breathing & coughing
Increase mobility/ ambulation
Hydration/fluid-electrolyte balance
Proper nutrition