ISOLATION PRECAUTION Standard Precautions
3.2 Transmission-based
These precautions apply to selected patients, based on a suspected or confirmed clinical syndrome, a specific diagnosis, or colonization or infection with epidemiologically important organisms. These precautions are to be implemented in conjunction with standard precautions. Three types of transmission-based precautions have been developed; airborne, droplet and contact. Few diseases e.g. varicella, influenza may require more than one isolation category. See table 1 2. Essential elements of each isolation category are outlined below; Airborne Precautions Designed to prevent the transmission of diseases by droplet nuclei particles 5 μm or dust particles containing the infectious agent. These particles can remain suspended in the air and travel long distances. If the particles are inhaled, a susceptible host may develop infection. Airborne precautions are indicated for patients with documented or suspected tuberculosis pulmonary or laryngeal, measles, varicella, or disseminated zoster. Patient Placement In descending order of preference; 1. Negative pressure room en-suite bath 2. Single room nursed with door closed and en-suite bath 3. Single room 4. Cohort not recommended unless absolutely necessary – consult Physicians microbiologists Respiratory protection Wear respiratory protection when entering the room of a patient with known or suspected infectious pulmonary tuberculosis. Susceptible persons should not enter the room of patients known or suspected to have measles or rubeola or varicella chickenpox if other immune caregivers are available. If susceptible persons must enter the room of a patient known or suspected to have measles rubeola or varicella, they should wear respiratory protection. Persons immune to measles rubeola or varicella need not wear respiratory protection Face shieldeye As per standard precautions protection For proceduresactivities likely to generate splashessprays of blood, body fluids, secretions and excretions Gloves and Hand As per standard precautions washing When touching blood, body fluids secretions, excretions, contaminated items, mucous membranes, non intact skin Policies and Procedures on Infection Control Ministry of Health Malaysia 16 Gown As per standard precautions For proceduresactivities likely to generate splashessprays of blood, body fluids, secretions and excretions Patient Transport Limit the movement and transport of the patient from the room to essential purposes only. If transport or movement is necessary, minimize patient dispersal of droplet nuclei by placing a surgical mask on the patient. Droplet Precautions Designed to prevent the transmission of diseases by large particle droplet particles 5 μm or dust particles containing the infectious agent. Unlike droplet nuclei, droplets are larger, do not remain suspended in the air, and do not travel long distances. They are produced when the infected patient talks, coughs, or sneezes, and during some procedures e.g., suctioning and bronchoscopy. A susceptible host may become infected if the infectious droplets land on the mucosal surfaces of the nose, mouth, or eye. Patient Placement No special air handling or ventilation required In descending order of preference; 1. Single room with en-suite bath 2. Single room 3. Cohort – place the patient in a room with a patients who has active infection with the same microorganism but with no other infection. 4. In the general ward, but maintain a spatial separation of at least 3 feet between infected patient and other patients and visitors. Place an isolation trolleytray at the entrance of the isolation zone. Respiratory protection Wear mask when working within 3 feet of the patient. If placed in a single room, wear mask before entering the room. Face shieldeye As per standard precautions protection For proceduresactivities likely to generate splashessprays of blood, body fluids, secretions and excretions Gloves and Hand As per standard precautions washing When touching blood, body fluids secretions, excretions, contaminated items, mucous membranes, non intact skinParts
» Bacaan Penuh ( bersaiz 5.5 MB)
» Roles of Hospital Infection and Antibiotic Control Committee
» Infection Control Doctor ICD
» Chairman of HIACC Bacaan Penuh ( bersaiz 5.5 MB)
» HOSPITAL INFECTION AND ANTIBIOTIC CONTROL COMMITTEE
» Frequency of meetings Circulation of minutes
» Emergency meetings and outbreak control
» Duties and responsibilities of the infection Control Nurse
» HEALTHCARE ASSOCIATED INFECTION SURVEILLANCE
» Types of Surveillance Bacaan Penuh ( bersaiz 5.5 MB)
» Data Collection Tabulation of Data
» Analysis and interpretation of data
» Preparation and dissemination of reports
» ISOLATION PRECAUTION Standard Precautions
» Respiratory hygienecough etiquette: Instruct symptomatic persons and health
» Signs, BHT, Isolation traytrolley
» Visitor Policy for Infection Control
» Dishes, Glasses, Cups, Eating Utensils and Medications
» Transportation of patients Transmission-based
» Hand Hygiene Bacaan Penuh ( bersaiz 5.5 MB)
» Natural ventilation Personal Protective Equipment PPE
» Use of mechanical ventilation
» Minimizing bacteria at entry points
» Maintaining sterility of instruments disposable items during a procedure
» Catheter change interval Urinary Catheter Care
» General principles of wound care 1.
» Spatial separation of catheterized patients Technique
» Environment Urinary Catheter Care
» Wound Care Bacaan Penuh ( bersaiz 5.5 MB)
» Procedure for insertion of catheter
» A dedicated lumen used for PN line should be identified and not be used for
» Nursing considerations for PN
» Storage Replacement of PN tubing and filters
» General Principles. Replacement of PN tubing and filters
» Specific practices transport, storage, transfusion, dispose
» Blood and Blood Products Transfusion
» Hand hygiene Urinary Tract Infection
» Catheter Insertion Urinary Tract Infection
» Closed Sterile Drainage Urinary Tract Infection
» Irrigation Urinary Tract Infection
» Specimen Collection Urinary Tract Infection
» Urinary Flow Urinary Tract Infection
» Meatal Care Urinary Tract Infection
» Catheter Change Interval Urinary Tract Infection
» Critical items - instruments or objects that enter directly into the vascular
» Semi-critical items - instruments or objects that come into contact with
» Developed a good surveillance system to study the incident of SSI.
» Nosocomial Respiratory Infection Bacaan Penuh ( bersaiz 5.5 MB)
» Introduction INFECTION CONTROL IN SPECIFIC HEALTHCARE SETTING
» Personal Protective Equipment Personnel .1
» Neonatal Intensive Care Unit
» Outer zone: This zone should contain:
» Laminar Flow Ventilation Ultra Clean Ventilation
» Wall Mounted Air Conditioners:
» Protective Clothing for Use in the Operating Theatre
» Surgical Hand Scrubbing Refer to hand hygiene section
» Gowning Free-standing Air Conditioners:
» Gloving Free-standing Air Conditioners:
» Draping Free-standing Air Conditioners:
» Establishing a Sterile Field
» Dispensing of the Sterile Supplies
» Maintaining the Sterile Field
» Waste and Linen Post operative
» Cleaning of the Operation theatre
» Intra operative Initial cleaning at the beginning of the day
» Concurrent cleaning between cases
» Haemodialysis unit water supply and air conditioning
» Staff health Terminal cleaning end of the day
» Hand hygiene Terminal cleaning end of the day
» Nephrology and Hemodialysis Unit
» Instrument processing area in the dental clinic
» Instrument cleaning refer to CSSD chapter
» Cleaning and Disinfection of Treatment Room 1.
» Dental Radiology Asepsis Components permanently attached to dental unit waterlines
» Dental Laboratory Materials and Equipment
» Storage and preparation rooms
» Movement of instruments Safety
» Collection of body from ward
» Routine case autopsy Mortuary
» Specimen handling Procedure for post-mortem examination of known or suspected CJD
» Clinical waste Procedure for post-mortem examination of known or suspected CJD
» Visitors Procedure for post-mortem examination of known or suspected CJD
» Quality control Procedure for post-mortem examination of known or suspected CJD
» Care Givers For Patient In The Burn Unit 1.
» Visitors Full time Care givers
» Culturing and Surveillance Full time Care givers
» Antibiotic Policy Full time Care givers
» Haematology and Oncology Unit
» Laboratory Bacaan Penuh ( bersaiz 5.5 MB)
» Introduction Bacaan Penuh ( bersaiz 5.5 MB)
» Personel protective equipment PPE
» Screening for HCW TUBERCULOSIS
» Infection control in specific area .1
» HOSPITAL OUTBREAK MANAGEMENT Steps in Outbreak Investigation and Management
» Introduction Introduction Bacaan Penuh ( bersaiz 5.5 MB)
» Policy Statement Training Bacaan Penuh ( bersaiz 5.5 MB)
» Arrangements Bacaan Penuh ( bersaiz 5.5 MB)
» Infection Control During Construction and Renovation
» Operation Theatre Commissioning Bacaan Penuh ( bersaiz 5.5 MB)
» Administrative monitoring Mechanical Monitoring
» Distribution of sterile items
» Establish a system Bacaan Penuh ( bersaiz 5.5 MB)
» Monitoring antimicrobial use using aggregated data on Defined Daily
» Each hospital shall send report on DDD every 6 months to National Infection
» However, individual local data shall be reported according to discipline
» It is recommended to have a national benchmark data specifically for Intensive
» It is also beneficial if each state have their own benchmark data from their
» A report of local monitoring data for hospital compared with national
» The aggregate benchmark data included numeric presentation of pooled
» Correlation between antimicrobial use and resistance rate
» Costquantity of empiric antimicrobial administered in a specified period.
» Antimicrobial management programstrategies Antimicrobial policy
» Multi-Resistant Organism 13. Bacaan Penuh ( bersaiz 5.5 MB)
» Methicillin Resistant Staphylococcus Aureus
» Vancomycin Resistant Enterococci Bacaan Penuh ( bersaiz 5.5 MB)
» HIV Bacaan Penuh ( bersaiz 5.5 MB)
» Dengue Bacaan Penuh ( bersaiz 5.5 MB)
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