ISOLATION PRECAUTION Standard Precautions

Policies and Procedures on Infection Control Ministry of Health Malaysia 15

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 skin