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Flashcards in Isolation Precautions Deck (23):

Nosocomial Infections

An infection that is acquired in the hospital

Healthcare-associated infections (HAIs)

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


Nosocomial infection common pathogens

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


Primary management for nosocomial infections

prevention by following standard precautions


Risk factors for developing a nosocomial

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


Those at risk for developing a nosocomial
infection (con’t)

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


CDC recommendations & work restrictions for
personnel w/ infectious disease

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


Isolation barriers two tiers

Standard precautions

Transmission based precautions


Standard Precautions

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


Standard precautions apply to

All body secretions, excretions, fluids
Mucous membranes
Damaged skin


Standard precautions don’t

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


Most common mode of pathogenic transmission


Why hand hygiene is so important


Hand hygiene- when

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

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


Gloves worn when

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


Glove guidelines

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
Wash hands after removing gloves


Transmission based precautions

For care of patients known or suspected to be infected or colonized w/ infectious
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


Three categories of transmission based precautions

Airborne precautions
Droplets precautions
Contact precautions

May be combined


Airborne Precautions {Airborne Infection Isolation Room (AIIR)}

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


Droplet precautions

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


Droplet precautions cont

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


Contact precautions

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


Protective isolation. - PT

Check labs before treating;

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


Other Methods of Prevention

Prophylactic abx therapy
Proper living conditions/sanitation


Proper living conditions/sanitation

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