At droplet nuclei and contact transmission. e.g.: varicella, Disseminated

At the beginning the of the 20th
century, efforts at isolation moved toward placing individuals together in one
hospital infectious disease hospitals or a hospital ward where caregivers used
gowns and antiseptic solutions handwashing barriers to disease for transmission
Patients who were considered infectious were routinely placed general hospital
units in separate rooms or in multiple-patient rooms with other

 patients who had the
same infection by 1970, the Centers for Disease Control.

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The Centers for Disease Control (CDC)
was actively involved in developing and 
recommending infection-control practices and procedures for hospitals.

 In 2007, the Centers for Disease Control (CDC)
updated its specific guidelines for 
transmission-based precautions.

Still now with health personnel
and governments and individuals recognize the need for an organized, systematic
approach to the control of infections even that Prevention

 of infection is a
major focus for nurses. As primary caregivers.




The term isolation, a protective procedure that limits the
of infectious diseases among hospitalized patients, hospital personnel, and

Isolation precaution is required
for a certain infected patient to prevent the spread of disease to other
patient isolation precaution is used to isolate the infection not patient.



•      Types of precautions

1.  Strict isolation:

Designed for highly contagious
infections that are spread by both airborne droplet nuclei and contact
transmission. e.g.: varicella, Disseminated herpes zoster, Viral hemorrhagic


Technique includes: 

Private room.

With negative airflow.

The use of masks, gowns,
and gloves for all persons entering the room.



2.  Contact Isolation:

Used for infections, diseases,
or germs that are spread by touching the patient or items in the room
(examples: MRSA, VRE, diarrheal illnesses, open wounds and RSV).


Technique includes:


Private room.

Masks for those personnel
providing close direct care to the patient.

Gowns if soiling is likely.

Gloves for touching
infective material.

Wear a gown and gloves
while in the patient’s room.

Remove them before leaving
the room.

hand washing or use hand
sanitizer when entering and leaving the room.

Visitors must check with
the nurse before taking anything into or out of the room.



3.   Respiratory Isolation:

designed to prevent transmission of diseases spread over
short distances through the air (droplet transmission).

Examples include: children with Haemophilus
influenza, epiglottitis, meningitis, pneumonia, patients with serious
meningococcal disease, mumps and pertussis.




•       Wear a clean mask when entering the room, and discard it when
leaving the room.


4.   Reverse isolation:


It protects the patient from the
other people, usually because they have a weakened immune system and can’t
fight against the bacteria and other infections that live on and around us all
the time. 


Technique includes: 

•       Private room with a special air ventilation system.

•       Require wearing masks, gloves and a gown and to wash hands
–thoroughly before putting all that on.

•       No gifts like flowers would be allowed in the room.

•       Extra precautions would be taken to cleanse or sterilize
anything that would be taken in.


5.   Airborne Precautions:


•       Airborne precautions help keep staff, visitors, and other people
from breathing in these germs and getting sick.

•       Germs that warrant airborne precautions include chickenpox,
measles, and tuberculosis (TB) bacteria.




•       People who have these germs should be in special rooms where the
air is gently sucked out and not allowed to flow into the hallway. This is
called a negative pressure room.

•       Anyone who goes into the room should put on a well-fitted
respirator mask before they enter.



6.   Droplet Precautions


Used when the patient has a type of germ that can be spread
to others through large droplets. These droplets are formed and can travel 3 to
6 feet before falling to the ground when the patient coughs, sneezes, talks,
laughs, or sings.  


Techniques include:

•       Wear a clean mask when entering the room, and discard it when
leaving the room.


B. Equipment:


1.Preparation of the isolation room or area.


1.     availability of the necessary cleaning and disinfection tools
and hand-washing facilities


2.     Provide sterilization equipment and machines near the care


3.     Ensure that the room has a good ventilation: 

negative pressure room these rooms have special technique
which take the contaminated air inside the room to outside through large tubes.
This kind of rooms is used to isolate airborne infections patients.


4.     Post sings outside the room:

     indicate that
this area is an isolation area. 


5.     Remove non-essential furniture or items. 

because the furniture surfaces are good media microorganisms.
Only the important furniture is allowed such; tables. Ensure that they are easy
to clean and should be cleaned and dried frequently to be sure that’s retain
dirt or moisture inside or on the its surface.


6.     Maintain the patient’s requirements

 next to him from
the drinking utensils and covers and all the necessary personal hygiene.


7.     Dedicate non-critical patient-care equipment

Cleaning and disinfection of equipment that can be used
for another patient must be done (e.g. stethoscope, thermometer, blood pressure
cuff and sphygmomanometer.)  


8.     Container with cover for equipment needed for sterilization.

Different sizes are available for patient safety and
infection prevention so that they are placed externally by the door.


9.     Adequate equipment for cleaning and disinfection of the room

1.     Eye protection (visor or goggles)

2.     Face shield (provides eye, nose and mouth protection)

3.     Gloves

reusable vinyl or rubber
gloves for environmental cleaning 

latex single-use gloves for
clinical care

4.     Hair covers (optional)

5.     Particulate respirators

6.     Medical (surgical or procedure) masks

7.     Gowns and aprons 

single-use long-sleeved
fluid-resistant or reusable non-fluid-resistant gowns.

plastic aprons (for use
over non-fluid-resistant gowns if splashing is anticipated and if
fluid-resistant gowns are not available).


10.  Secure communication method 

By providing a telephone or similar connection where the
isolated person can communicate with people abroad to minimize entry and exit
from the isolation area.


2.   Wearing and removing
personal protective equipment.


Have to prepare your Personal Protective Equipment (PPE)
depending on what will do with the patient and what type of infection the
patient have. The PPE are gown, goggle, gloves, and face mask these will
protect Health care providers from any contaminated such as blood, mucus or air
contaminated. PPE should be selected a proper size of PPE not loos and tight. 

The steps for wearing the
PPE are:


1-     Perform hand hygiene: wash hand 

2-     Gown: wear the gown by cove the body from neck to knees, and
arms to end of wrists, and warp it to the back

3-     Mask: you want to put it over nose and the strap around your
ears and pull the bottom the mask down chin.

4-     Goggle: place it in eyes and the strap behind your head, make
sure if it fixed or not.

5-     Gloves: wear the gloves, Pull the cuff up over the gown.

As much as can keep hands away from PPT, limit touching
areas in patient’s room. 

The steps of removing the
PPE are:


1-       Gloves: remove it gloves to gloves and skin to skin then discard
it in a waste container. 

2-       Goggle: remove it from the strap then discard it.

3-       Gown: remove it from back to front then pull it from inside to
outside then discard it 

4-       Mask: remove it from the straps by fingers then discard it.

5-       Wash hand immediately after removing the PPT


3.   Checklist for isolation
room or area trolley or table.

Important equipment:

Eye protection e.g. (visor
or goggles)      

Face shield (provides
protection to eye, nose and mouth)


rubber gloves for
environmental cleaning

latex single -use gloves
for clinical care

Hair covers (optional)     

Particulate respirators
e.g. (N95, FFP2)

Medical (surgical or
procedure) masks

Collection container for
used equipment

Linen bags

Appropriate clinical waste

Large plastic bags

Appropriate detergent for
environmental cleaning and disinfectant for disinfection of surfaces,
instruments or equipment 

Clean single-use towels
(e.g. paper towels)

Plain soap (liquid if
possible, for washing hands in clean water) 

Alcohol-based hand rub.



C. the staff

Isolation precautions by staff it is
important. it prevents the spread of microorganism in the hospital.

1.    Hand washing and Gloving.

2.    Patient placement:

Appropriate patient placement is a significant component of   isolation precautions. Also, a private room
with hand washing and toilet facilities it is important to prevent and reduce
opportunities for transmission of microorganisms.

  when a private room
is not available. an infected patient is pleased with appropriate roommate.

3.    Transport of Infected

In acute care hospitals and
long-term care and other residential settings, limit transport and movement of
patients outside of the room to medically-necessary purposes. but sometime
transport or movement in any healthcare setting is necessary. so, we should be
ensuring that infected or colonized areas of the patient’s body are contained
and covered. also Remove and dispose of contaminated PPE and perform hand
hygiene prior to transporting patients on Contact Precautions. ask patients to
wear medical masks when outside their room or area to prevent transfers



4.    Masks, Respiratory
Protection, Eye Protection, Face Shields:


During procedures and
patient-care activities that are likely sprays of blood, body fluids,
secretions and excretions, and for protect ourselves and others we need to Use
PPE to protect the mucous membranes of the eyes, nose and mouth. we need to
wear masks, goggles, face shields, and combinations of each according to the
need anticipated by the task performed.


Wear facial protection,
including a medical mask and eye protection (face shield or goggles), to
protect the conjunctivae and the mucous membranes of the nose, eyes and mouth.
When providing care in close contact with a patient with respiratory symptoms
for example: coughing or sneezing, use masks and eye protection, because sprays
of secretions may occur.


5.    Linen and Laundry: 

The patient in the isolation room
needs to change his clothes and covers. This task needs a specific procedure to
prevent the spread of the disease and not infect others, so follow this point:


Remove large amounts of
solid material like feces from heavily soiled linen, and dispose of the solid
waste in a toilet before placing the linen in the laundry bag.

Avoid sorting linen in patient-care areas. Place contaminated linen
directly into a laundry bag in the isolation room or area with minimal
manipulation or agitation, to avoid contamination of air, surfaces and people.