NUR 113: SKILL 7-2: CARING FOR PATIENTS UNDER ISOLATION PRECAUTIONS. SKILL 7-2: Caring for Patients Under Isolation Precautions.
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When a patient has a known or suspected source of colonization or infection, health care workers follow specific infection prevention and control practices to reduce the risk of cross-contamination to other patients.
Certain procedures performed at a patient’s bedside require the application of personal protective equipment (PPE) such as a mask, cap, eyewear, gown or gloves.
Standard precautions require you to wear clean gloves before coming in contact with mucous membranes, non-intact skin, blood, body fluids, or other infectious material.
Masks are worn when there is the risk of splash during a procedure or when certain sterile procedures such as changing a central line dressing are performed.
Protective eyewear and masks become important when there is a risk for splash or blood or other body fluids to the eyes or mouth.
A. Place specimen containers on clean paper towel in patient’s bathroom.
B. Follow agency procedure for collecting specimen of body fluids.
C. Transfer specimen to container without soiling outside of container. Place container in plastic bag and place label on outside of bag or per agency policy. Label specimen in front of patient. Perform hand hygiene and re-glove if additional procedures are needed.
D. Check label on specimen for accuracy. Send to laboratory (warning labels are often used, depending on agency policy). Label containers of blood or body fluids with a biohazard sticker.
10. Dispose of linen, trash, and disposable items.
A. Use single bags that are impervious to moisture and sturdy to contain soiled articles. Use double bag if necessary for heavily soiled linen or heavy wet trash.
B. Tie bags securely at top in knot
11. Remove all reusable pieces of equipment. Clean any contaminated surfaces with hospital approved disinfectant.
12. Resupply room as needed. Have staff colleague hand new supplies to you.
13. Leave isolation room. Order of removal of PPE depend on what you wear in room. This sequence describes steps to take if all barriers are worn.
A. Remove gloves. Remove one glove by grasping cuff and pulling glove inside out over hand. Hold removed glove in gloved hand. Slide fingers of ungloved hand under remaining glove at the writs. Peel glove off over first glove. Discard gloves in the proper container.
B. Remove eyewear, face shield, or goggles. Handle by headband or earpieces. Discard in proper container.
C. Untie neck strings and then untie back strings of the gown. Allow the gown to fall from the shoulders; touch inside of gown only. Remove hands from sleeves without touching outside of gown. Hold gown inside at shoulder seams and fold inside out into a bundle; discard in the laundry bag.
D. Remove mask. If the mask secures over the ears, remove elastic from the ears and pull the mask away from the face. For a tie-on mask, untie bottom mask string and then top strings, pull mask away from the face and drop it into the trash receptacle (do not touch outer surface of the mask).
F. Retrieve wristwatch and stethoscope (unless items must remain in the room) and record vital sign values on note paper.
G. Explain to the patient when you plan to return to the room. Ask whether the patient requires any personal care items. Offer books, magazines, audiotapes.
H. Dispose of all contaminated supplies and equipment in manner that prevents the spread of microorganisms to other persons (see agency policy). Perform hand hygiene.
I. Leave room and close the door, if necessary. Close the door if the patient is on airborne precautions or in a negative airflow room. – This maintains negative airflow environment and reduces transmission of micro-organisms.