Transmission PrecautionsTransmission Precautions

Overview of Policy

J. Iverson Riddle Development Center

Intern: Cynthia Attaway BSN, RN The University of N.C. at Greensboro

Overview Significance of PolicyOverview Significance of Policy

Infections are a significant source of morbidity and mortality

Infections result in an estimated 150,000-200,000 hospital admissions per year

Estimated cost of $673 million -$2 billion annually

Death rate for a resident can reach as high as 40%

Objectives for Nursing StaffObjectives for Nursing Staff

Review Transmission Policy.

Specify Transmission protocols with signs.

Identify Personal Protective Equipment with correct precaution.

Outcomes forOutcomes for Nursing StaffNursing Staff

Nursing staff to educate “Team” of Revised Transmission Policy

Nursing staff to monitor “Team” to follow Transmission Precautions

Transmission-Based PrecautionsTransmission-Based Precautions(A.K.A. Isolation Precautions(A.K.A. Isolation Precautions) )

Refers to actions (precautions) implemented in addition to standard precautions.

Actions that are used for residents with documented or suspected infections or colonized with infectious agents.

Implementation of Transmission-Implementation of Transmission-Based PrecautionsBased Precautions

Important for staff to identify the type of transmission precaution needed for the resident

Communication is essential of transmission-precautions to all “Team” members.

Staff to know the appropriate Personal Protective Equipment (PPE)

PPE readily available

Contact Precautions Contact Precautions

(Yellow Sign)(Yellow Sign)Measures that are intended to

prevent transmission of infectious agents including epidemiological important microorganisms which are spread by direct or indirect contact with the resident or environment.

MRSA

Contact (Special Enteric)Contact (Special Enteric)

Methicillian- Resistant Staphyloccus (MRSA)

Vancomycin- Resistant Enterococci (VRE)

Clostridium Difficile ( C. Diff.)

VREMRSA

C. Diff

Contact ( Special Enteric)Contact ( Special Enteric)

The resident is colonized with MRSA VRE and C. Diff. colonized in the

gastrointestinal tract and continent MRSA or VRE in an intact skin lesion or

wound that is covered with simple dressing

MRSA or VRE in urine and continent or wears briefs where urine is contained.

Must be placed outside the door

www.unc.edu/depts/Spice/resource.html

Droplet PrecautionsDroplet Precautions(Green Sign)(Green Sign)

Respiratory droplets transmit infections directly from the respiratory tract of an infected individual to susceptible mucosal surfaces of the recipient

Facial protection is necessaryCoughing, sneezing, talking,

suctioning, and CPR

Flu

Droplet-Borne Organisms Droplet-Borne Organisms ExamplesExamples

Large particle droplets greater than 5 microns in size

Influenza Mumps Pertussis

Must be placed outside the door

www.unc.edu/depts/Spice/resource.html

Airborne PrecautionsAirborne Precautions

Prevents the transmission of organisms that remain infectious when suspended in the air

Examples: Flu, Varicella Zoster (shingles) and M. Tuberculosis

Management of Airborne Infections Management of Airborne Infections ( Blue Sign)( Blue Sign)

Resident may be transferred to an acute care facility

Single-resident airborne isolation room

Staff caring for the resident should wear mask or respirator

Mycoplasma Tuberculosis

Must be placed outside the door

www.unc.edu/depts/Spice/resource.html

N-95 versus Regular MaskN-95 versus Regular Mask

N-95 Very close fitting Efficient filtration

of airborne particles

Blocks 95% very small particles

Single use

Face Masks

Loose fitting, disposable and physical barrier

Not intended to be used more than once

The Faces of Microorganisms :The Faces of Microorganisms :

Influenza Mycoplasma

(TB)

Clostridium Difficile

MRSA

VRE Pseudomonas

aeruginosa

Personal Protective EquipmentPersonal Protective Equipment

Sequence for Donning Personal Protective Equipment

1. Gown

2. Mask

3. Goggles or Face Shield

4. Gloves

Personal Protective EquipmentPersonal Protective Equipment

Sequence for Removing Personal Protective Equipment

1. Gloves

2. Goggles or Face Shield

3. Gown

4. Mask

Reasons for Non-ComplianceReasons for Non-Compliance

Family centered environment

Alcohol based hand rub is not safe to be placed inside and outside of doors

Residential living environment

Reasons for Non-ComplianceReasons for Non-Compliance

ReferencesReferences Center for Disease Control and Prevention

Guideline for Isolation Precautions www.cdc.gov

Google images J. Iverson Riddle Developmental Center

Policy 3.17 North Carolina Statewide Program for

Infection Control and Epidemiology for (N.C. Spice) Transmission-Based www.unc.edu/depts/Spice/resource.html