Changes to Isolation Guidelines Changes to Isolation Guidelines (effective July 1, 2005)

Why are the Guidelines Changing? reduce the number of isolation patients target patients and transmission methods with the highest risk of transmission promote the appropriate use of isolation supplies improve the quality of isolation practices at GWUH

In Service Objectives Participants will be able to : – State the color code for each isolation category – Discuss the proper selection and use of gowns, gloves and mask for isolation precautions – List at least two methods of interdepartmental communication of patient isolation status – Identify changes to use of gowns and mask for patient transport – Discuss changes to isolation requirements for patients with MRSA or VRE in the blood and patients who are colonized with MRSA or VRE

ISOLATION COLOR CODES AIRBORNE (blue sign) TB, chicken pox and measles CONTACT (pink sign) MRSA, VRE,C Diff, shingles DROPLET (green sign) influenza, bacterial meningitis

CONTACT ISOLATION REVIEW Gloves are required to enter the room Gowns required for extensive contact with patient, ( repositioning, bathing, dressing change, etc.). Patient must have dedicated non-critical equipment ( BP cuff, stethoscope, tourniquet,etc.) Ensure any dressings dry and intact prior to transport Assist patient with hand hygiene prior to transport

AIRBORNE ISOLATION REVIEW Place patient in a negative pressure room Door to the room needs to remain closed All staff wear N95 (duckbill mask) when entering the room N95 mask is removed after leaving the patient room Negative pressure in room is monitored and recorded daily while in use (nursing) Room must be vacant at least 30 minutes before being used for another patient

DROPLET ISOLATION REVIEW Wear surgical mask for all entry into the room Mask may be removed at door or immediately after leaving the patient’s room and disposed of in the regular trash container

Which mask should I use? Activity N95 Duckbill Mask Surgical Mask (one with ties) Entering a airborne isolation room YESNO Entering Droplet Isolation Room NOYES Placing a mask on a patient at anytime NOYES Activity with patient on standard precautions NOYES

WAYS TO COMMUNICATE ISOLATION STATUS All charts should have isolation sticker on front of chart ( nurse is responsible). Other departments will be notified of isolation when orders are entered into SMS placed or when services are requested by phone. All patient boards should identify isolation patients by “letter” or “Color” code placed next to patient name on board. Information regarding resistant organisms from a previous admission will be entered on the infection control advisory by infection control

ADDITIONAL CHANGES Disposable dishes no longer required Patients on contact isolation do not need to wear gowns and gloves when being transported When mask required for patient only use surgical mask

MRSA and VRE ISOLATION Patients colonized with with MRSA or VRE will not require isolation. Patients with MRSA or VRE in blood will not require isolation MRSA or VRE in wounds will require isolation MRSA or VRE in urine or stool will require isolation if : the patient is diapered or incontinent or if the patient has an invasive GI or GU device is foley or rectal tube.

ISOLATION REMINDERS Remove gown, gloves and mask (except N 95-duckbill mask) before leaving patient room Gown, gloves, mask are not to be worn outside the patient room. se proper hand hygiene before or immediately after leaving patient’s room