1. Transmission Precautions Overview of Policy J. Iverson Riddle Development Center Intern: Cynthia Attaway BSN, RN The University of N.C. at Greensboro

2. Overview 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%

3. Objectives for Nursing Staff Review Transmission Policy. Specify Transmission protocols with signs. Identify Personal Protective Equipment with correct precaution.

4. Outcomes for Nursing Staff Nursing staff to educate “Team” of Revised Transmission Policy Nursing staff to monitor “Team” to follow Transmission Precautions

5. Transmission-Based 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.

6. Implementation of Transmission- Based 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

7. Contact Precautions (Yellow Sign) Contact Precautions (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

8. Contact (Special Enteric) Methicillian- Resistant Staphyloccus (MRSA) Vancomycin- Resistant Enterococci (VRE) Clostridium Difficile ( C. Diff.) VRE MRSA C. Diff

9. 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.

10. Must be placed outside the door www.unc.edu/depts/Spice/resource.html

11. Droplet Precautions (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 necessary Coughing, sneezing, talking, suctioning, and CPR Flu

12. Droplet-Borne Organisms Examples Large particle droplets greater than 5 microns in size Influenza Mumps Pertussis

13. Must be placed outside the door www.unc.edu/depts/Spice/resource.html

14. Airborne Precautions Prevents the transmission of organisms that remain infectious when suspended in the air Examples: Flu, Varicella Zoster (shingles) and M. Tuberculosis

15. Management of Airborne Infections ( 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

16. Must be placed outside the door www.unc.edu/depts/Spice/resource.html

17. N-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

18. The Faces of Microorganisms : Influenza Mycoplasma (TB) Clostridium Difficile MRSA VRE Pseudomonas aeruginosa

19. Personal Protective Equipment Sequence for Donning Personal Protective Equipment 1.Gown 2.Mask 3.Goggles or Face Shield 4.Gloves

20. Personal Protective Equipment Sequence for Removing Personal Protective Equipment 1.Gloves 2.Goggles or Face Shield 3.Gown 4.Mask

21. Reasons for Non-Compliance Family centered environment Alcohol based hand rub is not safe to be placed inside and outside of doors Residential living environment

22. Reasons for Non-Compliance

23. References 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