INFECTION CONTROL/EXPANDED

PRECAUTIONS

In addition to standard precautions, Ambercare personnel will follow strict specifications when caring for patients with infectious diseases.

POLICY

Airborne Precautions as Recommended by the CDC Designed to prevent transmission of infectious

diseases primarily over short distances through airborne droplet nuclei.

Diseases which require airborne precautions are: Measles Varicella (including disseminated zoster) Tuberculosis (active pulmonary or laryngeal) Smallpox SARS

GUIDELINES

Keep patient in one room of the home as much as possible (unless household members are immune – i.e., chickenpox)

N95 respiratory mask must be worn by all Ambercare personnel that comes into contact with patient with suspected or known ACTIVE pulmonary or laryngeal TB

Patient must wear a surgical mask when he/she comes out of room

Gloves are indicated for contact with respiratory secretions

Standard/contact precautions must be followed as well (hand washing before and after touching the patient or potentially contaminated articles)

Articles, including linen must be thoroughly cleaned, disinfected, or discarded

Do NOT use fans in patient’s room

SPECIFICATIONS FOR AIRBORNE PRECAUTIONS

Droplet precautions are used for patients with known or suspected serious illnesses transmitted by large particle droplets . Diseases which require droplet precautions are: Hemophilus Infl uenza (type B) including meningitis,

pneumonia, epiglottitis, and sepsis Neisseria Meningitidis (including meningitis, pneumonia,

and sepsis) Diphtheria (pharyngeal) Mycoplasma pneumonia Pertussis (whooping cough) Staphylococcal (group A) pharyngitis, pneumonia, or

scarlet fever in infants and young children Pneumonic plague

INDICATIONS OF DROPLET PRECAUTIONS

AdenovirusInfluenzaMumpsParvovirus B19Rubella

SERIOUS VIRAL INFECTIONS SPREAD BY DROPLET

TRANSMISSION

Place patient in a room away from susceptible individuals Surgical masks may be worn when working within 3 feet of

the patient and until sputum smear is negative on culture Instruct patient to cover his/her mouth and nose

when coughing or sneezingPatient should NOT share personal items such as

drinking cupsNo fans in patient’s roomPregnant personnel susceptible to RUBELLA SHOULD

NOT TAKE CARE OF PATIENTS WITH RUBELLA!

SPECIFICATIONS FOR DROPLET PRECAUTIONS

Contact precautions are used for patients with known or suspected serious illnesses easily transmitted by direct patient contact or by contact with items in the patient’s environment; they include diseases such as:

GI, respiratory, skin, or wound infections or colonization with multidrug-resistant bacteria (MRSA for example)

Enteric infections including C-Diff; E-Coli; Shigella, Hep A or Rotavirus

CONTACT PRECAUTIONS

Diptheria (cutaneous)Herpes simplex virusImpetigoMajor (noncontained) abscesses, cellulitis,

or decubitiPediculosisScabiesZoster Viral hemorrhagic conjunctivitis

Ebola, Lassa, Marburg

HIGHLY CONTAGIOUS SKIN INFECTIONS

Minimize number of staff members assigned to patientMake eff orts to schedule patient as the last visit of the

day if possibleWhen feasible, leave nursing bag in car – take in only

minimal number of required supplies into home When feasible, leave stethoscope and blood pressure

cuffs in the home until precautions are discontinued. Upon removal staff member must follow decontamination protocol (dirty bin placement at offi ce) for proper disinfection.

Clean and disinfect contaminated patient care items, equipment, and surfaces on a daily basis

Linen and laundry require NO special treatment

SPECIFICATIONS FOR CONTACT PRECAUTIONS

Gloving when entering room of patient infected or colonized with multidrug-resistant microorganisms, otherwise use of gloves with patient contact

Gloves must be removed prior to leaving patient room – hands washed immediately after – with antimicrobial soap and water

Gowning is required when: Substantial contact with patient, environmental surfaces,

etc. Patient is incontinent, has diarrhea, an ileostomy,

colostomy or uncontained wound drainage The gown should NOT be worn outside patient room – and

NOT removed until ready to leave the room – must be discarded properly

SPECIFICATIONS FOR CONTACT PRECAUTIONS CONTINUED