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Transmission Precautions. Overview of Policy J. Iverson Riddle Development Center Intern: Cynthia Attaway BSN, RN The University of N.C. at Greensboro. Overview Significance of Policy. Infections are a significant source of morbidity and mortality
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Transmission Precautions Overview of Policy J. Iverson Riddle Development Center Intern: Cynthia Attaway BSN, RN The University of N.C. at Greensboro
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%
Objectives for Nursing Staff • Review Transmission Policy. • Specify Transmission protocols with signs. • Identify Personal Protective Equipment with correct precaution.
Outcomes forNursing Staff • Nursing staff to educate “Team” of Revised Transmission Policy • Nursing staff to monitor “Team” to follow Transmission Precautions
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.
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
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
Contact (Special Enteric) Methicillian- Resistant Staphyloccus (MRSA) Vancomycin- Resistant Enterococci (VRE) Clostridium Difficile ( C. Diff.) C. Diff MRSA VRE
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 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
Droplet-Borne Organisms Examples • 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 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 ( 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 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 N-95 versus Regular Mask
The Faces of Microorganisms : Mycoplasma (TB) Influenza MRSA Clostridium Difficile Pseudomonas aeruginosa VRE
Personal Protective Equipment • Sequence for Donning Personal Protective Equipment • Gown • Mask • Goggles or Face Shield • Gloves
Personal Protective Equipment • Sequence for Removing Personal Protective Equipment • Gloves • Goggles or Face Shield • Gown • Mask
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
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