Basic Infection Control
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Safety
- Wear PPE when the anticipated patient interaction indicates that contact with blood or bodily fluids may occur. Wear gloves when it is likely that you will touch blood, bodily fluids, secretions, excretions, nonintact skin, mucous membranes, or contaminated items or surfaces.
- Remove your gloves and perform hand hygiene between patient care encounters and when moving from a contaminated body site to a clean one.
- Use nonlatex gloves if the patient is allergic to latex.
- When there is a risk of excessive soiling, wear a gown that is impervious to moisture.
- Protect fellow health care workers from exposure to infectious agents through proper use and disposal of equipment.
Equipment
(Roll cursor over items to see labels)
Clean gloves
Face shield
Face mask
Respirator
Goggles or other eyewear
Nonimpervious gown
Impervious gown
Sign for the door indicating the type of isolation
PrintableDelegation
The skill of caring for patients under isolation precautions can be delegated to NAP. However, you must first assess the patient’s status and isolation indications. Be sure to inform NAP of the following:
- Special precautions regarding individual patient needs, such as transportation to diagnostic tests.
- Precautions about bringing equipment into the patient’s room.
- High-risk factors for infection transmission that pertain to the assigned patient.
Preparation
- Assess the need for personal protective equipment (PPE) for each task you plan to perform and for all patients, regardless of their diagnoses.
- Review the patient’s medical history for possible indications for isolation, for example, risk factors for TB, major draining wound, or purulent productive cough.
- Review laboratory test results.
- Consider the types of care measures you will perform while in the patient’s room, such as medication administration or a dressing change.
- Review the nursing care plan and notes, or confer with colleagues regarding the patient’s emotional state and his or her reaction and adjustment to being in isolation.
- Determine from the nursing care plan, medical record, or significant other if the patient and the family understand the purpose of isolation procedures.
Follow-up
- While in the patient’s room, ask if he or she has had a chance to discuss any health problems, the course of treatment, or other topics that are important to him or her.
- Ask the patient to describe the purpose of the isolation, and give him or her a chance to ask questions.
Documentation
Document any procedures performed and the patient’s response to social isolation. Also document any patient education performed or reinforced.
Review Questions
1. Which personal protective equipment (PPE) will the nurse wear if there is a risk of a blood splash when caring for a patient?
2. What will the nurse do first when preparing to apply personal protective equipment (PPE) before caring for a patient in isolation?
3. The nurse is discussing the guidelines for proper use of PPE by nursing assistive personnel (NAP). Which statement made by the NAP requires follow-up by the nurse?
"When in doubt, I wear gloves."
"I really dislike wearing a mask, so it's the first thing I take off."- "I always do hand hygiene when entering and leaving a patient's room."
- "I wear a mask whenever I am caring for a patient who's coughing."
4. When removing a gown worn as personal protective equipment (PPE) while caring for a patient in isolation, why does the nurse avoid touching the outside of the gown?
- To ensure that the gown can be reused
- To protect the nurse’s uniform
- To prevent touching contaminated material with unprotected hands
- To fold the gown correctly for reuse by the same nurse
5. When delegating patient care that requires nursing assistive personnel (NAP) to use personal protective equipment (PPE), it is necessary for the nurse to do what first?
- Discuss what equipment and supplies to bring into the patient's room
- Document that the care was delegated to the NAP
- Review the patient's need for a specific isolation precaution
- Observe the NAP donning the appropriate PPE
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