Transmission Precautions

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-precau
  tions to all Team members.
• Staff to know the appropriate Personal Protective
  Equipment (PPE)
• PPE readily available

7
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
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Contact (Special Enteric)

• Methicillian- Resistant Staphyloccus (MRSA)
• Vancomycin- Resistant Enterococci (VRE)
• Clostridium Difficile ( C. Diff.)

C. Diff
MRSA
VRE
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
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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
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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

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The Faces of Microorganisms
Mycoplasma (TB)
Influenza
MRSA
Clostridium Difficile
Pseudomonas aeruginosa
VRE
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Personal Protective Equipment

• Sequence for Donning Personal Protective
  Equipment
• Gown
• Mask
• Goggles or Face Shield
• Gloves

20
Personal Protective Equipment

• Sequence for Removing Personal Protective
  Equipment
• Gloves
• Goggles or Face Shield
• Gown
• Mask

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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

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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/resourc
  e.html