Care of the isolated patient source isolation nursing
Care of the isolated patient source isolation procedureSubject: Clinical Skills in Adult Nursing
Infection control
Edited by: Jacqueline Randle, Frank Coffey, Martyn Bradbury
Background
• Source isolation aims to prevent infected patients from infecting others.
Procedure: underlying principles
• Decontaminate your hands before and after any contact with the patient.
• Wear the correct personal protective equipment. The choice of personal protective clothing should be determined by a risk assessment of the anticipated contact with the patient.
• Explain the need for isolation and gain consent.
• Isolate the organism, not the patient, and consider the psychological needs of the patient.
• Maintain confidentiality of a patient's diagnosis while ensuring that health care workers (HCWs) and visitors are aware of the appropriate precautions for prevention and control of infection.
• Review the need for isolation regularly.
• The most appropriate type of isolation room should be selected— ideally a room with en-suite facility or a designated isolation ward.
• If isolation is not possible, patients can be cohorted in a bay, with appropriate precautions for prevention and control of infection.
• Furniture and equipment should be kept to a minimum in an isolation room.
• Equipment should, where possible, be single-use only, designated for single-patient use, or easily decontaminated.
• A dedicated team of HCWs should be allocated to caring for the patient/s.
• A trolley or dispenser for protective clothing must be allocated to an isolation room, to provide equipment relevant to the type of special precautions for prevention and control of infection.
• The patient's documents and charts should be kept outside the room.
• Visitors should be encouraged to decontaminate their hands. They do not, generally, need to wear protective clothing, unless they are involved in the practice of care.
• Avoid visits or transfers to other departments, where possible. The department should be notified in advance and the patient should follow other patients.
• Regularly and thoroughly clean, complying with local guidance for cleaning and decontamination. Detergent and hot water are usually recommended.
• Damp-dusting, normally using detergent and hot water, should be undertaken daily using a disposable cloth.
• The floor must be mopped daily.
• Soiled linen and clinical waste must be treated as infectious and bagged correctly and stored in a secure collection area.
• Spillages must be dealt with promptly, according to local policy.
• On discharge or death of the patient, ensure terminal cleaning of the room.
• Change curtains if they are soiled or the room has been occupied by a patient with an airborne infection.
• The room can be occupied by another patient after thorough cleaning has taken place.
Practice tips
• Adhere to local guidance that designates specific responsibilities for enhanced and terminal cleaning of the room and equipment.
• HCWs should use the correct colour-coded cleaning equipment.
Pitfalls
• HCWs not fully understanding the procedures and policies relating to isolation.
• Not considering the psychological needs of the patient with the result that they feel isolated and vulnerable.
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