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Chapter 34 - Isolation Technique

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Chapter 34 - Isolation Technique Powered By Docstoc
					                          BAKERSFIELD COLLEGE
                 LICENSED VOCATIONAL NURSING PROGRAM

                          1ST SEMESTER FUNDAMENTALS

                   SCIENTIFIC BASIS FOR NURSING PRACTICE

CHAPTER 34 - ISOLATION TECHNIQUE

INTRODUCTION

Often clients acquire infectious diseases that can easily be transmitted to other clients,
family members, or health care personnel. If special measures were not used to prevent
the spread of communicable diseases, they would spread rapidly throughout a health care
institution.

OBJECTIVES

Upon completion of this unit, the student will be able to:
A.    Theory
      1.     Identify and describe the two systems used for implementation of
             protective asepsis (isolation).
      2.     State the purpose of each category-specific isolation technique.
      3.     Identify the barriers required to maintain protective asepsis for each
             specific isolation technique.
      4.     Identify diseases or conditions that are controlled in each category-specific
             isolation.
      5.     Recognize the psychological implications of isolation.
      6.     List measures used to improve the client’s sensory stimulation during
             isolation.
      7.     Describe a protective environment.
      8.     State the primary reason for gowning, gloving, and using a face mask.
      9.     Describe how to give nursing care in an isolation room.
      10.    State how to collect a specimen from an isolation room.
      11.    Describe how to transport an isolation client to another service.

ASSIGNMENT

   A.      Read Chapter 34- Potter & Perry

   B.      Study Guide for Chapter 34 – questions related to isolation precautions
 CATEGORY Specific Isolation – Chapter 34

 Often clients acquire infectious diseases that can easily be transmitted to other
  clients, family members, or health care personnel
 If special measures were not used to prevent the spread of communicable
  diseases, such as measles and tuberculosis, they would spread rapidly throughout
  a health care institution
 In 1983 the CDC published revised guidelines for isolation precautions


 Disease-Specific System
     – Certain practices are followed for each infectious disease


 Category-Specific Isolation
     – 7 commonly used categories
             Strict
             Contact
             Respiratory
             Enteric
             TB
             Drainage/secretions
             Universal blood/body fluids


   The New System - 1996
   TIER 1 – STANDRD PRECAUTIONS
   Apply to all
   BLOOD
   ALL BODY FLUIDS, SECRETIONS AND EXCRETIONS
   NON-INTACT SKIN
   MUCOUS MEMBRANES



 PRECAUTIONS INCLUDE:
 Handwashing between client contact, after contact with blood or body fluids,
  non-intact skin and mucous membranes
 Gloves are worn during contact with blood, body fluids, secretions, excretions,
  non-intact skin, mucous membranes, or contaminated items
 Masks, eye protection, face shields if anticipate splashing
 Gowns are worn if soiling of uniform is likely
 Client care equipment is cleaned
 Contaminated linen is placed in leak-proof bag
 All sharps are placed in a puncture-proof container
 Private room is unnecessary

 Tier II – Transmission Categories
 AIRBORNE PRECAUTIONS
 droplet nuclei smaller than 5 um; chicken pox, TB; require private room with
  negative air flow, mask


 Tier II – Transmission Categories
 DROPLET PRECAUTIONS
 droplet precautions – droplets larger than 5 um; rubella, pneumonia; require
  private room or cohort clients, mask


 Tier II – Transmission Categories
 CONTACT PRECAUTIONS
 direct client of environmental contact; enteric pathogens, wound infections,
  scabies, varicella zoster (shingles); require private room or cohort clients, gloves,
  gowns


 Psychological Implications of Isolation
 Body Image May be Altered
 Interventions
      – Teach client and family now to prevent spread of disease
      – Provide sensory stimuli
      – Deliberately plan time to see the client


 Protective Environment
 Reduces possibility of transmission
 Cohort clients
 Avoid taking articles into the room that is to be reused outside of the isolation
  room
 Use disposable supplies if available


 Protective Clothing
 Gowns
     – Prevent soiling of clothing
 Masks
     – Prevent inhalation of microorganisms
     – Change every ½ hour or when moist
 Gloves
     – Prevent transmission of pathogens by direct and indirect contact
 Delivering Care in Isolation
 Medication administration
     – Med cart remains outside room
     – Take in only med cup and discard in room
     – Wear precautions as needed
     – Delivering Care in Isolation


 Use precautions to prevent cross-contamination if all equipment used cannot
  remain in room
     – BP cuff
     – Stethoscope
     – Wristwatch
     – Specimen collection
     – Bagging articles
              Prevents accidental contamination


 Remove protective clothing
     – Never leave an isolation room while wearing an isolation gown
 Transporting clients
     – Clean gown for client
     – Use isolation gown as the client’s robe
     – Respiratory client wears a mask
     – Transporting personnel should wear masks and gowns as needed
     – Use extra layer of sheets to cover gurney
     – Notify receiving dept. of isolation


   Role of the Infection Control Nurse
   Nurses who are especially trained in infection prevention and control
   Advise hospital personnel regarding infection control
   Monitor infections within the hospital
   Infection control professional can be a valuable resource for assisting nurses in
    controlling nosocomial infections

				
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