Isolation (Unit 2)

Asepsis Absence of disease-producing microbes.

Antisepsis Processes or chemicals that kill microbes or prevent them from causing infection.

Medical asepsis Clean technique; reduces the number of microbes and prevents their spread.

Surgical asepsis Sterile technique; practices used to remove ALL microbes.

Sterile Complete absence of all microbes.

Sterile field A work area free of ALL microbes, including spores.

Sterilization Process that destroys ALL microbes, including spores.

Disinfection Process of killing many pathogens, but NOT necessarily spores.

Disinfectant A chemical used to kill many or most pathogens, but not spores.

Contamination Process of becoming unclean.

Cross-contamination Passing microbes from one person/object to another through contaminated hands, equipment, or supplies.

Infection Invasion and growth of microbes in the body.

Infection control Practices and procedures used to prevent the spread of infection.

Healthcare-associated infection (HAI) An infection related to receiving healthcare that develops while a person is being cared for.

Pathogen A harmful microbe that can cause infection.

Non-pathogen A microbe that usually does not cause infection.

Normal flora Microbes that normally live and grow in certain areas of the body.

Microorganism A tiny living organism, or microbe, that can usually only be seen with a microscope.

Spore A bacterium protected by a hard shell; spores are NOT destroyed by normal disinfection.

Immunity Protection against a certain disease.

Vaccination Giving a vaccine to produce immunity against an infectious disease.

Carrier A human or animal that carries microbes and can spread them without developing the infection.

Vector An animal or insect that carries and transmits disease.

Vehicle A substance or material that transmits microbes.

Types of microbes Bacteria, fungi, protozoa, rickettsiae, and viruses.

What do microbes need to live and grow? A reservoir; common reservoirs include people/animals, soil, food, and water.

Chain of infection Infectious agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host.

Infectious agent The pathogen/germ that causes the infection.

Reservoir The place where a pathogen lives and grows.

Portal of exit The way a pathogen leaves its reservoir.

Mode of transmission The way a pathogen travels from one place/person to another.

Portal of entry The way a pathogen enters a new person.

Susceptible host A person who is more likely to become infected.

Who is more susceptible to infection? Very young/older adults, people who are ill, immunocompromised people, burn patients, transplant patients, and chemotherapy patients.

Common signs of infection Fever, nausea, chills, and fatigue. Older adults may have less obvious symptoms and can sometimes show confusion.

Multi-drug resistant organisms (MDROs) Microbes that have become resistant to medications that would normally kill them.

Why should antibiotics be finished as prescribed? Stopping them improperly can contribute to antibiotic resistance.

MRSA Methicillin-resistant Staphylococcus aureus; can cause serious infections and requires CONTACT precautions.

VRE Vancomycin-resistant Enterococci; resistant to vancomycin and requires CONTACT precautions.

Biohazardous waste Items contaminated with blood, body fluids, secretions, or excretions.

Communicable disease A disease caused by a pathogen that spreads easily from person to person.

OPIM Other Potentially Infectious Materials.

CDC Centers for Disease Control and Prevention.

PPE Personal Protective Equipment; clothing/equipment worn to protect against hazards or infection.

Standard Precautions Infection-control practices used with EVERY patient regardless of known infection status.

Main parts of Standard Precautions Hand hygiene, appropriate PPE, respiratory hygiene/cough etiquette, cleaning equipment/environment, and safe handling of textiles/laundry.

When should PPE be used? When exposure to blood, body fluids, secretions, excretions, or other infectious material is possible.

What protects against splashes or sprays? Goggles or a face shield.

Donning PUTTING ON PPE.

PPE donning order Gown → Mask/Respirator → Goggles/Face Shield → Gloves.

Doffing REMOVING PPE.

PPE doffing order Gloves → Goggles/Face Shield → Gown → Mask.

Why are gloves removed first? They are usually the most contaminated piece of PPE.

When should PPE be removed? Before leaving the isolation area according to facility procedure; plan your care so unnecessary entries/exits are limited.

Gowns in isolation Generally single-use for an isolation encounter; discard appropriately after use.

Transmission-Based Precautions Extra precautions used IN ADDITION to Standard Precautions for infections spread in specific ways.

Three Transmission-Based Precautions Contact, Droplet, and Airborne.

Contact Precautions Used for infections spread by direct or indirect contact; usually wear gloves and gown.

Contact Precautions examples MRSA, VRE, C. diff/diarrheal illness, RSV, and certain wound infections.

Contact Precautions equipment Use disposable or dedicated equipment when possible and limit unnecessary transport.

Droplet Precautions Used for pathogens spread through respiratory droplets from coughing, sneezing, or talking.

Droplet Precautions examples Influenza, pneumonia, whooping cough, and bacterial meningitis.

Droplet Precautions PPE Wear a mask when entering/when required by precautions.

Patient transport on Droplet Precautions Limit transport; patient wears a mask when transported.

Airborne Precautions Used for pathogens that remain suspended in the air and can spread through the airborne route.

Airborne Precautions examples Tuberculosis, measles, chickenpox, smallpox, and disseminated shingles.

Airborne Precautions room Negative-pressure airborne infection isolation room (AIIR).

Airborne Precautions PPE N95 respirator or other approved respirator.

Patient transport on Airborne Precautions Limit transport; patient wears a mask when transported.

Isolation room rule Gather everything you need BEFORE entering to avoid unnecessary trips in and out.

Isolation employee rule Do not enter when ill with symptoms such as vomiting, diarrhea, or other potentially infectious symptoms; follow facility policy.

Clean vs. dirty Keep clean items away from contaminated/dirty items and work from clean areas toward dirty areas.

Single-use equipment Throw it away after use.

Reusable equipment Clean and disinfect it properly between patients.

Basic cleaning sequence Wear PPE → work clean to dirty → remove organic matter → wash/scrub → rinse/dry → disinfect or sterilize as required → remove PPE → hand hygiene.

When must soap and water be used? When hands are visibly dirty and for infections such as C. diff where spores are a concern.

C. diff special hand hygiene Wash hands with SOAP AND WATER; do not rely only on alcohol-based hand sanitizer.

What helps remove/kill C. diff spores? Thorough soap-and-water handwashing removes spores from hands; use an appropriate sporicidal disinfectant such as bleach-based products for contaminated environmental surfaces per facility policy.

C. diff precautions CONTACT precautions.

C. diff PPE Gloves and gown.

C. diff C. difficile is a bacterium that causes diarrhea/colitis and forms hardy spores.

C. diff common symptoms Watery diarrhea, abdominal pain/cramping, fever, and nausea.

C. diff major risk factors Recent antibiotic use, healthcare exposure, older age, and weakened health/immunity.

C. diff prevention Handwashing with soap and water, proper PPE, environmental cleaning with a sporicidal product, and careful antibiotic use.

Tuberculosis (TB) A bacterial infection that usually affects the lungs and spreads through the AIR.

TB precautions AIRBORNE precautions.

TB PPE N95 respirator or approved respirator.

TB room Negative-pressure AIIR.

TB common symptoms Persistent cough, chest pain, fever, night sweats, fatigue, and weight loss.

TB prevention Airborne precautions, appropriate respiratory protection, screening/testing, and completing prescribed treatment.

Influenza (Flu) A contagious viral respiratory infection.

Influenza precautions DROPLET precautions.

Influenza common symptoms Fever, cough, sore throat, body aches, headache, and fatigue.

Influenza prevention Annual flu vaccination, hand hygiene, respiratory/cough etiquette, and avoiding spread when sick.

Pneumonia An infection/inflammation of the lungs that can be caused by bacteria, viruses, or other organisms.

Pneumonia precautions DROPLET precautions when required for the infectious cause; follow the patient's ordered precautions.

Pneumonia common symptoms Cough, fever, chills, shortness of breath, chest discomfort, and fatigue.

Pneumonia in older adults Older adults may have less obvious symptoms and may develop confusion.

Pneumonia CNA care Monitor/report breathing changes, position for easier breathing, assist with fluids/nutrition as ordered, encourage mobility as appropriate, and follow infection-control precautions.

Shingles Reactivation of the varicella-zoster virus, the same virus that causes chickenpox.

Why does shingles occur? The chickenpox virus stays dormant in nerve tissue and can reactivate later.

Shingles risk factors Older age, weakened immune system, immunosuppressive medications, chronic health conditions, and severe stress.

Shingles common symptoms Pain, burning, tingling, or itching followed by a blistering rash, usually on one side of the body.

Shingles rash pattern Usually follows the path of a nerve on one side of the body.

Shingles duration Rash usually scabs over in about 7–10 days and clears in roughly 2–4 weeks.

Disseminated shingles precautions AIRBORNE + CONTACT precautions.

Shingles complications Can include long-lasting nerve pain; eye involvement can threaten vision; secondary skin infection can also occur.

Shingles diagnosis Often diagnosed from the characteristic rash; blister fluid can be tested with PCR when needed.

Shingles prevention Shingles vaccination greatly lowers the risk of shingles and complications in eligible people.

HIV Human Immunodeficiency Virus; attacks the immune system, especially CD4 cells.

AIDS Acquired Immunodeficiency Syndrome; the most advanced stage of HIV infection.

How is HIV transmitted? Through certain body fluids, including blood, semen, vaginal/rectal fluids, and breast milk.

How is HIV NOT spread? Not through normal casual contact such as hugging, sharing a room, or touching intact skin.

HIV precautions STANDARD precautions unless another infection requires additional Transmission-Based Precautions.

HIV treatment Antiretroviral therapy (ART) suppresses the virus and protects the immune system.

HIV prevention Use Standard Precautions with blood/body fluids; medical prevention also includes testing and appropriate preventive treatment.

Hepatitis Inflammation of the liver; Hepatitis A, B, and C are caused by different viruses.

Hepatitis A transmission Primarily fecal-oral transmission, often through contaminated food/water or close personal contact.

Hepatitis A course Usually an acute infection and does NOT become chronic.

Hepatitis A prevention Vaccination, hand hygiene, safe food/water practices.

Hepatitis B transmission Blood and certain body fluids; can spread through sexual contact, shared needles, or from mother to baby during birth.

Hepatitis B course Can be acute OR chronic.

Hepatitis B prevention VACCINE is available; also prevent blood/body-fluid exposure.

Hepatitis C transmission Primarily through blood-to-blood exposure, especially shared needles or contaminated blood exposure.

Hepatitis C course Can become chronic and cause serious liver damage.

Hepatitis C vaccine There is NO vaccine for Hepatitis C.

Hepatitis B vs. C vaccine Hepatitis B = vaccine available. Hepatitis C = NO vaccine.

Hepatitis common symptoms Fatigue, nausea, abdominal discomfort, loss of appetite, dark urine, and jaundice; some people have few or no symptoms.

Which hepatitis is fecal-oral? Hepatitis A.

Which hepatitis types are commonly blood/body-fluid related? Hepatitis B and Hepatitis C, with Hepatitis C primarily bloodborne.

CNA priority with infections Follow precautions/PPE, perform hand hygiene, avoid cross-contamination, observe the patient, and REPORT changes to the nurse.

Why are isolation precautions used? To prevent infectious organisms from spreading between patients, staff, visitors, and the environment.

How should a person in isolation be treated emotionally? Provide normal respectful care, explain precautions, communicate, and help prevent unnecessary loneliness or isolation.

Transporting an isolation patient Limit transport to necessary reasons and follow the required precautions, including masking the patient when indicated.

Why limit transport during Transmission-Based Precautions? To reduce the chance of spreading pathogens to other people and areas.

Bagging contaminated items Place contaminated items into the proper bag/container without contaminating the outside.

Double-bagging Use when the outside of the first bag becomes contaminated or when required by facility policy; a clean person can hold the second bag outside the room.

Most important overall infection-control habit Proper hand hygiene.

Best way to break the chain of infection Interrupt any link—especially through hand hygiene, PPE, cleaning/disinfection, respiratory hygiene, and proper isolation precautions.