Infection Control and Precautions

Develop procedures for routine care, cleaning, and disinfection of environmental surfaces, especially frequently touched surfaces in patient care areas.
Standard precautions involve wearing gloves anytime you are about to test anything contaminated or handle equipment to prevent the transfer of microorganisms.
This may include cleaning equipment between uses.
Example: responsibility to wipe down incubators and transport incubators after every use between labor and delivery and the NICU.

Know how to clean, what to clean, and what to clean with.
Cavicide wipes are commonly used in clinical settings (purple top or white with a pink label).
Always wear gloves when using cavicide wipes, as they are toxic to the skin.
Hand hygiene: wash hands before entering and exiting every room.
Some places use foam in and foam out instead of washing, depending on the hospital.
Always wash hands depending on the patient.
In the NICU, scrub up to the elbows before every shift, including cleaning underneath fingernails.

Protocols vary depending on if patients have a central line, which may require chlorhexidine wipes or specific bathing patterns (e.g., bathing every 48 hours).
Each unit has its own protocols based on research, evidence, and quality improvement.

Computer on wheels (wows, formerly cows): wipe down the surface, mouse, and workplace to prevent the spread of bacteria and germs.

Direct contact with a patient can lead to the spread of pathogens.
Wear gown and gloves when touching or near a patient on contact precautions.
Ensure there is a trash disposal in the patient room for disposing of contaminated materials.
Contact precautions are the most common type of precaution in the hospital.
Examples: wound infection, UTI colonized with a resistant organism.
Requires a private room and PPE equipment outside the room, including gowns.
Wear PPE if there are concerns a patient may have MRSA.

Organisms spread through large droplets via mucous membranes through sneezing, coughing, and talking.
Wear a mask when within six feet of a patient on droplet precautions, and eye protection.
Example: patient with a trach who is positive for RSV.

Spread through air currents, requiring a negative pressure room.
Example: Tuberculosis (TB)
Requires an N95 respirator mask.
Notify public health officials (Department of Health) as TB is a public health emergency.
Common in homeless patients.
Wear a gown, gloves, and N95 mask when in a room with a patient who has TB.
Nursing students generally cannot go into rooms with airborne precautions.

Protects the patient from the spread of infection by limiting exposure to the outside world.
Patients need their own private room and PPE if you are close to them; often, the patients themselves wear a mask.
Patients who may need protective isolation: immunocompromised patients (e.g., oncology patients).
It is important to communicate to patients that the isolation is to protect them and prevent the spread of organisms like viruses, bacteria, or fungi to others.

Hospitals follow their own guidelines in addition to CDC guidelines.
Signage on doors indicates necessary precautions.
Airborne precautions only require an N95 mask, not a gown.
Flowers and fruits are often not allowed in protective isolation due to the bacteria they carry.

Sepsis is a quick, fast, and deadly condition, emphasizing the importance of prevention, identification, and treatment of infection.

Everyone is at risk, but higher risk groups include the elderly, immunocompromised, and those with current infections.
Also at risk are the very young, those with recent surgery or breaks in the skin, and those with indwelling catheters or devices.
People who are homeless, college students, and those in nursing homes are also at increased risk.

Use isolation rooms if needed, with dedicated equipment that should not leave the room.
Clean stethoscopes, especially the earpieces, before every shift.
Advocate for and communicate with patients while they are isolated.