Review of Transmission
Precautions
Devon Werner, PT, DPT, NCS
Pt 8490 Medically Complex Patients
Lecture Objectives
• By the end of lecture, students will be able to:
1.
Independently apply various types of isolation
precautions to patient cases for safe physical
therapy care. (CO 13, LO 1)
2.
Identify the correct personal protective equipment
that is needed for various isolation precautions.
(CO 12, LO 1)
3.
Correctly describe how to maintain a clean working
environment for patient safety. (CO 12, LO 1)
Why is all this Important?
• Healthcare Associated Infections1-5
• 5.7-19% prevalence in low to middle income countries
• In Europe 7.1% prevalence and cost 7 billion
• In US, 1 in 25 patients
• 3.2 to 4.2 billion to treat MRSA
• 1.45 to 1.62 billion to treat C diff
• 4.4 – 88.9% prevalence in the ICU
Why is all this Important?
• Healthcare Associated MRSA Infections6-7
• Clinical manifestations: PNA, sepsis, blood-stream infections, postop wound infections, UTI, skins/soft tissue infections
• Occur with current or recent hospitalization, residence in longterm care facility, presence of invasive devices, recent antibiotic
use
• Patient to patient, HCP to patient, contaminated equipment
• Community Associated MRSA Infections
• Different presentation
Standard
Contact
Types of
Precautions
Droplet
Airborne
Enteric
Standard
• Standard precautions are the minimum degree of
protection against the transmission of pathogens in the
hospital setting
• Hand Hygiene
• (soap or alcohol gel)
• Gloves
• Cough Etiquette
Contact
• Gloves
• Gown
• A gown is donned if you anticipate having direct
contact with the patient or with items that may
contaminate your clothing
• (clinically, it is a bit hard to mobilize a patient
without a direct contact)
Droplet
• Face mask
• Gloves
• Eye covering (potentially)
Gowns should be worn if you anticipate that your
clothing may become contaminated with infectious
materials.
Airborne
(Negative Pressure Room)
• N-95 respirator mask
• Gloves
Gown may be worn based on precautions if potential is
present to come into contact with contaminated
materials.
NEGATIVE PRESSURE ROOM REQUIRED
Don before entering, Doff AFTER leaving pressure room
Enteric (C-Diff)
• Standard precautions are the minimum degree of
protection against the transmission of pathogens in the
hospital setting
• Hand Hygiene
• (MUST BE SOAP and WATER)
• Gloves
• Gown
• MUST USE BLEACH
Cleaning for Infection
Prevention
References
1.
2.
3.
4.
5.
6.
7.
8.
World Health Organization. Health care-associated infections fact sheet. Save
lives clean your hands.
http://www.whoint/gpsc/country_work/gpsc_ccisc_fact_sheet_en_pdf.
Accessed May 1, 2017.
Centers for Disease Control and Prevention. Healthcare associated infections
(HAIs). http://www.cdc.gov/HAI/surveillance/index.html. Published March
26, 2014. Updated September 15, 2014.
Scott RD. Direct Medical Costs of Healthcare-associated infections in U.S.
hospitals and the benefits of prevention. Center for Disease Control and
Prevention 2009.
Harvard Health Publications. Proper hand washing technique: how to wash
your hands properly. 2007.
APIC. Hand hygiene for healthcare workers. 2005.
Calfee D, Salgado C, Classen D et al. Strategies to prevent transmission of
methicillin-resistant Staphylococcus aureus in acute care hospitals. Infect
Control Hosp Epidemiol. 2008. 29:S62-80.
Huang R, Metha S, Weed D, Price C. Methicillin-resistant Staphylococcus
aureus survival on hospital fomites. Infect Control Hosp Epidemiol. 2006.
27(11);1267-1269.
Kim M, Kim J, Jo H, et al. High isolation frequency of Acinetobacter
baumannii from physical therapy departments of geriatric care hospitals and
antiboiotic resistance patterns of isolated pathogens. J Phys Ther Sci. 2012.
24(1):105-109.