Editing Infection Control and Safety – RN Flashcards (section)

== Precautions ==

;To whom do standard precautions apply?
:'''Every client, every time, regardless of diagnosis.''' All blood, body fluids, secretions and excretions '''except sweat''', non-intact skin, and mucous membranes are treated as infectious.
;List the elements of standard precautions.
:Hand hygiene; PPE by anticipated exposure; respiratory hygiene and cough etiquette; safe injection practices; safe handling of equipment, linens, and the environment; sharps safety; sterile technique for spinal and epidural procedures; and risk-based patient placement.
;When are transmission-based precautions initiated?
:'''On clinical suspicion, not on culture confirmation.''' They are used '''in addition to''' standard precautions.
;PPE and placement for contact precautions?
:'''Gown and gloves''' on entry, single room preferred, cohorting permitted for the same organism, and '''dedicated or single-use equipment'''. Disinfect anything shared before it leaves the room.
;PPE and placement for droplet precautions?
:'''Surgical mask''' on entry, single room preferred with at least three to six feet between cohorted beds, and the door may remain open. The '''client''' wears a surgical mask during transport.
;PPE and placement for airborne precautions?
:'''Fit-tested N95 or higher respirator''' plus an '''airborne infection isolation room''': negative pressure, at least 6 air changes per hour in existing construction and 12 in new or renovated, exhausted outdoors or HEPA filtered, '''door closed''', pressure monitored daily.
;Which conditions require airborne precautions, and which require airborne plus contact?
:Airborne: '''tuberculosis (pulmonary or laryngeal) and measles'''. Airborne plus contact: '''varicella and disseminated herpes zoster''' (and smallpox). Localized zoster in an immunocompetent client needs only standard precautions with lesions covered.
;Which organisms require soap-and-water hand hygiene rather than alcohol rub?
:'''''Clostridioides difficile'', norovirus, and ''Bacillus anthracis''''', and any time hands are visibly soiled. Alcohol does not kill spores.
;How long are precautions maintained for meningococcal disease and for pertussis?
:Meningococcal disease: droplet until '''24 hours''' of effective antibiotic therapy. Pertussis: droplet until '''5 days''' of effective therapy.
;What is a protective environment and who needs one?
:A '''positive-pressure''', HEPA-filtered room with at least 12 air changes per hour and sealed construction for severely immunocompromised clients, classically '''allogeneic hematopoietic stem cell transplant''' recipients. It protects the client from the environment. No fresh flowers, potted plants, standing water, or construction dust.
;A transplant client develops varicella. What room is required?
:An '''airborne infection isolation room with an anteroom''' so that both positive-pressure protection for the client and negative-pressure containment of the pathogen can be met.
;After an infectious client leaves an airborne infection isolation room, how soon may an unprotected person enter?
:After enough time for adequate air exchanges, roughly '''one hour at 6 air changes per hour''' and about 35 minutes at 12. Facility policy governs.