HYGIENEAND
HEALTHCAREASSOCIATED
INFECTIONS
IV
ISOLATION PRECAUTION
MUDr. Bohdana Rezková, Ph.D.
Possibilities of
prevention
Standard
precautions
the basic level of
infection control
precautions
to be used, as a
minimum, in the care
of all
patients.
prevent transmision
from both recognized
and unrecognized
sources
Isolation
precautions
In specific situation
mostly aimed on
recognized pathogen
differ from the way of
transmission
Isolation
precaution
 Syndromic or empiric application (likely pathogen) of
transmission-based precautions.
 Based on supposed transmission way:
1. Contact transmission – direct, indirect
2. Droplet transmission
3. Airborne transmission
 Only for interhuman transmission! (e.g. not for legionelosis)
 Other possibilities: cohorting, keeping the patient with an existing
roommate, …
 For all persons in a contact with patient or medical equipment!!!
Isolation
precautions
Impact on the
patient
 anxiety, depression and other mood disturbances,
 perceptions of stigma,
 reduced contact with clinical staff.
Isolation
precautions
Impact on the
hospital ward
 Specific cleaning precaution
 Dedicated staff
 Organization of rounds (last in the sequence)
and e.g. last position in daily surgical schedule
 Individualized patient-care aids
 Increased costs
Indicate individually regarding the
compliance capability of the patient and
local proposition.
Contact
precautions
 Prevent transmission of infectious agents which are spread by
direct or indirect contact with the patient or the patient’s
environment (MDROs,Clostridium dif., norovirus, …)
 Patient placement: a single-patient room or in multi-patient
rooms, ≥ 1 m spatial separation between beds.
 PPE: gowns, gloves
Droplet
precautions
 Prevent transmission of pathogens spread through close
respiratory or mucous membrane contact with respiratory
secretions (B. pertussis, influenza virus, adenovirus, rhinovirus, N.
meningitides, and group A Streptococcus).
 Patient placement: a single patient room or spatial separation of
1.5 m and the curtain between patient beds.
 PPE: mask,….
 Patient transported outside the room: mask (if tolerated) and
following Respiratory hygiene/Cough etiquette .
Airborne
precautions
 Prevent transmission of infectious agents that remain infectious
over long distances when suspended in the air (e.g., rubeola virus
[measles], varicella virus [chickenpox], M. tuberculosis, and
possibly SARS-CoV)
 Patient placement: a single-patient room that is equipped with
special air handling and ventilation capacity (HEPA,…).
 Mask or respirator or other PPE, depending on the disease-specific
recommendations.