Download Airborne Precautions Guidelines

PLEASE NOTE: This online, read-only version of the Policy & Procedure is the OFFICIAL copy. 5/12/17 2:48 PM
Section 2
NEW ENGLAND BAPTIST HOSPITAL
INFECTION CONTROL MANUAL
_______________________________________________________________________________________________
Subject: AIRBORNE PRECAUTIONS
_______________________________________________________________________________________________
Effective Date: May, 2004
Supersedes: Nov, 2001
Approved By: Infection Control Committee, Medical Executive Committee
Authors:
Susan Davidson, M.D.
Maureen Spencer, M.Ed., R.N.
_______________________________________________________________________________________________
PURPOSE
Designed to reduce risk of airborne transmission of small droplet nuclei that remain suspended in air for long
periods or dust particles containing the infectious agent.
DISEASES REQUIRING AIRBORNE PRECAUTIONS
Pulmonary TB
Laryngeal TB
X-ray suggesting active TB
Sputum smear Positive-AFB
Chickenpox (Varicella)
Disseminated herpes zoster
Measles
EQUIPMENT FOR AIRBORNE PRECAUTIONS
Inside Room:
- Red lined trash container
- Bedside bag for tissue disposal
- Antiseptic hand rub (Cal Stat)
Outside Room:
- Precaution Cart
- Airborne Precaution Sign on doorway
- Airborne Precaution Sticker on chart and kardex
SPECIFICATIONS FOR AIRBORNE PRECAUTIONS
Private Room
- Negative Pressure Private room with bathroom facilities.
- DOOR SHOULD BE KEPT CLOSED AT ALL TIMES including when patient is not in room
- Special ventilation indicated-Notify Engineering Department of room number so that Negative Air Pressure
is checked daily. Check with Infection Control Coordinator, Nursing Coordinator or Admitting for current
rooms.
Gowns
- Not indicated unless gross contamination is likely.
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PLEASE NOTE: This online, read-only version of the Policy & Procedure is the OFFICIAL copy. 5/12/17 2:48 PM
Section 2
Masks
- All personnel must be fitted by Employee Health for NIOSH approved mask (N95)
- NIOSH approved masks indicated for all hospital personnel entering the room
- Remove mask when leaving room. Mask may be used for one patient or one day or until wet or soiled.
- Bearded personnel will use the powered air purifying respiratory (PAPR, Air Mate).
(see IC Policy: INSTRUCTIONS FOR AIR MATE HEPA 12 PORTABLE RESPIRATOR)
Handwashing/Antiseptic Hand Soap
- Wash before entering or use antiseptic hand rub (Cal Stat)
- Wash after giving care or use antiseptic hand rub
Gloves
- Indicated when touching infective material (i.e obtaining sputum specimen)
Linen
- No special precautions indicated
Disposal of Discharges, Excretions, Disposable Equipment
- Instruct patient to cough and expectorate into paper tissue then dispose of tissue in bedside bag.
- Dispose of excretions directly into patient's toilet using protective equipment if splattering is anticipated.
- Contaminated items are to be placed in red lined waste receptacle.
Laboratory Specimens
- Place into specimen container then close securely.
- Outside the room, place container into a transparent specimen bag closed securely.
- A requisition slip, if necessary, should be placed in outside pocket of specimen bag.
Thermometers
- No special thermometer is necessary.
Dishes and Water Pitchers
- No special precautions indicated.
- Dietary brings the tray to the patient's door.
- Nursing personnel delivers tray to the patient.
- Nursing personnel will pick up the tray.
- Tray may be put back onto dietary truck for routine dishwashing.
Treatment of Patient's Belongings
- Articles (fomites) are rarely involved in transmission of TB. Articles should be sent home with family unless
contaminated with sputum. These contaminated items may be cleaned with hospital approved disinfectant.
Transporting Patient
- Transport only if essential.
- Notify the service area the patient is being transported to and confirm that Airborne Precautions are
in place.
- Regular surgical mask should be worn by the patient when leaving room.
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PLEASE NOTE: This online, read-only version of the Policy & Procedure is the OFFICIAL copy. 5/12/17 2:48 PM
Section 2
Visitors
- Should be kept to a minimum.
- Instruct visitors on handwashing and appropriate use of mask or other special precautions.
- May use N95 mask. Personnel may teach visitors to apply mask. It is not necessary to fit test visitors.
Stethoscope & Sphygmomanometer
- No special precautions indicated.
Concurrent Housekeeping
- Routine daily cleaning procedures are performed with hospital approved disinfectant.
Terminal Housekeeping
- Door is to be kept closed for 4 hours after patient is discharged.
- Housekeeping personnel must wear NIOSH approved masks during this 4 hour period when entering room.
- Protocol for housekeeping terminal cleaning should be followed.
Admission of patient to room after cleaning.
-
No new admission to a previous Airborne Precaution room will be done until the room has been
empty for 4 hours with the door closed.
DISCONTINUATION OF TB PRECAUTIONS
Discontinue precautions only when TB patient is on effective therapy, is improving clinically, and has three
consecutive negative sputum smears collected on different days, or TB is ruled out.
References:
1) Centers for Disease Control and Prevention and Hospital Infection Control Practices Advisory Council.
Guideline for Isolation Precautions in Hospitals, Am J Infect Control. 1996 Jun;24(3):199-200.
2) Centers for Disease Control and Prevention. Guidelines for preventing the transmission of tuberculosis in
health-care facilities, 1994. MMWR 1994;43(RR-13):1-132, and Federal Register 1994;59(208):54242-54303.
3) New England Baptist Hospital, Infection Control Policy and Procedure. INSTRUCTIONS FOR AIR MATE
HEPA 12 PORTABLE RESPIRATOR, December, 1998.
4)
Occupational Safety and Health Administration Department Of Labor - Part 1910 Subpart I--Personal
Protective Equipment, Sec. 1910.139 Respiratory protection for M. tuberculosis, 29CFR1910.139
July 1, 1998.
Revised: 9/92, 5/97, 11/01, 1/04
*AFBIC04.doc*
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