Download Chapter 4 - Guidelines for isolated patient 2014 amalgamated policy

Infection Prevention & Control Manual
Chapter 4
Isolation Policy
Version 7
Document Summary
This policy provides guidance for the appropriate actions and responsibilities
for the management of patients in isolation.
DOCUMENT NUMBER
APPROVING COMMITTEE
DATE APPROVED
DATE IMPLEMENTED
NEXT REVIEW DATE
ACCOUNTABLE DIRECTOR
POLICY AUTHOR
TARGET AUDENCE
KEY WORDS
STHK0046
Patient Safety Council
10 September 2014
1 October 2014
1 October 2017
Sue Redfern, Director of Nursing, Midwifery &
Governance
Karen Allen, Director of Infection Prevention &
Control
All clinical staff
Isolation, barrier nursing.
Important Note:
The Intranet version of this document is the only version that is maintained.
Any printed copies should therefore be viewed as “uncontrolled” and, as such,
may not necessarily contain the latest updates and amendments.
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Document Version History
Date
Version
August 1992
1
1 February 2001
2
1 August 2003
3
1 December 2006
4
1 December 2008
5
1 November 2011
6
1 November 2014
7
1st
November 2017
Summary of key changes
Format Changed.
Contact details updated.
Appendix 1: Isolation audit tool
added
Format Changed.
Chapters 4 (Guidelines for
isolated patient) and 12
(Isolation Policy) amalgamated
into a single policy.
Review
date
Infection Control Manual - Chapter 4-Isolation Policy-Version 7 (clinical)
Issue Date: 1st October 2014
Author
Designation
Service Manager
Infection Prevention
& Control
Service Manager
Infection Prevention
& Control
Service Manager
Infection Prevention
& Control
Service Manager
Infection Prevention
& Control
Service Manager
Infection Prevention
& Control
Service Manager
Infection Prevention
& Control
DIPC
Lead Nurse,
Infection Prevention
& Control
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CONTENTS
Item No.
Subject
Page No.
1.
Scope
4
2.
Introduction
4
3.
Statement of Intent
4
4.
Definitions
4
5.
Duties, Accountabilities and Responsibilities
4
Process
Sources of infection
Risk assessment
Categories of isolation and recommended precautions
General principles of isolation nursing
Isolation procedures
 The side room
 Transporting patient outside isolation area
 Death of patient in isolation
Staff injuries or illness
Visitors to patients in isolation
Outbreaks of infection/infectious disease
For further advice and guidance
Glossary
5
5
5
5
6
10
10
12
13
14
14
14
15
15
7.
Training
15
8.
Monitoring compliance
15
8.1.
Key Performance Indicators of the Policy
15
8.2.
Performance Management of the Policy
16
9.
References and Bibliography
16
10.
Related Policies and Procedures
16
11.
12.
Equality analysis
Appendices
Appendix 1: Audit tool: isolation precautions
Appendix 2:
Summary of isolation nursing and isolation precautions
Appendix 3
A-Z quick reference guide for isolation requirements
16
6.
6.1
6.2
6.3
6.4
6.5
6.5.1
6.5.2
6.5.3
6.6
6.7
6.8
6.9
6.10
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17
19
20
St Helens & Knowsley Teaching Hospitals NHS Trust
1. Scope
This policy applies to all clinical and Medirest staff within St Helens and Knowsley
Teaching Hospitals NHS Trust to ensure that appropriate actions are taken when isolation
precautions are required.
2. Introduction
The aim of isolation nursing or isolation precautions is to confine the pathogenic organism,
prevent spread to other patients or staff, and eradicate it if possible. This does not always
mean confining a patient to a single room but that relevant and effective precautions are
taken. Isolation may be very disturbing for some patients and they will require additional
moral support while isolated.
Hospital-acquired infections can have considerable consequences. These may include: Increased pain, distress and anxiety
 Delayed or prevented recovery
 Extended hospitalisation
 Financial implications for patients and the health authority.
 Potential outbreaks
 Legal implications
The correct and timely placement of infected patients (suspected or proven) into single
rooms can be very effective in reducing the overall numbers of infective patients (DH
2007). It is also a requirement of the Health Act 2006 (DH) that an evidence based
isolation policy exists incorporating local risk assessment findings and measures. This
policy describes the general principles of isolation precautions, when they may be required
and the rationale behind their use.
3. Statement of Intent
The aim of the policy is to control the spread of transmissible infections within the Trust.
4. Definitions
Isolation is the use of infection prevention and control precautions aimed at controlling
and preventing the spread of infection.
Source Isolation (barrier nursing) is where the patient is isolated because they pose an
infection risk to others
Protective Isolation (reverse barrier nursing) is where the patient is isolated because they
at risk of acquiring infection from others i.e. they are immunocompromised.
5. Duties Accountabilities and Responsibilities
For full details of infection control responsibilities see Infection Control Policy, Chapter 28B
Infection Control Manual.
5.1. Staff
It is the responsibility of all clinical staff to:
 be aware of the current guidelines.
 put these guidelines into practice.
 bring to the attention of the Unit Manager or Infection Prevention and Control Team
any problems in applying these guidelines
Breaches of this policy may lead to disciplinary action being taken against the individual.
5.2. Unit managers (person in charge of a ward or department) must ensure that
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



The policy is readily accessible to all staff.
The required facilities and equipment are available to enable compliance with the
policies.
All staff within their area of responsibility have received training in the appropriate
procedures with respect to infection control.
The ADT/HEARTS/EDMS systems are checked for infection alert status when a
patient is admitted.
5.3 Medirest
It is the responsibility of Medirest management to ensure that all domestic, catering and
portering staff adhere to the Trust Isolation Policy.
6. Process
6.1 SOURCE OF INFECTION
6.1.1 Self-infection (endogenous infection)
Self-infection results when tissue becomes infected from another site in the patient’s body
e.g. by own normal microbial flora of body.
6.1.2 Cross-infection (exogenous infection)
Cross-infection may be caused by infection from patients, hospital staff or visitors who are
suffering from the relevant disease or who are symptomless carriers. Other factors e.g.
equipment, bedding, food, air, hands of staff etc. may also transfer pathogens.
6.2 RISK ASSESSMENT
All patients identified with infectious diseases or alert organisms will be risk assessed for
the need for isolation. This will take place between the Infection Prevention and Control
Team and the clinical team. Risk assessment will take into account:
 The classification of the pathogen and the ability to protect against or treat
individual infections.
 The probable route of transmission and evidence of transmission.
 Susceptibility of the other patients near to the infected patient in the same bay i.e.
do the other patients have open wounds or an invasive device.
 Whether the organism is antibiotic resistant.
6.3 CATEGORIES OF ISOLATION AND RECOMMENDED PRECAUTIONS
There are 4 categories of isolation and precautions are recommended, each with a specific
purpose. Information posters detail the relevant precautions to be taken. These should be
affixed to the outer side of the cubicle door. Isolation posters can be downloaded from the
Infection Prevention & Control website.
6.3.1 Blood and body fluid isolation universal/standard precautions (no poster
required)
Used to prevent infection with blood borne disease. Health care workers who come into
contact with blood, secretion and excreta may be exposed to pathogens including blood
borne viruses such as HIV, Hepatitis B and C. As it is impossible to identify all those with
infection it is recommended that all body fluids are regarded as potentially infectious and
universal precautions are used. See appendix A for further details.
6.3.2 Contact isolation
Used to prevent the dissemination of infections normally spread by direct contact/or
contact with any body fluids or secretions and articles which have been in close contact
with the infected patient.
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6.3.3 Airborne isolation
Used to prevent infection with airborne pathogens, those that are transmitted by
large/small droplet nuclei and generated in the course of talking, coughing, sneezing and
during procedures involving the respiratory tract i.e. suction.
6.3.4 Protective isolation (reverse isolation nursing)
This is used to prevent both airborne infections and those spread by direct contact to
susceptible patients (e.g. those immunosuppressed by disease or drug therapy).
Precautions are therefore to prevent contamination by direct contact and by self-infection
(endogenous) from the patient’s natural flora.
N.B. These patients should not be nursed in the vicinity of infected patients.
6.3.5 Isolation charts
Copies of isolation charts are available to download from the Infection Prevention &
Control Intranet Website. Refer to Chapter 4B, Isolation Instruction Charts, Infection
Control Manual.
Do not photocopy charts. Only computer-generated charts are acceptable. All charts
must be laminated.
6.3.6 Quick reference table
For a list of infections requiring isolation and precautions/posters required see Appendix 3.
6.4 GENERAL PRINCIPLES OF ISOLATION NURSING
6.4.1. Hand decontamination
This is the most important measure in preventing the spread of infection. Washing the
skin thoroughly with liquid soap, quickly removes harmful bacteria. Hands must be wet
first, be rinsed well and dried thoroughly using paper towels.
Hands must be washed
 before handling patient.
 after handling patient and prior to leaving the isolation room, after removal of
gloves.
 when soiled.
6.4.2 Hand sanitiser gel
Use on physically clean hands immediately after leaving isolation room. Rub vigorously
covering fingers, hands and wrists thoroughly. Continue rubbing until dry. (Use Ayliffe
technique, see Chapter 12). Hand sanitiser gel is ineffective with some infections, viral
diarrhoea, Clostridium difficile infection. Soap and water must always be used when
dealing with these infections. (Refer to Chapter 5, Personal Protective Equipment).
6.4.3 Protective clothing
When specifically advised in Isolation Policy.
Plastic aprons and gloves to be worn for patient contact when handling contaminated or
infected articles, excreta, secretions. N.B. always when handling blood/body fluids or
articles soiled with blood/body fluids
Surgical masks, Visimasks only when specifically advised in Isolation Policy.
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FFP3 filter masks only when specifically advised in Isolation Policy e.g. for smallpox,
SARS/MERS, multi-drug resistant TB (Refer to Chapter 5, Personal Protective
Equipment).
6.4.4 Single Room
Use as directed in Isolation Policy. Single room essential for respiratory and protective
isolation.
Always keep door closed as bacteria and viruses are often spread by the airborne route.
6.4.5 Crockery and cutlery
Conventional crockery and cutlery is to be used and washed in central dishwasher. If the
dishwasher is out of action, use disposable crockery/cutlery. Wash hands after handling
used crockery and cutlery.
N.B. No disinfection is normally required nor is the use of disposable items unless
specifically advised by the Infection Prevention & Control Team e.g. VHF
6.4.6 Sharps
Discard carefully into ’sharps box’ (within the cubicle if patient is isolated). Keep it out of
patients reach especially if they are elderly, confused of children. Do not store on floor, use
bracket to affix to wall.
Do not re-sheath needles as there is a great danger of needlestick injuries. (Refer to
Infection Control Manual, Chapter 22 Sharps Policy)
6.4.7 Laundry
Place contaminated laundry into red-alginate bag then into a white plastic (Sunlight) bag
(available from laundry). Secure top and affix ward indicator labels.
N.B. There is rarely an indication for incineration of laundry.
6.4.8 Clinical waste
Place into orange/yellow plastic bag, no more than 3/4 full. Tie securely, attach bag
identity tag. Avoid external contamination of the bag. Orange bags for clinical waste
should be held on the appropriate stand in the isolation room. Send for immediate
incineration. (Refer to Chapter 15, Hospital Waste Disposal Policy),
6.4.9 Equipment
Use as little as possible in infected area. Disinfect after precautions are discontinued (see
Chapter 9, Disinfection Policy).
Disposable bed pans, urinals, vomit bowls, blood pressure cuffs, tourniquets and sputum
containers to be used. Keep individual items e.g. bed pans shells for patient’s sole use.
If the ward mobile telephone is used: thoroughly wipe over with disinfectant wipes e.g.
Sanicloth, before returning it to the main ward. If the telephone has been handled by a
patient with active Clostridium difficile infection (CDI), wipe it over with Chlorclean first.
6.4.10 Bathing of patients
Where possible shower patients. Patients washing bowl must be disposal. If patient is
bathed, thoroughly clean using chlorclean and dry bath after use. Leave room to dry
before use by any other patient.
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6.4.11 Spillage of blood or body fluid
Blood/Blood Stained Body Fluids
Sprinkle 10,000ppm chlorine releasing granules (Haz tab granules) over spill until all
moisture is completely absorbed. Leave for at least 2 minutes. Use paper towels to
collect granules and discard into yellow clinical waste bag. Then wipe over area with
10,000 ppm Haz tab solution.
Body Fluids – Faeces/Vomit/Urine
Make a 10,000ppm chlorine solution. Add four Haz tab tablets to the small 1 litre dilute
and fill to the line with tepid water. When the tablets have dissolved, screw down the
diluter cap and mix by inversion. Use with disposable paper towels to wipe area and
remove drips or splashes on vertical surfaces. Rinse disinfected area thoroughly and wipe
dry.
6.4.12 Diagnostic specimens
Accurately label container and request form. Place into sealable plastic specimen bag.
Transport immediately to laboratory. Danger of infection labels are to be affixed if patient
is known or suspected to be suffering from a dangerous infection e.g.:
HIV/AIDS
SARS/MERS
Anthrax
Hepatitis B/C
Paratyphoid
Tuberculosis
Typhoid
Viral haemorrhagic fever
Rabies
Plague
It is the responsibility of the doctor requesting the test to ensure that any specimen from
such patients and the appropriate request forms are so labelled and contain the relevant
clinical information. Specimens which are a ‘danger of infection’ should be transported to
the laboratory as soon as possible in a sealed plastic bag. Do not use staples or pins to
seal the bag.
6.4.13 Cleaning
Domestic staff
The domestic manager must be informed by the nurse in charge of the ward as soon as
isolation nursing is commenced. He or she will then provide the ward domestic with
appropriate instructions. The nursing staff must check that the ward domestics understand
and are following their instructions correctly.
Domestic management
(See Chapter 12A, Infection Control Manual for details).
Use disposable yellow cloths and yellow labelled disposable mop and bucket (available
from Domestic Manager). Report to nurse in charge before starting work in the isolation
room. Wash hands outside the room. Put on plastic apron and gloves. A mask may also
be occasionally necessary if the patient is in respiratory or protective isolation. For patients
in containment isolation, clean these rooms last; for those in protective isolation, clean
these rooms first.
Terminal clean
When the patient has been discharged the Response Cleaning Team is available for
terminal cleaning 24 hours a day.
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Daily management
Wipe over all surfaces with Chlorclean. Wipe instruments (stethoscope,
sphygmomanometer etc.) with disinfectant wipes e.g. Sanicloth. Spillages of body fluids
(urine, faeces, vomit etc.) should be first cleaned up using a disinfectant as directed in
Chapter 9.
Wall washing
Washing of isolation room walls is seldom necessary. It is only required on the request of
the Infection Prevention and Control Team or where there is obvious contamination with
blood, excreta or body fluids.
6.4.14 Recommended disinfectant/antiseptic agents
See Decontamination Policy, Chapter 9, Infection Control Manual for further details.
General purpose detergent
Keeping surfaces clean and dry will prevent infection.
Chlor-clean
To be used for general purpose cleaning on all acute wards/units.
Hypochlorite
Especially for use for blood borne viral infection
1% - general use (Chlor-clean) 1,000ppm
10% - for all blood/body fluid spillages (HazTabs) 10,000ppm
Hand sanitiser
Hand sanitiser to be used when hands are physically clean but require disinfection.
(Not effective against CDI or norovirus).
Liquid soap
To be used when hands are physically dirty
Hard surface wipes
Disinfectant wipes for use in disinfecting surfaces and some instruments.
6.4.15 Staff allocation
A minimum number of staff should be involved with an infected patient. The nurse
concerned with the infected patient should not also attend to other susceptible patients. If
isolation nursing is for an infectious disease e.g. chickenpox, shingles or measles, it is
preferable that only personnel who are immune (disease/vaccination) should attend this
patient. For individual advice contact the Infection Prevention and Control Nurse or
Health, Work and Wellbeing Department.
6.4.16 Notification of infection/infectious diseases
6.4.16.1 Notification to IPCT
Notification by telephone must be made to the Infection Prevention & Control Nurse of any
patient with or suspected of having an infectious disease.



wound infections (especially post-operative infections)
blood borne infections (Hepatitis B/C, HIV, AIDS)
infestations e.g. scabies, fleas
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




herpes zoster (shingles or chickenpox)
any outbreaks of diarrhoea/vomiting, respiratory or other infections
amongst patients or staff ie. more than two people.
the commencement of isolation precautions for any patient
any infection according to the discretion of the nurse in charge of the ward
N.B. Patient’s diagnosis of personal details must not be divulged to staff not directly
concerned with the patient’s nursing or medical care.
6.4.16.2 Notification to CCDC
Many infectious diseases are legally required to be notified to the Consultant in
Communicable Disease (CCDC). A comprehensive list of these and means of notification
may be found in Chapter 3, Infection Control Manual.
6.4.17 Communication with the isolated patient and visitors
Careful explanation to the patient is essential so that he/she can co-operate fully with the
restrictions. The nurse should be sensitive to the psychological implications of being
labelled infectious and being confined in isolation. The patient’s visitors must also be
informed why the isolation restrictions are necessary. They must be taught to observe the
correct procedures for entering and leaving the room. As children are more susceptible to
infection than adults and have higher carriage rates of pathogenic organisms, any visit by
a child should be discussed with the appropriate personnel. Give each patient the
isolation explanation booklet for patients. Ward should keep a stock, spare copies are
available from the Infection Prevention & Control Nurse Specialists or on the Infection
Prevention & Control Website.
6.5 ISOLATION NURSING PROCEDURE
See Appendix 2 for summary. See Appendix 3 for A-Z quick reference guide for isolation
requirements for individual infections.
6.5.1 THE ISOLATION ROOM
ACTION
RATIONALE
Place appropriate isolation chart outside the To inform anyone intending to enter the
door.
room of the situation and give appropriate
instructions.
Dani Centre/trolley or shelf outside the room Protective clothing available prior to
to contain:
entering room.
 Yellow plastic apron
 Gloves
 Masks (If directed by Infection
Prevention & Control).
Hand sanitiser gel available.
Patient’s charts to be kept outside of the
room.
Remove all non-essential furniture.
To minimise the risk of furniture harbouring
The remaining furniture should be easy to microbial spores or bacterial growth and
clean and should not conceal or retain dirt makes terminal cleaning easier.
or moisture either within or around it.
Stock the wash hand basin, liquid soap, Facilities for handwashing within the
hand sanitiser gel and paper towels for staff infected area are essential for effective
use.
isolation nursing.
For use by patient, visitors and staff.
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Place a hand sanitiser gel dispenser at
patient’s bedside.
Place an orange clinical waste bag in the For containing contaminated waste within
room on a foot operated stand. The bag the room.
must be sealed before it is removed from
the room by knotting when ¾ full.
Place a container for sharps in the room.
To contain contaminated sharps within
infected area.
N.B.: When the sharps container is full it
must be kept in the room until collected for
incineration.
Keep the patient’s personal property to a
minimum. Advise him/her to wear hospital
clothing. All belongings taken into the room
should be washable, cleanable or
disposable.
Provide the patient with his/her own
sphygmomanometer and disposable, singlepatient-use blood pressure cuff and all items
necessary for attending to personal
hygiene.
Keep dressing solutions, creams and lotions
etc. to a minimum and store them within the
room.
Safety of sharps.
The patient’s belongings may become
contaminated and should not be taken
home unless they are washable or
cleanable. Do not wash on the ward: send
to laundry as infected linen.
Equipment used regularly by the patient
should be kept within the infected area to
prevent the spread of infection.
All partially used materials must be
discarded when isolation nursing ends (resterilisation is not possible) therefore
unnecessary waste should be avoided.
Ensure patient has a working call button.
So that patient can summon assistance.
Give patient an information booklet.
To give him/her special information about
isolation and so reduce anxiety.
Inform the Infection Prevention & Control To ensure that precautions are appropriate
Nurse
for individual patients needs.
ENTERING THE ROOM
Collect all equipment needed.
To avoid entering and leaving the infected
area unnecessarily.
Adhere to ‘Bare Below the Elbow’ policy.
To protect clothing from contamination.
Put on a disposable plastic apron (and To protect clothing from contamination.
mask if directed)
Put on disposable gloves.
To reduce the risk of contaminating your
hands.
Enter the room, shutting the door behind
you.
LEAVING THE ROOM
Remove and discard gloves and then plastic Correct disposal of clinical waste.
apron into orange bag.
Thoroughly wash hands using liquid soap.
To remove bacterial contamination.
Rinse and dry well.
Leave the room, closing the door behind
you. Remove any eye protection. Discard
mask directly into clinical waste e.g. sluice.
Wash hands immediately.
Use hand sanitiser gel.
To remove pathogenic organisms acquired
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form the door handle etc.
6.5.2 TRANSPORTING PATIENTS OUTSIDE THE ISOLATION NURSING AREA
ACTION
TO OTHER WARDS/DEPARTMENTS
Before transferring the patient, inform the
head of department or nurse in charge of
the ward/department of any information
regarding the type of infection and
precautions to be taken. If possible arrange
for the patient to have the last appointment
of the day.
Complete the risk of infection section on all
request forms.
Any porters involved must be given
necessary instructions.
RATIONALE
In order that special arrangements may be
made and infection risks to other patients or
staff are minimised.
So that porters transporting patient and staff
in the receiving department are conversant
with any special precautions required.
Fears are allayed and infection risks are
minimised.
The patient should preferably be transferred To minimise the risk of infection.
using a wheelchair or trolley.
Use fresh linen and discard after the
transfer is complete.
Decontaminate trolley/wheelchair.
If the patient is to be transferred by bed, all
linen must be changed and the frame wiped
over with Chlor-clean or disinfectant wipes
prior to transfer.
TO THE OPERATING THEATRE
The operating theatre must be informed in In order that appropriate precautions may
advance.
be taken to minimise the possibility of cross
infection and to avoid potential hazards and
delays.
If possible, the patient should be transferred To minimise the risk of infection.
to and from theatre on a trolley. All linen
should be changed before using the trolley
for another patient. The trolley must be
decontaminated with Chlorclean. Should
the patient require transfer in his own bed,
all linen must be changed immediately
before transfer and the bed frame wiped
over with Chlorclean.
TRANSFER BY AMBULANCE
The ambulance officer must be given prior So
that
ambulance
personnel are
information regarding the type of infection. conversant with any special precautions,
Details of special precautions required must fears are allayed and infection risks are
be entered on the transfer form.
minimised.
DICHARGE FROM HOSPITAL OF AN INFECTED PATIENT
Inform the Infection Prevention & Control To advise on any special precautions and
Nurse/Doctor when the patient is due for give advice regarding the home or to inform
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discharge.
the Department of Environmental Health of
patient’s discharge.
The nurse in charge of the ward must inform To minimise any infection risks and allay
the community care staff if any special fears.
precautions need to be taken in the home or
nursing home or residential home. Details
must be documented on discharge
summary.
Tagging of notes/computer records is To indicate special precautions required
normally done at the time of diagnosis of should re-admission be necessary or clinic
MRSA/CDI/VRE/CPE.
appointments. To minimise infection risks.
The case sheet, if necessary, will have been
marked by colour-coded sticker on the
inside flap. A white alert sticker will have
been affixed to the front of the case notes.
Stickers are available from IPCN.
The WebPAS, ADT and EDMS patient
records will also have been tagged by the
IPCN if required.
The room should be stripped and aired. All To remove contaminated articles and
linen should be placed in a red alginate bag, associated infection risks.
which is placed inside a white plastic
laundry bag. Curtains should be changed
and sent to the laundry.
All equipment, surfaces and floors should Cleaning of surfaces is effective in removing
be thoroughly cleaned as per Chapter 12A, bacterial containments.
Infection Control Manual and dried well.
Use Chlorclean.
N.B.: Pillows should be contained within To minimise cross-infection.
plastic covers.
Wall or ceiling disinfection is not required Not generally an infection risk.
unless there is obvious soiling by blood,
excreta or body fluids or unless specifically
advised by Infection Prevention & Control
Team, see Wall washing policy, Chapter 26
Infection Control Manual.
Leave window open to air. Room may be
occupied one hour after cleaning is
completed.
6.5.3 DEATH OF A PATIENT IN ISOLATION
If a patient is likely to die or dies in isolation, To reduce any infection risk to staff as body
inform the Infection Prevention & Control may remain infectious after death.
Team.
It is the responsibility of the
Consultant in charge of the patient to
forewarn the Pathologist and Mortuary Staff
of the confirmed or suspected infection.
Protective clothing should be worn whilst
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performing Last Offices.
See Infection
Control Manual, Chapter 16.
It may be necessary to place the patient in a To comply with legal regulations.
cadaver bag if the body is thought to be
contaminated with dangerous pathogens.
These include: Hepatitis B/C, HIV, AIDS,
untreated tuberculosis, typhoid/paratyphoid
fever.
Attach a completed ‘Danger of
Infection’ label. For further details see the
Infection Control Manual, Chapter 16.
N.B.: See Chapter 16 Infection Control
Manual for details of where body bags are
available for each division.
6.6 STAFF INJURIES OR ILLNESS
6.6.1 STAFF ILLNESS
These must be reported to the Health Work & Well-being Department for appropriate
action and treatment.
Staff suffering an active infection e.g. cold sores, boils or weeping eczema or any similar
condition should not care for any patient.
6.6.2 STAFF INJURIES
In the event of needlestick injury or splashes of blood/body fluids into the eye or mouth or
a fresh cut refer to– Infection Control Manual- Chapter 13A –Blood Borne Viruses Policy
6.7 VISITORS TO PATIENTS IN ISOLATION
All visitors should report to the nurse in charge of the ward before entering any isolation
room.
Top coats and jackets should be removed prior to entering the room. Protective clothing, if
recommended by Infection Prevention & Control personnel, should be put on before
entering the room.
If the patient has an infectious disease, non-immune staff and visitors should be excluded.
Relatives and friends must not visit other patients on the ward.
Social visiting may be restricted on an individual basis by the Consultant in charge of the
patient and the nurse in charge of the ward.
It is recommended that no more than two adult visitors at any one time are allowed to see
the patient. If may also be necessary to discourage children from visiting.
6.8 OUTBREAKS OF INFECTION/INFECTIOUS DISEASE
An outbreak of infection may be defined as two or more epidemiologically related
infections caused by an organism of the same type. Immediate action is required to
prevent further spread to staff and patients. Therefore, the Consultant Microbiologist or
Infection Prevention & Control Nurse must be informed should an outbreak be suspected.
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It is the responsibility of the Consultant Microbiologist to declare an outbreak and to
institute control procedures. Out of hours, contact the on-call Microbiologist
(Consultant/Specialist Registrar) via Whiston Hospital switchboard.
6.9 FURTHER ADVICE
For further advice and guidance please contact:
Lead Nurse, Infection Prevention & Control
Ext. 1193
Clinical Nurse Specialists, Infection Prevention & Control
Ext. 2452/1384
Consultant Microbiologists
Ext. 1836/1622/1834 or duty Microbiologist via switchboard out of hours.
The following are available from the Infection Prevention & Control Nurses:
- Isolation information posters (also available to print on Infection Prevention &
Control website)
- Case note stickers if required
- Isolation information booklets (available from the Infection Prevention & Control
website)
- Disease specific information booklets
- Quick reference posters detailing infections/infectious diseases requiring special
precautions.
6.10 GLOSSARY
AIDS: Acquired immune deficiency syndrome
CDI: Clostridium difficile infection
HIPG: Hospital Infection Prevention Group
HIV:
Human immmunodeficiency virus
IPCT: Infection Prevention & Control Team
SARS: Severe acute respiratory syndrome
TB:
Tuberculosis
7. Training
Training required to fulfil this policy will be provided in accordance with the Trust’s
Induction Mandatory and Risk Management Training Policy - Training Needs Analysis.
8. Monitoring compliance with this document
8.1 Key performance Indicators of the Policy
Describe Key Performance Frequency
Indicators (KPIs)
Review
Infection Prevention Society Audit Annual
Tool for isolation precautions
(Appendix 1)
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of Lead
Lead Nurse, Infection
Prevention & Control
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8.2 Performance Management of the Policy
Aspect
of Monitoring Individual
Frequency Group
/
compliance
method
responsible of
the committee
or
for
the monitoring which
will
effectiveness
monitoring activity
receive
the
being
findings
/
monitored
monitoring
report
Compliance
Ward audit
with audit tool
Appendix 1
IPCT
Annual
HIPG
Group
/
committee /
individual
responsible
for
ensuring
that
the
actions are
completed
HIPG
9. References/ bibliography
9.1. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious
Agents in Healthcare Settings Healthcare Infection Control Practices Advisory
Committee (HICPAC).
http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf
10. Related trust policy/procedures
Chapter 4B:
Isolation instruction charts policy
Chapter 5:
Personal protective equipment policy
Chapter 9:
Disinfection policy
Chapter 15:
Hospital waste disposal policy
Chapter 12:
Isolation Policy
Chapter 12A:
Cleaning for isolation cubicles policy
Chapter 21:
Hand decontamination policy
Chapter 22:
Sharps policy
Chapter 24:
Clostridium difficile policy
Chapter 33:
Viral gastro-enteritis policy
11. Equality analysis
Please refer to the overarching document which covers all chapters of the Infection Control
Manual. http://nww.sthk.nhs.uk/MANAGE/library/documents/EqualityAnalysisforICM.pdf
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APPENDIX 1
INFECTION PREVENTION AND CONTROL AUDIT TOOL
CLINICAL PRACTICES
ISOLATION PRECAUTIONS
Standard: Clinical practices will be based on best practice and reflect infection control
guidance to reduce the risk of cross infection to patients’ whilst providing appropriate
protection to staff
NB. This section should be undertaken over a period of time to allow for the observation of
as many practice elements as possible
Date ………………………. Ward …………………………………..
Auditor ………………………………………….
Yes No
N/A Comments
1
Isolation facilities are available in
inpatient areas
2
Patients requiring isolation facilities due
to infection have access to them
3
Where a patient is being isolated for
infection
control
reasons,
the
precautions are appropriate and
according to local policy
4
Protective clothing is readily available
upon entering the isolation room
5
Hand hygiene facilities are available,
accessible and clean within the room
6
No inappropriate or unnecessary items
are stored in the isolation room (no
clutter)
7
Where a patient is being isolated for
infection control reasons, the patient is
aware of the need or rationale for this
8
Clear instructions for staff and visitors
are in place when a patient is in
isolation (e.g. confidential notice on the
door)
9
Appropriate information leaflets are
available to patients for common
infections e.g. MRSA, Clostridium
difficile infection (CDI).
10
Visitors are advised that they do not
routinely need to wear protective
clothing
11
Reusable equipment which may
become
readily
contaminated
is
dedicated for the patients use only (e.g.
commode, hoist, sling) are they clean?
12
Used linen, waste and crockery have
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13
14
15
16
17
18
19
20
been removed from the room in a timely
manner
Continued
Yes No
Housekeeping staff are aware of the
local policy and procedures for cleaning
isolation rooms
Separate
colour
coded
cleaning
equipment is in use for isolation
facilities
Isolation precautions are discontinued
when no longer necessary
Nursing documentation is outside the
room
Are staff following infection control
policy/:
i.e.
wearing
PPE,
decontaminating hands
Are MRSA/CDI Care plans evident in
nursing documentation?
Have CDI patients’ had referral to
dietetics?
Are fluid balance/stool charts evident in
CDI patients’ documentation?
N/A
Comments
Comments:
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Appendix 2: Summary of isolation nursing and isolation precautions
Contact
Instruction
Charts
Single room
Plastic
apron
Masks
Routine
hand
washing
Additionally
Gloves
Contact
isolation chart
Category of Isolation
Blood and
MRSA/CDI
body fluid Airborne
isolation
MRSA/CDI
isolation chart
Not
necessary
Airborne
Isolation Chart
Protective
Available if
required –
clinical
decision
Not
necessary
Not
usually Necessary.
unless
Necessary.
Necessary.
necessary but Door closed
advised by
Door
Door closed.
desirable.
Infection
closed.
Control
personnel
For
patient For
patient
For
contact
contact,
contact
For
with
handling blood handling blood handling
blood/body
Patient
body fluids or body fluids or blood
or fluids
contact
contaminated
contaminated
body fluids respiratory
articles
articles
secretions
No
No
No
No
No
Unless specifically recommended by Infection Control Personnel
1. Always before and after patient contact.
2. Before any contact with a susceptible site e.g. wound, IV site etc.
3. After any contact with blood/body fluids or contaminated
articles/equipment.
4. After any activity where hands may have become contaminated.
Handling
Only
Contact
with
blood
or
required
Handling
infected area, For
patient bloodfor
contaminated
e.g. dressing contact.
soiled
handling
items.
or urine
items,
or
blood and
body fluids.
body fluids
Own toilet, disposable bed pans, liners macerated immediately after use
Excreta
Disinfectant:
routine and Chlor-clean unless otherwise recommended by Infection Prevention &
terminal
Control Team
cleaning
10,000ppm chlorine releasing granules for blood and body stained fluids
Spillages
10,000ppm chlorine releasing solution for faeces/vomit/urine (see section
6.4.11 for details)
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Appendix 3: A-Z quick reference guide for isolation requirements
See separate chapter of Infection Control manual, as indicated for further details.
Anthrax
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Chapter 31
Contact
Secretions
Gowns, mask and gloves
Until lesion has healed.
There is no evidence of airborne person-to-person transmission
of anthrax. Therefore isolation in side room is not necessary.
However direct contact with the skin lesions in cutaneous anthrax
may result in cutaneous infection. Gowns, mask and gloves must
be worn. Hands must be washed on removal of gloves.
Specimens for culture must be marked as possible anthrax and
High risk so that appropriate containment facilities will be used in
the laboratory.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Campylobacter (see Diarrhoea)
Carbapenemase-producing Enterobacteriaceae (CPE)
Separate chapter of Chapter 46
Infection
Control
Manual
Category of isolation Contact, single room
Infective material
Secretions
Protective clothing
Plastic apron and gloves
Period of isolation
Until instructed by IPCT
Comment
Chickenpox
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Chapter 37
Airborne, single room
Vesicles, nasopharyngeal secretions
Plastic apron and gloves
7 days after onset of rash
Staff who have not had this disease or been vaccinated must
avoid nursing these patients. If staff think they are susceptible,
blood should be sent (via Health, Work & Well-Being) for HVZ
IgG.
Visitors who have not had the disease must be warned of the
risks.
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Chlamydia
Separate chapter of
Infection
Control
Manual
Category of isolation Standard precautions. Open ward.
Infective material
Secretions and infected lesions.
Protective clothing
Plastic apron and gloves for handling infected sites and
contaminated articles.
Period of isolation
After 24 hours of correct antibiotics.
Comment
Cholera (see Diarrhoea)
Clostridium difficile
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Chapter 24
Contact, single room
Faeces
Plastic apron and gloves
Until diarrhoea has stopped for 48 hours but continue to nurse in
side room in case of recurrence.
Treat according to C difficile algorithm on Infection Control
intranet website (CDI toolkit)
Cryptosporidium (see Diarrhoea)
Diarrhoea/Gastroenteritis
e.g. Salmonella, Shigella, Campylobacter, Cryptosporidium, cholera, dysentery,
rotavirus, E. coli 0:157/HUS (Haemolytic Uraemic Syndrome),
Separate chapter of Chapter 33 (Viral gastroenteritis)
Infection
Control Chapter 24 (C difficile infection)
Manual
Category of isolation Contact, single room
Infective material
Faeces
Protective clothing
Plastic apron and gloves
Period of isolation
Until diarrhoea has ceased for 48 hours or as directed by IPCT.
Comment
If two or more patients or staff on the same ward develop
diarrhoea at about the same time, the Infection Prevention &
Control Nurse or Consultant Microbiologist must be informed and
stool specimens for culture obtained.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
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Diphtheria
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Airborne, single room
Respiratory secretions
Plastic apron and gloves
From onset until two consecutive nose and throat swabs (and
skin lesions in cutaneous diphtheria) are negative (not less than
1 day apart and at least 1 day after stopping antibiotics).
Consider transfer to Regional Infectious Diseases Unit.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Dysentery (see Diarrhoea)
E. coli 0:157, HUS (Haemolytic Uraemic Syndrome) (see Diarrhoea)
Gas gangrene ( Clostridium perfringens)
Separate chapter of
Infection
Control
Manual
Category of isolation Isolation not required
Infective material
Protective clothing
Period of isolation
Comment
Glandular fever/ Infectious mononucleosis
Separate chapter of
Infection
Control
Manual
Category of isolation Airborne, single room
Infective material
Oral secretions
Protective clothing
Plastic apron and gloves when handling oral secretions
Period of isolation
While in hospital
Comment
Gonorrhoea
Separate chapter of
Infection
Control
Manual
Category of isolation Standard precautions
Infective material
Secretions and infected lesions.
Protective clothing
Plastic apron and gloves for handling infected sites and
contaminated articles.
Period of isolation
After 24 hours of correct antibiotics.
Comment
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Hepatitis A
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Hepatitis B
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Hepatitis C
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Contact, single room
Faeces
Plastic apron and gloves
For first week of jaundice
Blood precautions should also be taken if Hepatitis B or C is
suspected, until the laboratory results are available.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Chapter 13A (standard precautions)
Standard precautions
Blood and body fluids
Plastic apron and gloves when handling blood or blood soiled
articles. Visimasks to be used if blood splashes are likely during
procedures.
Not necessary, unless bleeding.
Use ‘Danger of Infection’ sticker on specimens.
Avoid
needlestick injuries. Should accidental inoculation injuries occur
immediately contact the Health, Work & Well-Being Department.
Hepatitis B immunoglobulin may be offered to vaccine nonresponders.
Acute cases: Doctor must notify CCDC (see Chapter 3, Infection
Control Manual).
Chapter 35
Standard precautions
Blood and body fluids
Plastic apron and gloves when handling blood or blood soiled
articles. Visimasks to be used if blood splashes are likely during
procedures.
Not necessary, unless bleeding.
Use ‘Danger of Infection’ sticker on specimens.
Avoid
needlestick injuries. Should accidental inoculation injuries occur
immediately contact the Health, Work & Well-Being Department.
Acute cases: Doctor must notify CCDC (see Chapter 3, Infection
Control Manual).
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HIV/AIDS
Separate chapter of Chapter 11
HIV/AIDS
Infection
Control Chapter 11A
HIV infected HCWs
Manual
Chapter 11B
HIV/AIDS in pregnancy
Chapter 11C
HIV/AIDS in Paediatric patients
Category of isolation Standard precautions
Infective material
Blood and body fluids
Protective clothing
Plastic apron and gloves when handling blood or blood soiled
articles. Visimasks to be used if blood splashes are likely during
procedures.
Period of isolation
Not necessary, unless bleeding or has secondary infections e.g.
tuberculosis (TB)
Comment
Additional isolation may be required if patient has secondary
infections (e.g. TB, Cryptosporidium etc.)
Herpes simplex
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Herpes zoster
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Contact, single room
Lesion secretions
Plastic apron and gloves
Until lesions dry, no fresh vesicles
Cuts or abrasions on fingers should be covered if in contact with
infected patient.
Staff with active lesions should be excluded from neonatal and
maternity wards, and not attend immunosuppressed or
eczematous patients.
Chapter 35
Airborne, single room
Lesions secretions
Plastic apron and gloves
Until lesions dry, no fresh vesicles (usually 7 days after onset)
Non-immune staff who have not had chickenpox (infection or
immunisation) or pregnant staff or visitors must avoid attending
these patients (check HVZ IgG levels).
Worried contacts who are not certain if they have had chickenpox
should have blood sent (via Health, Work & Well-Being
Department) for HZV IgG.
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Influenza/acute viral respiratory infections
Separate chapter of Chapter 23 (influenza)
Infection
Control
Manual
Category of isolation Airborne, single room
Infective material
Respiratory secretions
Protective clothing
Depends on whether seasonal/pandemic/avian/swine flu.
See chapter 23 for full details.
Period of isolation
5 days (adult), 7 days (child), longer if immunocompromised
Comment
Malaria
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Measles
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Inform Infection Prevention & Control Nurse if two or more
patients are affected.
Vaccination is offered via Health, Work & Well-being Department
to susceptible staff.
Standard precautions
Blood & body fluids
Plastic apron and gloves for contact with blood/body fluids
Not necessary
Not transmitted from person-to-person except through transfusion
rarely and through a failure to follow Standard Precautions during
patient care.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual) (by telephone if UK acquired).
Airborne, single room
Respiratory secretions
Plastic apron and gloves
Until 5 days from onset of rash
If outbreak on paediatric ward do not admit non-immune children
until 14 days after last contact has been discharged or isolated.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
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Meningitis/encephalitis
Separate chapter of Chapter 34
Infection
Control
Manual
Category of isolation Airborne, single room.
Contact precautions for viral meningitis.
Infective material
Respiratory secretions, faeces (viral meningitis)
Protective clothing
Plastic apron and gloves
Period of isolation
Until 48 hours after start of antibiotics for bacterial meningitis or
while symptoms persist for viral infections
Comment
Doctor must notify CCDC of all cases of meningitis/encephalitis
(see Chapter 3, Infection Control Manual).
Mumps
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Airborne, single room
Respiratory secretions
Plastic apron and gloves
For 9 days after onset of parotid swelling or onset of illness.
Exclude non-immune staff if possible.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Multiple Antibiotic Resistant Gram-Negative Organisms (MARO)
(Infection or colonisation)
Separate chapter of Chapter 42
Infection
Control
Manual
Category of isolation Standard precautions (single room if requested by IPCT)
Infective material
Secretions, urine, faeces or exudate from infected or colonised
sites, or articles contaminated with these.
Protective clothing
Plastic apron and gloves
Period of isolation
While in hospital
Comment
Isolation precautions to continue until directed by IPCT.
Meticillin-resistant Staphylococcus aureus (MRSA)
Separate chapter of Chapter 14
Infection
Control
Manual
Category of isolation Airborne, single room
Infective material
Skin
Protective clothing
Plastic apron and gloves
Period of isolation
Until instructed by IPCT
Comment
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Ophthalmia neonatorum (gonococcal or Chlamydia)
Separate chapter of
Infection
Control
Manual
Category of isolation Contact, single room or incubator
Infective material
Secretions
Protective clothing
Plastic apron and gloves
Period of isolation
24 hours after starting effective treatment
Comment
Screening and treatment of the parents is essential. They should
be referred to the Genitourinary Medicine/Sexual Health
Department.
Poliomyelitis
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Rabies
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Contact, single room
Faeces, respiratory
Plastic apron and gloves. Surgical mask for first week.
Droplet & enteric precautions for 1 week, then stop droplet
precautions.
Virus may be detected in faeces for up to 6 weeks.
Doctor must notify CCDC. (see Chapter 3, Infection Control
Manual).
Airborne, single room while awaiting transfer to ID Unit
Oral and respiratory secretions
Plastic apron and gloves. Mask
Duration of illness
Inform IPCT.
Transfer to ID Unit if possible.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Rotavirus (see Diarrhoea)
RSV
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Airborne, single room
Respiratory secretions
Plastic apron and gloves
Duration of illness
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Ringworm
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Standard precautions
Infected skin, hair or nails
Plastic apron and gloves when handling patient
While lesions are present.
Nurse child in single room.
Rubella (German measles)
Separate chapter of
Infection
Control
Manual
Category of isolation Airborne, single room
Infective material
Respiratory secretions
Protective clothing
Plastic apron and gloves
Period of isolation
5 days from onset of rash
Comment
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Exclude staff and visitors who may be pregnant unless known to
be immune.
Salmonella (see Diarrhoea)
Shigella (see Diarrhoea)
SARS/MERS
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Chapter 38
Airborne, single room
Respiratory secretions
A filter mask (FFP3 respirator)
Gloves.
Eye protection
Disposable gown (long sleeved fluid-repellent)
Plastic apron
Until informed by IPCT
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
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Scabies
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Comment
Chapter 6
Contact
Skin lesions
Plastic apron and gloves when handling patient
Until successfully treated.
Smallpox
Separate chapter of Chapter 36
Infection
Control
Manual
Category of isolation Airborne. Lobbied side room while awaiting transfer to High Level
Isolation Unit (HLIU)
Infective material
Respiratory secretions and contact with contaminated bed
linen/clothing.
Protective clothing
Impermeable, disposable gown
Respirator FFP3 mask
Eye protection
Head cover
Gloves
Period of isolation
Comment
Until last scabs falls off.
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Streptococcal infection (Group A)
Separate chapter of
Infection
Control
Manual
Category of isolation Contact, single room
Infective material
Oral secretions, infected site
Protective clothing
Plastic apron and gloves
Period of isolation
Until infected site clear and not less than 48 hours after starting
effective antibiotic therapy.
Comment
Streptococcal infection (Group B, Maternity Unit only)
Separate chapter of
Infection
Control
Manual
Category of isolation Airborne, single room (mother & baby together)
Infective material
Infected or colonised secretions
Protective clothing
Plastic apron and gloves
Period of isolation
Duration of stay in hospital
Comment
Precautions taken to prevent cross infection (and potentially
serious infection) of other babies.
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Syphilis (Primary or secondary)
Separate chapter of
Infection
Control
Manual
Category of isolation Standard precautions
Infective material
Secretions and infected lesions.
Protective clothing
Plastic apron and gloves for handling infected sites and
contaminated articles.
Period of isolation
After 48 hours of correct antibiotics.
Comment
Tetanus
Separate chapter of
Infection
Control
Manual
Category of isolation Isolation not necessary
Infective material
Protective clothing
Period of isolation
Comment
Tuberculosis
Separate chapter of Chapter 19
Infection
Control
Manual
Category of isolation Airborne, single room.
Lobbied side room if possibility of MDR (multi-drug resistant) TB.
Infective material
Respiratory or other infected secretions
Protective clothing
Plastic apron and gloves i.e. use standard precautions for contact
with blood, body fluids, secretions and excretions.
FFP3 masks for staff & visitors during contact with a patient with
suspected or known MDR TB.
FFP3 masks should also be worn for aerosol-generating
procedures
Period of isolation
For the first 2 weeks of antituberculous treatment.
Longer if known/risk factors for MDR TB. Seek advice from IPCT.
Comment
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Typhoid/paratyphoid (enteric fever)
Separate chapter of
Infection
Control
Manual
Category of isolation Contact, single room
Infective material
Faeces, urine
Protective clothing
Plastic apron and gloves
Period of isolation
Whilst in hospital
Comment
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Infection Control Manual - Chapter 4-Isolation Policy-Version 7 (clinical)
Issue Date: 1st October 2014
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Viral Haemorrhagic fever
Separate chapter of Chapter 17
Infection
Control
Manual
Category of isolation Lobbied side room while awaiting transfer to High Level Isolation
Unit (HLIU)
Infective material
Blood, body fluids
Protective clothing
Hand hygiene;
Double gloves;
Fluid repellent disposable gown or suit;
Plastic apron (over the disposable gown or suit)
Disposable visor;
FFP3 respirator
Overshoes or boots should be considered if there are large
blood/body fluid spills from patients with a high possibility of VHF
(or a confirmed VHF case).
Period of isolation
Until advised by Infectious Diseases physician
Comment
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
VRE
Separate chapter of
Infection
Control
Manual
Category of isolation
Infective material
Protective clothing
Period of isolation
Chapter 29
Contact, single room
Colonised/infected sites. Environment.
Plastic apron and gloves
Once patients have acquired VRE, prolonged carriage is
inevitable and may persist for many years.
Comment
Whooping cough (pertussis)
Separate chapter of
Infection
Control
Manual
Category of isolation Airborne, single room
Infective material
Respiratory secretions
Protective clothing
Plastic apron and gloves.
Surgical mask.
Period of isolation
After 3 days erythromycin.
Infectious for 3 weeks after onset if no antibiotics.
Comment
Post-exposure chemoprophylaxis for household contacts and
HCWs with prolonged exposure to respiratory secretions.
http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/131713671
3302
Doctor must notify CCDC (see Chapter 3, Infection Control
Manual).
Infection Control Manual - Chapter 4-Isolation Policy-Version 7 (clinical)
Issue Date: 1st October 2014
Page 31 of 32
Policy Reference number: STHK0046
St Helens & Knowsley Teaching Hospitals NHS Trust
Worms e.g. tapeworm, threadworm
Separate chapter of
Infection
Control
Manual
Category of isolation Isolation not required
Infective material
Protective clothing
Period of isolation
Comment
Infection Control Manual - Chapter 4-Isolation Policy-Version 7 (clinical)
Issue Date: 1st October 2014
Page 32 of 32
Policy Reference number: STHK0046