Download Quick Isolation Guidelines

Quick Isolation Guidelines
(Most Common Organisms)
Type of Organism
Type of
Isolation
Aseptic Meningitis
(Viral Meningitis)
Standard
Precautions
C. Difficile
Contact
(stool)
(special note)
Due to the high
sensitivity and
specificity of the DNA C
difficile assay, the
accuracy of this test
eliminates the need for
additional testing and/or
repeat testing of
multiple patient samples
 Submission of
more than one
stool specimen
within 7 days
will not be
done
 If patient is
positive the lab
will not repeat
a test until 10
days have
lapsed
 Do not submit
stool for test of
cure
 Sample must be
fresh, unformed
stools.(formed
stool will be
rejected
Place Into
Isolation
Take Out of
Isolation
Admitting diagnosis =
C. diff colitis or
positive C.diff toxin in
a patient with diarrhea
Patient will remain
in contact isolation
until discharge
For R/O C diff: As
soon as physician
order is received for
C. diff stool assay
Personal
Protective
Equipment
Gown and
Gloves
A MUST
FOR
EVERYONE
BEFORE
ENTERING
ROOM
Diagnosed with C.diff
within the last 3
months and the patient
has diarrhea
1
Type of Organism
Multi Drug
Resistant
Pseudomonas or
Acinetobacter
Type of
Isolation
Contact
(wound
and/or urine)
OR
ESBL-Extended
Spectrum BetaLactamase
Inhibitors, or
Carbapenem
Resistant (CPR)
Droplet &
Contact
(sputum)
Place Into
Isolation
Diagnosed on current
admission or
admission within past
3 months
(If in the urine, must
isolate whether or not
there is an indwelling
catheter)
In sputum and
coughing
OR
In respiratory tract and
the patient has a
tracheostomy
Take Out of
Isolation
Continue for
duration of the
admission
OR
if same site
recultured is
negative for growth
________________
Continue for the
duration of the
admission
OR
Coughing ceases
and reculture is
negative
Personal
Protective
Equipment
Gown and
gloves
Surgical
mask, gown
and gloves
Meningococcal
disease
(Meningitis,
Bacteremia,
Pneumonia)
Droplet
Admitting diagnosis =
R/O bacterial
meningitis AND/OR
culture results are
positive for Neisseria
meningitides
OR
H. Influenza
24 hours after the
first dose of
antibiotic OR
physician makes a
different diagnosis
such as aseptic
meningitis
Surgical mask
MRSA
Contact
Patient with infected
wound or skin lesion
When wound can
be covered or if
drainage no longer
is seeping through
dressing
Gown and
gloves
(wound or
skin)
Droplet
and
Contact
(sputum)
If organism is:
in the respiratory tract
and has productive
cough
OR
has a tracheostomy
OR
has pneumonia
______
Isolation until
infection gone and
culture negative
and cough ceases
Surgical
mask, gown
and gloves
2
Type of Organism
Lice (head)
VRE
Scabies
Type of
Isolation
Contact
Place Into
Isolation
Private Room
Standard
Precautions
Private Room
Contact
(skin)
Take Out of
Isolation
Personal
Protective
Equipment
Follow Pharmacy
directions for
application of lice
medication.
Remove from
isolation when no
live, crawling lice
are found on the
scalp
Gown and
gloves.
Follow Pharmacy
instructions for
medication
treatment and
application.
Gown and
gloves
.
Release after
medication is
bathed or showered
off and bed linens
changed.
Herpes Zoster –
Dermatomal
(Shingles)
Herpes ZosterDisseminated
Shingles
Private room if skin
Standard
Precautions vesicles are moist or
Gloves
*with care by:
caregivers who have
had varicella vaccine
or history of having
chickenpox
When lesions are
both dry and
crusted or can be
contained under
clothing or a
dressing.
May have
unrestricted
roommate
Airborne & Negative Pressure
Room with diagnosis
Contact
When released by
physician
Gloves and
gown
cannot be covered.
of disseminated zoster.
Door to the room is
kept closed.
* with care provided
by caregivers who
have had the varicella
vaccine or chickenpox
** N 95 mask
not required if
immunity to
varicella from
vaccine or
having had
chickenpox
3
Type of Organism
Tuberculosis
Type of
Isolation
Airborne
Place Into
Isolation
Negative Pressure
Room
Take Out of
Isolation
Personal
Protective
Equipment
Physician makes a
different diagnosis
N95
respirator and
the door to
the room is
kept closed
Admitting diagnosis =
R/O TB and chest xray is suspicious of TB
Positive skin test AND
positive chest x-ray
OR
sputum smear positive
for AFB
Influenza
Droplet
(sputum)
Upon admission with
diagnosis of influenza
OR
R/O influenza
OR
positive nasal swab
OR
on Tamiflu
(oseltamivir) or
amantadine or
rimantadine
Three sputum
smears are negative
for AFB: collect
one sputum smear
in the morning and
two more 8 hours
apart
For cases of active
TB, at the
discretion of
Pulmonary or
Infectious Disease
Physician
Five days after
admission if no
antiviral drug
OR
36 hours after first
dose of oseltamivir
drug and afebrile
for 24 hours
Surgical mask
References:
Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices
Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of
Infectious Agents in Healthcare Settings.
APIC Text of Infection Control and Epidemiology, 3rd Edition, 2009, Chapter 18, Isolation
Precautions, pages 18-1 to 18-8.
Heymann, David L., MD, Control of Communicable Diseases Manual, Nineteenth edition, 2008.
Revised: 03/08, 6/09, 2/11, 8/2012. 2/2013, 9/2013
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