Contact, droplet, and airborne precautions./PPE

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Contact precautions are used when:
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Patients who have an infection that can be spread by contact with the person’s skin, mucous membranes, feces, vomit, urine, wound drainage, or other body fluids, or by contact with equipment or environmental surfaces that may be contaminated by patient/resident or by his/her secretions and excretions.
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Infections/conditions that require contact precautions:
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Salmonella, scabies, shigella, and pressure ulcers.
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In addition to standard precautions, nurses should also take these actions:
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—Wear a gown and gloves upon room entry of patient on contact precautions. —Use disposable/ resident dedicated noncritical care equipment. (BP cuffs, Stethoscopes.)
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When are “special” contact precautions needed?
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When organisms likely to have spores ( like Clostridium difficile) and some diseases ongoing transmission ( like Norovirus) In addition, perform hand hygiene with soap and water and consider hypochlorite solution( bleach for environmental cleaning)
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Droplet Precautions are used when:
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Patients have an infection that can be spread through close respiratory or mucous membrane contact with respiratory secretions.
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Infections/conditions that require Droplet precautions:
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Influenza, N Meningitidis( one of the causes of meningitis), pertussis( whooping cough), and rhinovirus ( common cold).
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In addition to standard precautions, use these as well on patient needing droplet precautions.
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-Wear a mask upon room entry of a patient on droplet precautions. – A single patient room is preferred. If not available, spatial separations of more than 3 feet and drawing the curtain between beds is especially important. – When patient is transferred outside of room should wear a mask if tolerated and follow respiratory hygiene.
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Airborne Precautions are used when:
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Patient have an infection that can be spread over long distances when suspended in the air. These disease particles are very small and require special respiratory protection and room ventilation.
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Infections/conditions that require airborne precautions:
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Chickenpox, measles, and tuberculosis.
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In addition to standard precautions uses these airborne precautions as well:
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-Wear a mask or respirator prior to room entry, depending on the disease-specific recommendations. ( Most disease will require N95 or higher respiratory protection.) -Place patient in an airborne infection isolation room ( AII)- single room that is equipped with special air handling and ventilation capacity. – If facility does not have an AII room, place person in a private room until person is transferred to another facility with an AII. -When possible, non-immune healthcare workers should not care for patients with vaccine preventable airborne diseases ( like measles or chickenpox) -AAIR room (negative pressure room). This mean it shares no ductwork or heating and cooling with the general hospital system. It must have its own ventilation, heating and cooling that has no communication with any other room in the hospital. – It must have a vent to the outside that must be three to six feet above the highest roofline of the institution. By the time it is vented out, the concentration of the molecules are harmless. They have been diluted beyond the point of being communicable – The room must exchange air 6-12 times an hour. The air in the room is vacuumed out and replaced with fresh air 6-12 times an hour, or every 5-10 minutes
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Proper donning and removal of Personal protective Equipment (PPE)
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Donning- Always put your protective equipment on before entering the room, for you are protecting yourself. PPE- Gown – mask – goggles – gloves. Unless otherwise specified, PPE means gown, mask, goggles, and gloves.
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Removing/ doffing:
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Remove inside the room, except for the mask, so that you don’t breathe in the pathogens. Goggles are usually used for universal precautions when you are suctioning. Gloves – goggles – gown – mask.

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