Precautions for Infections

Precautions for Infections Passed by Contact

Contact May Be Direct or Indirect

Many infections spread either through direct contact (touching the source) or indirect contact (touching something or someone who has contacted the object and has the organism on it.)  The precautions for infections spread by contact required that you  have a barrier between you and the item that has the infection on it to prevent the spread of the infection.

How to Build a Barrier

Building a barrier between you and the organism can  reduce your risk of acquiring or spreading the infection. You can accomplish this by washing your hands, wearing gloves, or covering your clothing.  If a job is going to be extremely messy, you may want to add a cap and mask to your outfit.  Your goal is to keep the nasty organism from entering any opening in your skin, even the ones you can’t see.  

 

Wash Hands and Wear Gloves with Cuts

I wash my hands frequently and, therefore, have multiple cuts and abrasions from friction burns. I always wear gloves as an added barrier to cover these openings even if I’m not aware of Lynn having any harmful bacteria I need to avoid. 

Lippincott Nursing Procedures (2019) 8th Ed. Philadelphia:Wolters Kluwer. (200)

precautions for Infections Passed by Airborne Means

Airborne Germs Travel Throught the Air

Your doctor may tell you that your family member has a condition that requires “airborne precautions.” What that means is that they have a respiratory infection they can pass to other people. As a caregiver you need to know the precaution for infections that are spread by airborne means.

 

How  Germs Spread Through the Air

      There are lots of ways to spread germs. The bacteria or virus can travel through the air with coughing, sneezing, blowing the nose, spitting (when making a sound), during eating (child), or other expressions of saliva (children have many creative ways). The tiny microscopic virus or bacteria may catch a ride on a speck of dust and travel through the air to other family members to infect them as they take their next breath.

 

Particles Travel 3 Feet When Coughed

 

     The particles are less than 5 micrometers in size and can travel up to three feet to land on someone else. (Is there any wonder that the flu spreads so quickly in school systems?)

 

 Follow These Precautions

     If your care-receiver has a condition that is spread by airborne means, observe the following precautions:

  • Wash your hands with soap and water thoroughly (sing Happy Birthday twice to yourself to make sure you have washed long enough)
  • Wear a mask if you are going to be within three feet of them.  If they are coughing, also cover your clothing and wear gloves because what they cough on you is alive, and the surfaces you touch has live germs on them.
  • Keep the person in a room to themselves with the door shut. A towel placed in front of the door will block air from escaping from within the room.
  • Use disposable plates and utensils for meals or wash dishes in the dishwasher to disinfect.  Wash clothes separately from the rest of the family in hot water wash.
  • Place discarded tissues in a plastic bag and mark it as biohazard to take to a landfill or label as biohazard if you have trash pick-up.

Reference: https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html

Precautions for Infections passed on Droplets

Bacteria and Viruses Tavel of Droplets

     We handle conditions spread through droplets the same way we manage airborne diseases. The offending germs travel on a respiratory droplet from a sick person through a sneeze, cough, or talking up to three feet to invade the mucous membranes of a susceptible host. The family member needs to know the precautions for infections related to droplet transmission.

What to do
  • Wearing a mask can help reduce your risk of letting those droplets get through. The mouth and nose must be covered to prevent germ access to your respiratory system. 
  • Wearing gloves helps reduce the transfer of the germs by preventing you from coming into contact with the droplets that land on surfaces.  If you touch the surface and then touch your nose or mouth with your hand, you introduce the germs from the droplets to your mucous membranes.
  • Discard used tissues promptly.  Do not reuse handkerchiefs that maintain moisture creating a breeding ground for the germs to multiply.
  • Cough into the bend of your elbow to prevent contaminating your hands with droplets from your cough/sneeze.
  • Please wash your hands thoroughly after sneezing, coughing into them, or coming into contact with anything that may be contaminated. 

A point of interest:  The common cold (rhinovirus) is contagious for the duration of the illness for as long as you are producing moist secretions. 

 Lippincott Nursing Procedures (2019) 8th Ed. Philadelphia:Wolters Kluwer. (240)

Conditions Requiring Contact Precautions

An abscess (draining) – Duration of drainage or until contained with a dressing

Acute viral hemorrhagic conjunctivitis – duration of illness

All bacterial-induced diarrhea gastroenteritis– Till symptoms under control

Adenovirus pneumonia – Duration of sickness and maybe long for immunocompromised patients. 

Avian flu – 14 days after onset of symptoms

Bronchiolitis – duration of illness

Clostridium difficile (C diff) gastroenteritis – duration of illness plus several days after diarrhea stops because the virus continues to shed for several days. Alcohol-based hand cleaners do not kill C diff. – must use soap and water and antimicrobial soaps.

Coronavirus – isolate for 14 days or until symptoms are gone whichever is longer.

Diphtheria, (skin) – until two cultures obtained 24 hours apart come back negative.

Hepatitis A – for one week after onset of symptoms

Shingles (Herpes zoster) – If anyone in the house is immunocompromised, cover the lesions entirely and keep them covered until all are dry and crusted

Impetigo – for 24 hours after treatment starts

Norovirus gastroenteritis – duration of illness and 24-72 hours afterward. Recommend wearing a mask while cleaning up after any spills or accidents that occur.

Head or body lice – 24 hours after treatment starts

Chickenpox – until all lesions crusted

Streptococcus Group A skin wound or burn – 24 hours after starting effective treatment

Staphylococcus aureus skin wound or burn – duration of illness

Reference:

Lippincott Nursing Procedures (2019) 8th Ed. Philadelphia:Wolters Kluwer. (201)

The following conditions require airborne and Droplet precautions:

Avian Flu – isolate for 14 days after onset of symptoms

Chickenpox – isolate until all lesions crust, and no new lesions appear 

Coronavirus – isolate for 14 days or until symptoms are gone whichever is longer.

Herpes zoster – isolate as long as present in a patient who is immunocompromised.

Influenza (Flu) – May carry the virus for 1-4 days after exposure and 24-hours after fever ends.

Measles – isolate for four days after the onset of the rash.

Meningitis – may carry bacteria for 1-10 days, depending on type before symptoms show. Isolate until treatment is effective for acute symptoms for 48 hours.

Monkeypox – isolate while excluding smallpox.

Mumps – isolate for five days after the onset of parotid gland swelling. May carry the germs for 16-18 days before symptoms show. 

Norovirus – Isolate for 24 hours after symptoms stop. Symptoms begin 12-24 hours after exposure. Must use extremely good handwashing with this one. Very contagious.

Pertussis (whooping cough) – Isolate for at least five days following initiation of appropriate antibiotic therapy.  The course of this condition takes weeks to resolve. The first symptoms show 9-10 days after exposure. 

Rubella (German Measles) – First symptoms show 14-17 days after exposure. Isolate for seven days after the rash begins.  It is vital to keep away from pregnant women while this disease is active. Due to risks to unborn children if exposed. 

Severe acute respiratory syndrome – for the duration of illness plus ten days after resolution of fever.

Smallpox – For the duration of illness and until all scabs are crusted and separated

Streptococcal Diseases – Scarlet Fever and Strep Throat. Symptoms begin 2-5 days after exposure. Isolate during acute illness and after antibiotic therapy is effective. 

Tuberculosis – (extrapulmonary draining lesion) Until the patient improves clinically and drainage has ceased or has three negative cultures

Tuberculosis, pulmonary or laryngeal disease, confirmed – until the patient develops clinical while on effective therapy and has three consecutive sputum smears negative for acid-fas bacillus, collected on separated days

References: https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html