Question

1-Explain why it's important for the nurse to Identify probable precautions early?

2- What is standard precaution ?

3- What PPE is expected with airborne Isolation?

4- Explain the differences between Airborne and Droplet precautions!

Answer 1

1.It is important for the nurse to identify probable precautions early because :-

a. Precautions are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered.

                     b. The safety of nurses from workplace-induced injuries and illnesses is important to                           nurses themselves as well as to the patients they serve.

c. Nurse may get more exposure with patient and this may increase the risk of getting infection from the patient .

d.. Nurse can even act as a carrier and spread infection to other patients and healthcare workers.

e.To promote a safe environment both for patients and healthcare workers .

f. To provide a quality care.

g. To prevent hospital acquired infection .

h. Identifying probable precautions early would reduce unnecessary risks associated with health care.

2. Standard Precaution

They are the basic level of infection control precautions which are to be used, as a minimum, in the care of all patients. Standard precautions are meant to reduce the risk of transmission of blood borne and other pathogens from both recognized and unrecognized sources.

Key elements in standard precaution :-

a. Hand hygiene - It is a major component of standard precautions and one of the most effective methods to prevent transmission of pathogens associated with health care.

b. Personal Protective Equipments - It refers to the clothing and devices designed to protect the wearer's body from exposure to infection. PPE can include gloves, face masks, gowns, and more.

c. Prevention of needle stick and injuries from other sharp instruments- care when: Handling needles, scalpels, and other sharp instruments or devices.

d. Respiratory hygiene and cough etiquette - Persons with respiratory symptoms should apply source control measures like covering their nose and mouth when coughing/sneezing with tissue or mask etc.

e. Environmental cleaning - Use adequate procedures for the routine cleaning and disinfection of environmental and other frequently touched surfaces.

f. Linens - Handle, transport, and process used linen in a manner which prevents skin and mucous membrane exposures and contamination of clothing.

g. Waste disposal - Ensure safe waste management.

h. Patient care equipment - Handle equipment soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of pathogens to other patients or the environment.

3. Airborne Isolation

  
Airborne isolation precautions—used for diseases or very small germs that are spread through the air from one person to another (examples: Tuberculosis, measles, chickenpox).

-Some procedures are believed to generate aerosols and droplets as a source of respiratory pathogens . Examples – Intubation , extubation ,non-invasive ventilation etc.

- For patients with infections like COVID -19 and aerosol generating procedures we have to use contact , droplet and airborne precautions combined for protection. Some critically ill patients requiring extended length of care may also require addition of airborne precautions.

PPE includes :-

-Gloves, protect the hands,

-gowns or aprons protect the skin and/or clothing,

-masks and respirators protect the mouth and nose, -Wear an N95 Respirator or Powered Air-Purifying Respirator (PAPR) - Healthcare worker to wear appropriately fit-tested N95 respirator upon entering room  and when assisting or performing any procedures .

-goggles protect the eyes, and face shields protect the entire face.

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4. Difference between Airborne and Droplet precautions

    Droplet precautions: -

• Droplet precautions are necessary when a patient infected with a pathogen, such as influenza, is within three to six feet of the patient.
• Infections are transmittable through air droplets by coughing, sneezing, talking, and close contact with an infected patient's breathing. Droplets are about 30 to 50 micrometers in size.
• Patients should be placed in individualized rooms, if possible.
• In addition to standard precautions, personnel should wear protective surgical masks should always before interacting between an infected patient or his/her environment.

Airborne precautions:-

• Airborne precautions are required whenever entering a patient's room or environment who has been diagnosed with or is being tested for with high suspicion of diseases like anthrax, tuberculosis, measles, chickenpox, or disseminated herpes zoster or other pathogens that can be transmitted through airflow that are 5 micrometers or smaller in size and remain in the environment for long periods of time.
• In addition to standard precautions of wearing gloves and a gown, the CDC requires additional PPE of an approved N95 respirator mask properly fitted for each person working in the health-care environment.
• The CDC also strongly recommends placing patients diagnosed with or receiving testing for, with high suspicion of an infectious airborne organism in a single room known as an airborne infection isolation room (AIIR). These are negative pressure rooms that provide air filtration and 6 to 12 air exchanges per hour to reduce the risk of transmission.