Question

Mrs. Shimizu is an 80-year-old female admitted to the hospital 9 days ago for treatment of cirrhosis of the liver. On admission she was placed in a semiprivate room with a roommate with kidney failure. Because of her age, she has a compromised immune system and has begun to show signs, by auscultation and radiograph, of lung infiltrate. Physical therapy services, specifically respiratory care, and bed mobility have been ordered for Mrs. Shimizu.

2.What infection-control guidelines should be followed in providing care?

3. What standard precautions should be implemented by physical therapists/assistants providing care?

4.As part of overall management of this patient, when should the physical therapist/assistant wash their hands?

Answer 1

As per the question Mrs. Shimizu is a 80 years old female admitted to hospital 9 days ago for the treatment of cirrhosis of liver. Her room in the hospital was shared with a patient of kidney failure. As she was too old her immune system was too weak. Due to her poor immune system she has begun to show the sign of lungs infiltration. Lungs infiltration is a airbore disease in which foreign substance accumulate or diffuse over the cells of lungs. She has been recommended for immediate physical therapy, respiratory care and bed mobility.

Following guidelines must be followed to control the furthur infection:

Artifitial manipulation shall be done on patient's airways by the Aerosol-generating medical procedures (AGMPs). some example are manual ventilation, open endotracheal suctioning, nebulized therapy, CPR, bronchoscopy, chest therapy etc.

N95 respirator must be use to cover patient nose, mouth and chin. That mask filter 95% of the airbone particles from the air.

Patient must be placed in airbone isolation room. Room must be ventilated and clean.

Standard precautions that must be implemented by the therapist while providing cares are:

Ventilation and inward directional flow of the airborne isolation room must be monitered.

The direct exhaust of the room to outwards must be filtered through HEPA filter before free circulation.

Door and windows must be close all the time even if the patient is not present in room to maintain negative pressure of the room.

All therapist must be equipped with the PPE essentials example are face mask, hand gloves, shoe cover, hair cover, body aprons, etc. before entering the patient room. And shall be disposed safely later on.

If there is no facility of airbone room then patient must be place in single room.

Only limited visitors should be allowed in patient, if possible no one shall allowed to enter the room.

Family and visitors should be educated to take all precautions of airbone sginage,

During the overall management of this patient, therapist must follow the hand hygiene specially before entering the patient room and after leaving the patient room, hand wash must be done.

Better for them to wash their hands before and after every interaction with the patient.