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|2007 Source Isolation Policy (92 kB)|
Page updated 30 April 2007
Do a risk assessment and prepare the room & patient
Plan equipment for the room
Print out a Contact Precautions (Source Isolation) Notice to stick on the door
SOURCE ISOLATION PROCEDURE:
Use plastic aprons (yellow / pink depending on your local hospital practice) and gloves
Clean hands or gloves before you touch the patient
Discard protective clothing into the yellow sack in the room
Clean hands when you leave
Arrange special cleaning of the room or bed space
INFORM THE INFECTION CONTROL TEAM
Check if the disease needs to be notified (See Notifiable Diseases)
Do a risk assessment to decide whether it is necessary to source isolate a patient for the protection of others. Record this in the patient's notes and clearly state the reasons. You may ask for and the patient may request a visit from a member of the Infection Control Team for a more complete explanation.
If the number of side rooms is limited, then the following hierarchy of risk should be used when deciding who should go into a side room:
It may be necessary to cohort nurse all patients with a particular condition (e.g. diarrhoea) in a section of the ward or whole ward. A decision then has to be made as to whether to close a ward because of an unacceptable risk to new admissions.
Prior to moving the patient into a single room:
Equipment required for source isolation:
Note: for some diseases (e.g. viral haemorrhagic fever) all waste and linen will be put into disposable sealable bins for incineration
In the ward:
Before entering the room, staff members should:
Inside the room (or visiting bed space):
Before leaving the room or bed space:
Outside the room:
The risks to visitors should be assessed (low risk for MRSA, high risk for chickenpox). If in doubt, ask the Infection Control Team before allowing visits. Visits by children should be discouraged. The following actions should be followed if a visitor is allowed to see a patient in source isolation:
If equipment is removed from the room it must be decontaminated according to the disinfection policy. If it is to be serviced, a Permit to Work certificate is required to ensure safety of the maintenance staff members.
The nursing staff should consider the following points when decontaminating the room after a patient has been in source isolation:
Domestic staff membes should wear protective clothing (yellow plastic apron and domestic rubber gloves).
Daily cleaning should be done by ward domestic staff members after cleaning the rest of the ward. Disposable cloths will be used and discarded. Domestic staff members should use Marigold gloves or equivalent, not clinical gloves.
The following points should be kept in mind:
After discharge of patients harbouring methicillin-resistant Staphylococcus aureus (MRSA), glycopeptide-resistant enterococci (GRE) and Streptococcus pyogenes or other diseases at discretion of the Infection Control Team, special cleaning will be performed.
Curtains will be taken down and sent for laundering in an alginate bag. Paper curtains will be disposed of in a yellow sack.
When the surfaces have been cleaned with detergent, all hard surfaces must be wiped with fresh chlorine-releasing solation at 10,000 ppm free chlorine and allowed to dry.
On completion of the cleaning, the bucket must be cleaned and the mop head disposed of or sent for laundering. The domestic should then remove the plastic apron and discard it into the yellow bag. The bag must be secured before sending for incineration.
Domestic rubber gloves should be washed whilst sill wearing them and then placed with the mop bucket. Throw them away if they are perforated. Thorough handwashing should then be carried out before leaving the room and again after disposing of the yellow bag. Later, return and replenish soap, paper towels, replace curtains, etc. Inform local nursing staff and supervisor that the task is complete.
For further details, see Section on Cleaning Areas Used for Source Isolation and the domestic cleaning policies held in local domestic cleaning departments. If a room is carpeted, seek advice from the Infection Control Team.