Podcast
Questions and Answers
What is the primary purpose of Standard Precautions (SP)?
What is the primary purpose of Standard Precautions (SP)?
Transmission-based precautions are unnecessary if Standard Precautions are followed.
Transmission-based precautions are unnecessary if Standard Precautions are followed.
False
What two environments apply the two-tier system of isolation precautions?
What two environments apply the two-tier system of isolation precautions?
Hospital and community
Standard Precautions mainly prevent the transmission of microorganisms via contact with __________.
Standard Precautions mainly prevent the transmission of microorganisms via contact with __________.
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Match the type of precaution with its description:
Match the type of precaution with its description:
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What is the second tier of isolation precautions called?
What is the second tier of isolation precautions called?
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All patients in a hospital setting must be identified at all times.
All patients in a hospital setting must be identified at all times.
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What are the special precautions for Multidrug Resistant Organisms (MDROs)?
What are the special precautions for Multidrug Resistant Organisms (MDROs)?
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Which of the following is NOT included in standard precautions?
Which of the following is NOT included in standard precautions?
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Standard precautions apply only to patients with known infections.
Standard precautions apply only to patients with known infections.
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What is the preferred method of hand hygiene if hands are not visibly soiled?
What is the preferred method of hand hygiene if hands are not visibly soiled?
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Standard precautions apply to all patients, including contacts with _____ and body fluids.
Standard precautions apply to all patients, including contacts with _____ and body fluids.
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Match the hand hygiene situations with the appropriate actions:
Match the hand hygiene situations with the appropriate actions:
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In which scenario should hand hygiene not be performed?
In which scenario should hand hygiene not be performed?
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Environmental control is considered part of standard precautions.
Environmental control is considered part of standard precautions.
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What is the time duration recommended for effective hand washing?
What is the time duration recommended for effective hand washing?
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When should gloves be removed during a procedure?
When should gloves be removed during a procedure?
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A staff member should wear a mask if they have respiratory symptoms.
A staff member should wear a mask if they have respiratory symptoms.
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What is the primary purpose of a gown/apron in healthcare settings?
What is the primary purpose of a gown/apron in healthcare settings?
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Masks and eye protection are necessary when __________ are likely to generate splashes.
Masks and eye protection are necessary when __________ are likely to generate splashes.
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Match the following PPE items with their primary usage:
Match the following PPE items with their primary usage:
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What type of precaution is needed for patients with MRSA?
What type of precaution is needed for patients with MRSA?
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A single-use gown can be reused for multiple procedures.
A single-use gown can be reused for multiple procedures.
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Name one condition that might require droplet precautions.
Name one condition that might require droplet precautions.
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What is the main purpose of Droplet Precautions?
What is the main purpose of Droplet Precautions?
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More frequent environmental cleaning is necessary for preventing cross infection during contact precautions.
More frequent environmental cleaning is necessary for preventing cross infection during contact precautions.
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What spatial separation should be maintained between infected patients and others during Droplet Precautions?
What spatial separation should be maintained between infected patients and others during Droplet Precautions?
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Active damp scrubbing should be used to clean and disinfect ______ surfaces.
Active damp scrubbing should be used to clean and disinfect ______ surfaces.
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Match the following terms with their definitions:
Match the following terms with their definitions:
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What should healthcare workers wear when working within one metre of patients with communicable diseases?
What should healthcare workers wear when working within one metre of patients with communicable diseases?
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Patients with airborne diseases can be placed in a regular patient room without special ventilation.
Patients with airborne diseases can be placed in a regular patient room without special ventilation.
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For what purpose should patients be transported outside their room?
For what purpose should patients be transported outside their room?
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What is the minimum requirement for MRSA clearance screening?
What is the minimum requirement for MRSA clearance screening?
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Healthcare workers should wear a _______ mask when transporting patients who have droplet-transmissible diseases.
Healthcare workers should wear a _______ mask when transporting patients who have droplet-transmissible diseases.
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Match the following diseases with their appropriate isolation precautions:
Match the following diseases with their appropriate isolation precautions:
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Swabs for MRSA screening should be taken from the nasopharynx only.
Swabs for MRSA screening should be taken from the nasopharynx only.
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What must be avoided after the completion of targeted antimicrobial treatment for MRSA?
What must be avoided after the completion of targeted antimicrobial treatment for MRSA?
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What should be done if an infectious patient cannot be placed in an airborne infection isolation room?
What should be done if an infectious patient cannot be placed in an airborne infection isolation room?
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All patients with communicable diseases must wear a surgical mask during transport.
All patients with communicable diseases must wear a surgical mask during transport.
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When handling dead bodies, you must wear appropriate __________ equipment.
When handling dead bodies, you must wear appropriate __________ equipment.
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Match the following components with their relevant practices for handling dead bodies:
Match the following components with their relevant practices for handling dead bodies:
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What should be done with patients in an ambulatory setting waiting for examination if isolation facilities are not available?
What should be done with patients in an ambulatory setting waiting for examination if isolation facilities are not available?
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What is the required interval between swabs for MRSA screening?
What is the required interval between swabs for MRSA screening?
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It is safe to touch your eyes, mouth, or nose when handling a dead body.
It is safe to touch your eyes, mouth, or nose when handling a dead body.
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What thickness should a plastic bag used for deceased bodies be at a minimum?
What thickness should a plastic bag used for deceased bodies be at a minimum?
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Study Notes
Protective Measures (I): Isolation Precautions
- Protective measures for different transmission modes are discussed.
- A two-tier system is employed for isolation precautions in hospitals and communities.
- The first tier, Standard Precautions (SP), applies to all patients regardless of their diagnosis.
- SP aims to prevent the transmission of microorganisms through contact with blood, body fluids, secretions, excretions, mucous membrane and non-intact skin.
- The second tier, Transmission-Based Precautions, is used in addition to SP when Standard Precautions are insufficient to prevent infection.
- Examples include respiratory infections needing additional precautions.
Learning Objectives
- Students will compare isolation precautions for diseases with different transmission modes.
- Students will describe special precautions for multidrug-resistant organisms (MDROs).
- Students will describe the criteria for clearance of MRSA carriage.
- Students will devise a plan for isolation precautions for specific communicable diseases.
Isolation Precautions in Hong Kong
- A two-tier system is used: Standard Precautions and Transmission-Based Precautions.
- Standard Precautions apply to all patients, regardless of their diagnosis, to prevent transmission of microorganisms through contact with blood, body fluids, secretions, excretions, mucous membranes, and non-intact skin.
- Transmission-Based Precautions are used in addition to Standard Precautions for specific diseases where standard precautions are not enough to prevent infection.
1. Standard Precautions
- Standard precautions apply to all patients, regardless of diagnosis.
- They cover situations involving contact with blood, body fluids, excretions, secretions, and non-intact skin (excluding sweat).
- Standard precautions include hand hygiene, use of Personal Protective Equipment (PPE), patient placement, handling of used equipment, environmental control, and linen management.
- Precaution measures also include prevention of needlesticks and sharps injuries, safe injection practices, and respiratory hygiene/cough etiquette in healthcare settings.
1.1 Hand Hygiene
- Hand hygiene (hand washing/handrub) is performed between direct patient, resident and client contacts.
- It's done after touching body fluids, excretions, secretions, mucous membranes and contaminated items.
- Alcoholic handrub is prioritized if hands are not visibly soiled.
- Facilities for hand hygiene should always be available and accessible to residents and visitors.
- Education on hand hygiene should be provided to all patients.
1.2 Use of Personal Protective Equipment (PPE)
- Gloves are used when contact involves blood, body fluids, secretions, excretions, mucous membrane and non-intact skin.
- Gloves are removed after completing the procedure.
- Masks, eye protection and face shields are used when splashes of blood, body fluids, excretions, or secretions are anticipated or likely.
- Gowns/aprons are used to protect clothing from contamination.
1.3 Patient Placement
- Patients at high risk of transmitting infection or poor hygiene should be in single rooms or physically separated locations.
- Spatial separation of at least 1 meter is needed for droplet precautions.
1.4 Handling of Used Equipment
- Handle used equipment to prevent skin and mucous membrane exposure and contamination.
- Contaminated reusable equipment should be cleaned and disinfected before use by another patient.
1.5 Environmental Control
- Areas near patients (bed rails, bedside tables, etc.) should be cleaned more often than other areas.
- Terminal cleaning and disinfection of patient areas should be performed upon discharge.
1.6 Linen Management
- Used linen should be handled and processed correctly to avoid contaminating people and the environment.
- Bulky soiled material (e.g., feces) should be removed from linen before placing it in laundry bags.
1.7 Prevention of Needlesticks and Sharps Injuries
- Use safe needle alternatives whenever possible.
- Avoid practices that increase injury risk.
- Use a one-handed "scoop" or mechanical recapping device when recapping is unavoidable.
- Put used needles in a puncture-resistant container.
1.8 Safe Injection Practices
- Use sterile, single-use needles and syringes for each injection.
- Single-dose vials are preferred over multiple-dose vials.
- Needles/cannulas and syringes must be sterile if using multi-dose vials.
1.9 Respiratory Hygiene/Cough Etiquette
- Alert patients to respiratory hygiene/cough etiquette.
- Mask and separate individuals with respiratory symptoms.
- Observe droplet precautions.
2. Transmission-Based Precautions
- Additional precautions for highly transmissible pathogens.
- Includes contact, droplet, and airborne precautions.
- Used in addition to standard precautions.
2.1 Contact Precautions
- Used for patients with or suspected of infections transmitted by direct or indirect contact.
- Includes placing patients in single rooms, minimizing environmental contamination during transport and using appropriate PPE when handling equipment.
2.2 Droplet Precautions
- Used for patients with or suspected of infections transmitted by large particle droplets (e.g., coughing, sneezing).
- Includes placing patients in single rooms with one-meter separation, using surgical masks when working within one meter of the patient, and transporting patients only for necessary purposes, using a surgical mask.
2.3 Airborne Precautions
- Used for airborne infections transmitted via small-particle residues in the air.
- Includes placing patients in negative pressure rooms and using respirators when entering the room.
- Additional precautions should be taken for patients with measles or chickenpox.
3. Precautions for Multidrug-Resistant Organisms (MDROs)
- MDROs are germs that have adapted to antibiotics.
- Examples include MRSA and VRE.
- Colonization: Presence of the germ on or in the body without illness.
- Infection: Illness resulting from germ presence and invasion.
- Precautions include using single rooms, minimizing the number of people entering the room, frequent cleaning, and using dedicated non-critical items.
- Transferring patients should be avoided if possible, otherwise, the receiving department should be notified.
- Patient risk of spreading MDROs should be evaluated and appropriate precautions implemented.
3. Precautions for Clearance of MRSA Carriage
- Two consecutive screening cultures with negative results.
- Swabs taken from specified areas with a 48-hour interval.
- Patients must take baths with a chlorhexidine solution, and apply a povidone-iodine ointment to the nostrils for several days to decolonize.
- Patients who take antimicrobials for MRSA should be screened 48 hours after completing their treatment to ensure the results aren't skewed.
4. Handling of Dead Bodies
- Avoid direct contact with body fluids.
- Wear appropriate PPE.
- Wounds should be covered.
- Do not touch eyes, mouth, or nose.
- Place the body in opaque, leak-proof plastic bags.
- Label the body bag with proper identification.
- Remove PPE and wash hands afterwards.
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Description
This quiz focuses on isolation precautions, including Standard and Transmission-Based Precautions implemented in healthcare settings. Students will explore the differences in protective measures based on various transmission modes and understand special considerations for multidrug-resistant organisms (MDROs). Further, they will learn about MRSA clearance criteria.
