Understanding Isolation in Healthcare Settings

2. Outline Definition of isolation Principles of Isolation Isolation Policy Policy implementation Personnel Roles & Responsibilities Visitation

3. Definition of Isolation Isolation refers to the precautions that are taken in the hospital or department to prevent the spread of an infectious agent from an infected or colonized patient to susceptible or uninfected patient.

4. Principles of Isolation The main purpose of isolation is to control and prevent the nosocomial infection. Isolation principles in Neonates are the same as those used in adult isolation, in addition to extra rules and recommendations. Isolation room should be available at all times, which may care for infants having multiple infections.

5. Neonates with the following conditions should be kept in a separate isolated room: Nosocomial infections, e.g. klebsiella. Babies who have positive culture for ESBL producer, pseudomonas or other gram negative bacteria. Infants born to mothers with High vaginal swab for group B Strep. Newborns who are susceptible to be infected with Tetanus or Gonorrhea

6. Neonates with the following conditions should be kept in a separate isolated room: Congenital infections (syphilis, CMV, neonates with rubella), toxoplasmosis need not to be isolation. Neonates admitted from outside the hospital regardless of age and history until proven by cultures and other lab tests the free of sepsis.

7. Isolation Policy Apply comprehensive standard precautions to all babies admitted to isolation room in NICU. Ensure utilizing effective communication channels between all levels of care providers. Use single disposable items for each baby admitted to isolation room. Always label the isolation room with the type of isolation, and necessary instructions.

8. Isolation Policy For airborne precautions, use extra measures beside standard precaution measures, especially for those patients known or suspected to be infected with any microorganisms transmitted by the airborne route. For droplet precautions, use extra measures in addition to standard precautions for a patient known or suspected of being infected with microorganisms transmitted by large-particle droplets. For contact precautions: use extra measures in addition to standard precautions for a patient known or suspected of being infected or colonized with microorganisms transmitted by direct contact with the patient, or indirect contact with environmental surfaces, or patient care items.

9. Isolation Policy No rings, watches or other ornaments should be worn when entering to isolation room or NICU. No other clothes accepted in the isolation room except the uniform that should be changed daily. Clean Gown for each baby should be worn over the uniform when handling the baby and do not forget to change gown when handling other baby. No food or beverage should enter to the isolation room under no circumstances.

10. Isolation Policy Avoid unnecessary circulation in the isolation room. Nurse scheduled to work in the isolation room should not work with any other baby outside the isolation room. Strict adherence to hygienic rules when performing any invasive procedure such as cannula, handling the UVC or obtaining lab tests. Incubators should be changed at least weekly and cleaning should be done in a special area outside the isolation room. Oxygen & suction equipments should be changed daily.

11. Policy implementation Consider every person (patient or staff) as potentially infectious and susceptible to infection. Wash your hands which is the most important procedure for preventing cross-contamination Wear gloves on both hands before performing any invasive procedures or touching the patient. Use an alcohol-based antiseptic product, For cleansing the skin prior to any invasive procedure.

12. Policy implementation Use physical protective barriers such as gloves, gowns, or masks if splashes and spills of any body fluids are expected. Use safe work practices such as not recapping or bending needles, and safely pass sharp instruments. Safely dispose of infectious waste materials to protect those who handle them and prevent injury or spread of infection to the community.

13. Personnel Roles & Responsibilities Should comply with the pre-employment health requirements. Should not work in the isolation area if they have skin, eye, respiratory, gastrointestinal or other active infections. Women employees with child-bearing potential should be advised regarding the importance of rubella antibody determination. All personnel should be competent and qualified in using all types of standard precautions. Cover coats (closed) should be worn whenever leaving the isolation.

14. Personnel Roles & Responsibilities All personnel from other departments should scrub hands and wear long-sleeved gowns over their clothes whenever they enter the NICU. Nails should be kept short and clean. Jewelry should not be worn in the isolation. No one with an infection is allowed to work in the ISOLATION. In situations where a physician or nurse with a mild upper respiratory infection needs to handle a baby, a double mask should be worn and changed frequently as needed.

15. Personnel Roles & Responsibilities Assist in the formulation of infection control guidelines, policies and procedures. Review status of infants daily to detect occurrence of transmissible infections. Observe, assess, and enforce adherence to infection control policies and procedures. Periodically review and revise as necessary the infection control policies and procedures. Notify Infection Control Committee of all reportable diseases.

16. Visitation Only parents are accepted to visit in the isolation. Parents with any signs of infection should not visit in the isolation. Parents should comply with the hospital infection control and procedures (hand washing and gowning). Parents should be taught the infection control guidelines, polices and procedures for infection control to visit the isolation.