KKKk,;][xz;x

DEFINITION
ISOLATION:
Separation of infected person from
others in order to prevent the direct
or indirect transmission of infectious
agent.
PURPOSE
• Reduce transmission of infectious agents

between patients, caregivers, and others

in the medical environment.

• To reduce the incidence of nosocomial

infections among patients.

CHAIN OF INFECTION
The spread of infection is best described as a chain with six links:
1. Infectious agent.
2.The reservoir.
3.Portal of exit.
4.Mode of transmission.
5.Portal of entry.
6.Susceptible host.
CHAIN OF INFECTION
1.Infectious Agent

A microbial organism with the ability to cause

disease.

Infectious agents are :

bacteria

virus

fungi and parasites

CHAIN OF INFECTION
2.Reservoir
A place within which microorganisms can thrive and reproduce. E.g. microorganisms
thrive in human beings, animals, and inanimate objects such as water, table tops and door
knobs.
CHAIN OF INFECTION
3.Portal of Exit
A place of exit providing a way for
microorganisms to leave the reservoir.
CHAIN OF INFECTION
4.Mode of Transmission
Method of transfer by which the

organism moves or is carried from one

place to another.
CHAIN OF INFECTION
5.Portal of Entry
An opening allowing the microorganism to enter the host.
CHAIN OF INFECTION
5.Susceptible Host
A person who cannot resist a microorganism invading the body, multiplying, and resulting
in infection.
Breaking the Chain of Infection
 CDC guidelines for Isolation in hospitals.

The Revised guidelines(2016) contain Standard and Transmission-Based Precautions in

healthcare settings
1.Standard Precautions
2. Transmission based Precautions
a.Air borne
b.Droplet
c.Contact
d.Strict Isolation
STANDARD PRECAUTIONS
It aims to prevent transmission of infections from
1. Patient to health care worker
2. Health care worker to patient
3. Patient to patient
4. Hospital environment to patient
5. Hospital waste to community based
STANDARD PRECAUTIONS
Hand Hygiene.
Personal Protective Equipment.
Patient Placement.
Patient – Care Equipment.
Management of Linen.
Waste Management.
Spill management
Safe injection practices .
Respiratory Hygiene/Cough Etiquette .
TRANSMISSION BASED PRECAUTIONS

1.Airborne Precautions

2. Droplet Precautions

3. Contact Precautions
TRANSMISSION BASED PRECAUTIONS
TRANSMISSION BASED PRECAUTIONS
1.Airborne Transmission

 It occurs when droplet nuclei <5micron in

size are disseminated in air.

 These particles are suspended in air, dry

and produce particles ranging from 1-
5microns
TRANSMISSION BASED PRECAUTIONS
TRANSMISSION BASED PRECAUTIONS
1.Patient Placement
• Isolation room preferably single room.
• Room with a monitored negative air
pressure.

• HEPA filtered / N-95 mask

• Room air is directly exhausted
to the outside.
TRANSMISSION BASED PRECAUTIONS
2.Personal Protective Equipment(
PPE )
• Personal respirator ( N-95 mask )
• surgical mask
3.Patient Transport
• Limit movement of patient.
• Patient must wear a surgical mask.
• Follow respiratory hygiene and cough
etiquette
TRANSMISSION BASED PRECAUTIONS
2.Droplet Transmission
1. It occurs when there is adequate contact

between the mucous membrane of nose

and mouth/conjunctiva of a susceptible

person.

2. Large particles >5microns

TRANSMISSION BASED PRECAUTIONS
TRANSMISSION BASED PRECAUTIONS
1.Patient Placement
•Single room.
•Cohort with same microorganism.
•If cohorting not achievable, maintain
spatial separation of at least 3 feet between
the infected patient and other patients.
2.Personal Protective Equipment
3.Patient Transport
• Limit movement of the patient.
• Patient must wear a surgical mask.
TRANSMISSION BASED PRECAUTIONS
3.Contact transmission
• Direct transmission occurs when microorganisms are transferred from one infected
person to another person without a contaminated intermediate object or person.
eg:Blood/body fluids, cuts or brasions in the skin etc
• Indirect contact transmission involves the transfer of an infectious agent through a
contaminated intermediate object or person.
TRANSMISSION BASED PRECAUTIONS
TRANSMISSION BASED PRECAUTIONS

.
TRANSMISSION BASED PRECAUTIONS
1.Patient Placement
• Single room.
• Cohort with same microorganism.
• Maintain 3 feet distance between patients
• If cohorting and single room is not available.
•Keep the patient notes outside the room.
•Keep patient bedside charts outside the room.
•Disinfect hands upon leaving room and after writing
in the chart.
•Keepdoors closed
TRANSMISSION BASED PRECAUTIONS
2.Personal Protective Equipment
3.Patient Transport
• Limit movement of patient if
possible.
• Ensure that PPE is maintained
during transport.
FORMS OF ISOLATION
1.Strict isolation
 Strict isolation is used for diseases spread
through the air and in some cases by contact.
 Patients must be placed in isolation to prevent
the spread of infectious diseases.
 Examples include: diphtheria, pharyngeal,
herpes zoster, pneumonia and varicella
FORMS OF ISOLATION
2.Respiratory isolation
• Used for diseases that are spread through
particles that are exhaled.Those having
contact with or exposure to such a patient
are required to wear a mask.

• Examples include:H. Influenza, measles,

mumps, N. Meningitis.
FORMS OF ISOLATION
3.Reverse isolation
• Reverse isolation is a way to prevent a patient
in a compromised health situation from being
contaminated by other people or objects

• Patients whose immuno system has been

depressed prior to receving the
transplants,severed burns,patients receving
chemotherapy or radio treatments, immuno
system have ben failed.
FORMS OF ISOLATION
3.High isolation
• High isolation is used to prevent the
spread of unusually highly contagious,
or high consequence, infectious
diseases (e.g., smallpox, Ebola virus).
FORMS OF ISOLATION
4.Cohort isolation
• Cohorting- grouping of infectious
patients and nursing them within an
area of a hospital ward
• Hospital-acquired infection due to
meticillin-resistant Staphylococcus
aureus (MRSA) is common within
intensive-care units.
DONNING OF PERSONAL PROTECTIVE EQUIPMENTS
DUFFING OF PERSONAL PROTECTIVE EQUIPMENTS
• At door way, before
leaving patient room
or in ante - room.
• Remove respirator outside
room after door has been
closed.
EXAMPLES
TRANSMISSION BASED PRECAUTIONS
Contact Precautions Airborne Precautions Droplets Precaution
 MRSA,Enteric  Tuberculosis  Hib B
infections(E.Coli, HSV,  Varicella  Influenza Pneumoniae
Enterovirus,  Measles  Rubella
Parainfluenza)  Small pox  Mumps
 Scabies  SARS  Diptheria
 Non-contained  chicken pox  pertusis
abscesses/ulcers(especi  pulmonary plague  meningitis
ally for S.Aureaus )
 Any one entering this  Any one entering this  Any one entering this
patients room MUST patients room MUST patients room MUST
wear: wear: wear:
-Gloves -Surgical mask -Surgical Mask
-Gown or N-95 mask
What are the Isolation Precautions?
What are the Transmission - Based Precautions
Demonstration on donning & doffing of PPE?