1M Universal Precaution Isolation Technique and Double Bagging

Cebu Doctors’ University
College of Nursing
Mandaue City, Cebu
NCM 118:
Care of Clients with Communicable Diseases, Life-Threatening Conditions,
Acutely Ill/Multi-organ Problems, High Acuity, and Emergency Situations
(Acute & Chronic)
RLE 1M:
Universal Precaution, Isolation Technique, and Double
Bagging
Submitted by:
Miasco, Herra - CLO #3

Sabanal, Pauline - CLO #4
Sidon, Sophia - CLO #2, CLO #5
Son, Vaughn Joshua - CLO #1, CLO #6
Uy, Elaiza Mae - CLO #2, CLO #7 & #8
Facilitator:
Ms. Patricia Mae Gabaca, RN
Date Submitted:
August 19, 2023

COURSE LEARNING OUTCOMES
CLO #1: define the following terms in relation to universal precaution, isolation technique and
double bagging.
● communicable disease
● contagious disease
● infection
● isolation
● isolation room
● isolation technique
● negative-pressure isolation room
● nosocomial infection
● quarantine
● universal precaution
● double bagging
● health care waste
CLO #2: discuss the importance of universal precaution, isolation technique, and double
bagging.
CLO #3: classify the indications of universal precaution, isolation technique, and double
bagging.
CLO #4: explain the principles of universal precaution, isolation technique, and double bagging.
CLO #5: explore the following types of isolation techniques according to their purpose,
diseases, type of isolation room, standard precautions, and nursing responsibilities.
● strict
● contact
● respiratory
● Tuberculosis
● enteric
● blood and body fluids
● drainage and secretions
● Reverse
CLO #6: outline the color-coding scheme for healthcare wastes and healthcare waste
management.
● Black- Non-infectious dry waste

● Green- Non-infectious wet waste
● Yellow- infectious and pathological
● Yellow with black band- Chemical waste
● Orange- Radioactive waste
● Red- Sharps and pressurized containers
CLO #7: present the 2007 Guidelines for Isolation Precautions in the Health Care Settings
based on the Healthcare Infection Control Practices Advisory Committee / Centers for Disease
Control and Prevention.
● Handwashing
● Respiratory Hygiene / Cough Etiquette
● Safe Injection Practices
● Personal Protective Equipment (PPE)
CLO#8: demonstrate beginning skills in double bagging.

CLO#1: define the following terms in relation to universal precaution, isolation technique, and
double bagging.
Learner: Mr. Son, Vaughn Joshua G.
Terms:
• communicable disease
- Is an illness caused by an infectious agent or its toxic products. Communicable disease
may be transmitted directly or indirectly to a healthy person through an agent, vector or
inanimate object. This includes bodily discharges or fluids (such as respiratory droplets,
blood or semen)
• contagious disease
- a communicable disease that can spread rapidly from person to person through direct
contact (touching a person who has the infection), indirect contact (touching a
contaminated object), or droplet contact (inhaling droplets made when a person who has
the infection coughs, sneezes, or talks).
• infection
- the invasion and multiplication of microorganisms such as bacteria, viruses, and
parasites that are not normally present within the body.
• isolation
- the condition of being separated from other people, towns, countries, etc,:
geographic/rural/social isolation.
• isolation room
- special hospital rooms that keep patients with certain medical conditions separate from
other people while they receive medical care.
• isolation technique
- a medical aseptic practice, that inhibits the spread and transfer of pathogenic organisms
by limiting the contact of the patient and creating some kind of, physical barrier between
the patient and others.
• negative-pressure isolation room
- also called an airborne infection isolation room (AIIR), is a single-occupancy patient-care
room used to isolate persons with a suspected or confirmed airborne infectious disease
- it is called negative air pressure because the air pressure inside the room is lower than
the air pressure outside the room.
• nosocomial infection
- the term nosocomial infection is retained to refer only to infections acquired in hospitals
- is an infection acquired at least 72 hours after hospitalization.
• quarantine
- A period of isolation decreed to control the spread of infectious disease.
- Before the era of antibiotics and other medications, quarantine was one of the few
available means for halting the spread of infectious diseases.
• universal precaution
- a standard set of guidelines to prevent the transmission of bloodborne pathogens from
exposure to blood and other potentially infectious materials (OPIM).
- This exercise examines general safety precautions and emphasizes the importance of
using an interdisciplinary team while implementing them.
• double bagging
- is an infection control measure in which one bag containing contaminated articles or
materials, such as soiled linen, is placed within another.
• health care waste

- sharps, non-sharps, blood, body parts, chemicals, medications, medical waste, and
sharps are all examples of healthcare waste.
CLO#2: discuss the importance of universal precaution, isolation technique, and double
bagging.
Learner: Ms. Uy, Elaiza
❖ Importance of:
● Universal precaution
○ prevent parenteral, mucous membrane, and nonintact skin exposures of
health-care workers to bloodborne pathogens
○ reduce the risk of transmitting HIV and other infectious diseases.
○ protect the patients as well as the healthcare providers.
○ prevent occupational exposure and accidents from sharp objects
● Isolation technique
○ separates sick people with a contagious disease from people who are not
sick or the general public.
○ ensures the safety of immunosuppressed individuals who are highly
susceptible to contracting other microorganisms from other patients or
medical personnel.
○ to minimize the spread of contagious diseases (COVID-19)
● Double bagging
○ decreases contaminants on the bag's exterior for a safer approach
○ provides additional security/ layer for garbage bags holding infectious
materials
○ guards against the bag being readily torn and pierced
CLO#3: classify the indications of universal precaution, isolation technique, and double
bagging.
Learner: Ms. Miasco, Herra
Indications of:
1. universal precaution
- It is a protective barrier to one’s individual most especially to Medical Health

workers.
For example:
1.1. A nurse working around human immunodeficiency virus (HIV) or
hepatitis B virus (HBV)
1.2. A nurse assigned to patients with bloodborne pathogens which could

put healthcare workers at risk for parenteral, mucous membrane, and
non-intact skin exposure.
1.3. A nurse assigned to patients with infected blood or body fluids visibly
contaminated with blood transmitted through direct contact. This includes
semen, vaginal secretions, CSF, synovial fluid, pleural fluid, peritoneal fluid,
pericardial fluid, amniotic fluid, and tissues
2. isolation technique
2.1 A nurse assigned to patients diagnosed with an infectious disease that

can be transmitted in a short distance, either airborne or droplets.
2.2 A nurse assigned to a patient infected with a type of microorganism

specifically from the GIT secretions or excretions that can be spread to
others directly or indirectly through contact with clothing, hands, surfaces, or
objects that are contaminated with microorganisms that are alive.
2.3. A nurse assigned to patients diagnosed with an infectious disease that

can be transmitted in a short distance, either airborne or droplets.
3. double bagging
3.1. Utilized when disposing of medical waste from clients with infections
(e.g. HIV).
3.2. To safely dispose of linens soiled by bodily waste/fluids.
3.3. To avoid contamination in each single bag being used.

CLO #4: explain the principles of universal precaution, isolation technique, and double bagging.
Learner: Ms. Sabanal, Pauline
Universal Precaution
Microbiology – This is done to stop the spread of infectious diseases inside hospitals and the
cross-contamination of microorganisms. To stop the transmission of microbes and infectious
diseases, people practice hand hygiene and wear PPE.
Anatomy and physiology – Healthcare professionals should be prepared and educated

about the portal of entry of the microorganism and how it impacts the general state of the
body.
Chemistry – To clean and stop the transmission of infection, the necessary and appropriate
chemical agents are used.
Safety and security – By preventing cross-contamination, this principle guarantees the

security of both the patient and the healthcare provider. The client is also examined by the
nurse to look for complications. To guarantee everyone's safety, a hazard-free atmosphere is
also maintained.
Sociology – Rapport is established between the healthcare provider and the nurse by
assessing the client’s level of comfort through interactions and assessments.
Psychology – Procedures are properly explained to the client to decrease their level of
anxiety.
Isolation Technique
Microbiology – This principle ensures isolation precautions are observed to prevent an

infectious agent from spreading to another area. Hand hygiene is strictly observed after every
contact with a client, wearing personal protective equipment (masks, gloves, gowns) is also
worn for protection.
Chemistry – The correct antiseptic agent is used when observing hand hygiene, as well as
disinfectant solutions for environmental sanitation.
Safety and security – Precautionary measures are practiced within the hospital setting for
the protection of both the health care provider and the client (hand hygiene, environmental
hygiene).
Psychology – The nurse allows the client to verbalize emotions as well as provides
emotional support during their isolation.
Double Bagging
Microbiology – Double bagging ensures that other hospital personnel and clients will not be
contaminated by the infectious agents within the first bag that would possibly contaminate and
infect other personnel and clients.
Safety and security – The nurse observes safety measures, handwashing, and wearing of
ppe, to protect themself from being infected and from spreading the infectious agent.
Time and Energy – All of the materials are prepared before conducting the procedure in
order to observe the principle of time and energy.
CLO#5: explore the following types of isolation techniques according to their purpose, diseases,
type of isolation room, standard precautions, and nursing responsibilities.
Learner: Ms. Sidon, Sophia
Types of Isolation Techniques
1. Strict
Purpose
● Its purpose is to prevent the spread of extremely contagious illnesses that can be
transmitted through both contact and airborne routes. It prevents the
transmission of pathogens from an infectious patient to others and protects
immunocompromised patients.
Diseases
● Chickenpox (Varicella) - a highly contagious viral infection that can be spread
through airborne droplets or direct touch.
● Tuberculosis - when an infected individual coughs or sneezes, the virus, which
predominantly affects the lungs, can spread via the air.
● Ebola Virus Disease - a viral disease that can be contracted by coming into
contact with an infected person's blood, saliva, organs, or other bodily fluids.
● COVID-19 - the disease caused by the novel coronavirus, SARS-CoV-2, can
spread through respiratory droplets and close contact.
Type of Isolation Room

There should be no offices, laboratories, other patient wards, or other regular human
activities under, over, or around this isolation unit. The unit should be located in a
separate ward, preferably in a separate building with direct access via an external sluice
and internal access through a negative air pressure sluice with sufficient areal for
donning and doffing and for safe treatment of infectious equipment and waste.
Specifications:
2 2
● Including the sluice (6 𝑚 ), decontamination room/bathroom (5 - 6 𝑚 ), and
2 2
patient room (20-25 𝑚 ), each isolation should be 35 to 40 𝑚 . Around the
patient's bed, there should be a least 2-meter free zone on each of the long sides
as well as at the foot end.
● There must be direct access from the patient room to the decontamination
room/bathroom.
● Interlocked doors must be included in the sluice system. Opening of the doors
should be in the direction from negative pressure to the positive pressure room to
avoid air leaks. If the negative pressure increases in the room, the door will close
even tighter.
● No through-put cabinet from the disinfection room/bathroom, because it can
create imbalances in the air pressure.
● Through-put autoclave/decontaminator from the disinfection room to the sluice
may be recommended if secured and controlled against air leakage.
● Graduated negative air pressure is quality ensured by measurements, pressure
manometer, and control of ventilation.
● Exhaust from the isolation unit must be disinfected in a satisfactory manner so
that it does not expose personnel, patients or passers-by to infection.
Standard Precautions
● Always observe hand hygiene.
● Always wear PPE like face masks, face shields, gowns, aprons, gloves, and shoe
covers.
● Limit patient transportation outside the room to essential purposes only.
● Observe strict cleaning and disinfection guidelines for the patient's surroundings,
including for surfaces that receive a lot of touch.
● Ensure proper disposal of medical waste and contaminated materials.
● Clean and disinfect equipment before and after use.
● Minimizing visitor access to the patient's room and requiring visitors to wear the
appropriate PPE.
Nursing Responsibilities
Before:
● Assess the patient's condition, medical history, and the specific infectious agent
to determine the appropriate isolation precautions.
● Ensure the isolation room is properly equipped, ventilated, and maintained at the
appropriate air pressure
● Disinfect hands/ proper handwashing
● Proper donning of PPE (gown, surgical cap, respiratory mask, large disposable
hood, face protection, gloves, shoe covers)
During:
● Maintain a clean and organized environment in the isolation room.
● Limit movement and transport of the patient within the isolation room.
● Encourage patient verbalization of feelings towards isolation.
After:
● Proper doffing and disposal of PPE.
● Document all care provided, patient responses, and any changes in the patient's
condition
2. Contact
Purpose
● Utilized to stop the spread of infectious diseases that can be contracted directly
or indirectly. Contact isolation is primarily used to safeguard both patients and
medical staff against the spread of contagious pathogens, such as bacteria or
viruses, which are easily conveyed by direct personal contact or contact with
contaminated surfaces.
Diseases
● Contact-Transmitted Infections:
- herpes simplex virus (HSV) infections
- human papillomavirus (HPV) infections
● Fecal-Oral Transmission Infections:
- Salmonella
- Shigella
- Escherichia coli (E. coli)
● Respiratory Infections:
- Respiratory syncytial virus (RSV) infection (in infants and
immunocompromised patients)
- Adenovirus infection (in immunocompromised patients)
● Clostridium difficile (C. difficile) Infection:
- C. difficile-associated diarrhea or colitis
● Gastrointestinal Infections:
- Norovirus infection (causing gastroenteritis)

Specifications:
● Single patient room with own toilet, patient sink and handwashing sink.
● Multi-Patient rooms with at least 3 feet of space between beds and patients are
of the same condition.
● For any interactions involving touch with patients or possibly contaminated
surfaces and equipment in the room, medical workers are required to wear a
gown and gloves.
● Before being used by another patient, bathrooms and other communal facilities in
multi-patient rooms must be cleaned and sanitized.
Before:
● Proper donning of PPE
During:
● Limit cross-contamination of people, surfaces and equipment.
● Use disposable or dedicated equipment
After:
● Proper doffing of PPE
● Proper disposal of PPE
● Decontamination of equipment
● Document all care provided, patient responses, and any changes in the patient's
condition
3. Respiratory
Purpose
● Used when a patient is known to be infected with a pathogen that can spread by
respiratory droplets or airborne particles, or when it is suspected that they may
be.
Diseases
● Tuberculosis - an infection brought on by the bacteria Mycobacterium
tuberculosis. When an infected individual coughs, sneezes, or talks, it spreads
via the air and predominantly damages the lungs. When caring for patients with
active TB, airborne precautions are crucial, including the use of N95 respirators.
● Measles - a viral infection that is extremely infectious and can be transmitted by
respiratory droplets. Fever, rash, and other symptoms are caused by it.
● Varicella (Chickenpox) and Herpes Zoster (Shingles) - the varicella-zoster
virus is what causes both varicella and herpes zoster. The highly contagious
illness varicella can spread by respiratory droplets.
● Severe Acute Respiratory Syndrome (SARS) - SARS is caused by a
coronavirus (SARS-CoV) and can lead to severe respiratory illness. It is spread
through respiratory droplets and close contact.
● Pertussis (Whooping Cough) - pertussis is a bacterial infection caused by
Bordetella pertussis. It is highly contagious and spreads through respiratory
droplets.

Specifications:
● Single-patient room
● Multi-Patient rooms with at least 3 feet of space between beds and patients are
of the same condition and curtains drawn between patients
● Keep the infected patient at least 3-6 feet apart from other patients and visitors if
a separate room is not available and cohorts cannot be achieved. The door can
stay open and no special ventilation or air management is required.
● Educate patients about proper respiratory hygiene, including covering their mouth
and nose with a tissue or elbow when coughing or sneezing.
● Hand hygiene and proper disinfection after contact with respiratory secretions
● >3 feet spatial separation in common areas
● Wear additional PPE, such as an N95 respirator, face shield, or gown, depending
on the specific situation
Before:
● Proper donning of PPE (especially the mask)
During:
● Draw curtains between patients that are rooming together.
After:
4. Tuberculosis
Purpose
● Used to prevent the spread of the bacteria that causes tuberculosis,
Mycobacterium tuberculosis. As TB germs can spread via the air when an
infected person coughs, sneezes, speaks, or exhales, the main goal of the TB
isolation approach is to protect patients as well as healthcare professionals from
this risk.
Diseases
● Tuberculosis (M. tuberculosis)
Specifications:
● Negative pressure AIIR (airborne infection isolation room) with special
air-handling and ventilation capacity.
○ 120 sq. ft per patient
● Local exhaust ventilation (e.g. hoods, tents or booths)
● HEPA filter
● Ultraviolet Germicidal Irradiation (UVGI)
● Healthcare workers must wear either of the following NIOSH-approved masks
when entering the isolation room:
- Nonpwered air-purifying respirators such as N95, N99, N100, R95, R99,
R100, P95, P99, and P100
- Powered air-purifying respirators (PAPRs) with high-efficiency filters
- Supplied-air respirators
● Keep doors and windows closed as much as possible.
● Observe proper respiratory etiquette (cover your mouth and nose with a tissue
when you cough, sneeze or laugh)
● Do not have visitors, especially children and people with weak immune systems.
● Do not go to public places and avoid contact with others.
Before:
● Disinfect hands/ proper handwashing.
● Proper donning of PPE (especially the mask, impermeable gown, gloves, face
shield)
During:
● Keep doors and windows closed
● Assess the patient such as auscultation of breath sounds, quality of breathing,
quality of sputum.
● Give the correct medication to the patient
After:
5. Enteric
Purpose
● Utilized to stop the spread of enteric pathogens, which are germs that
predominantly impact the GI tract. The main goal of the enteric isolation tecnique
is to stop the spread of infectious bacteria that can result in diarrheal diseases
and gastrointestinal infections.
Diseases
● Clostridium difficile Infection (CDI) - a bacterial infection that can cause severe
diarrhea and colitis, may require enteric isolation to prevent the spread of C.
difficile spores.
● Norovirus Infection - a highly contagious virus that causes gastroenteritis and is
often associated with outbreaks in healthcare settings, schools, and other
institutions.
● Salmonellosis - caused by the Salmonella bacteria, this infection leads to
symptoms such as diarrhea, abdominal cramps, and fever.
● Hepatitis A - the Hepatitis A virus frequently spreads through tainted food or
water and can cause acute liver inflammation.
● Cholera - is brought on by the Vibrio cholerae bacterium, can result in extremely
dehydrating diarrhea.

Specifications:
● Single-patient room with toilet
● Multi-patient rooms with toilet
○ Rooming of patients that are infected or colonized with the same organism
FOR PATIENTS:
● Frequently wash your hands with soap and water, especially after following a
restroom visit.
● Ensure that anyone entering the room has read the sign posted on the door.
● Only leave the room if it's medically required, then wash wearing a clean gown
and washing your hands with soap and water every time you do.
● Limit your visitors to a few family members or close
● friends.
FOR VISITORS:
● Prior to entering, thoroughly wash their hands with soap and water leaving the
room.
● Before entering the chamber, put on gloves and a gown, and while inside, leave
them on.
● Before exiting the room, take off your gloves and robe.
Before:
● Proper donning of PPE (gown and gloves)
● Place an “Enteric Precaution” sign on the door for people to be aware of what to
do.
During:
● Use patient-dedicated or disposable equipment
After:
6. Blood and Body Fluids
Purpose
● Used to prevent the transmission of diseases that are caused by blood-borne
pathogens.
Diseases
● HIV/AIDS
● Hepatitis B virus (HBV)
● Hepatitis C virus (HCV)
Type of Isolation Room Specifications:

● Single-patient room with restroom
● Disinfect hands/ handwashing
● Wearing of PPE
● Safe injection practices
● Safe sharps management and disposal
● All re-usable items taken into an exam room or home should be cleaned and
disinfected before removed. Disposable items should be discarded at point of
use.
Before:
● Proper donning of PPE (gloves, gown, mask, eye protection)
During:
● Safe injection practices
○ Fishing method
○ No reusing of needles
● Clean and disinfect area if there are any blood or bodily fluid spills
After:
● Proper disposal of sharps and hazardous materials
7. Drainage and Secretions
Purpose
● To prevent infection to be transmitted via direct or indirect contact with purulent
material and other drainage from an infected site.
Diseases
● Wound drainage
● Infected wounds
● Conjunctivitis
● Herpes
● Ringworm
Type of Isolation Room Specifications:

● Single-patient room with restroom
- specialized ventilation is not required for drainage and secretions isolation
technique. Maintaining a clean and controlled environment is essential to
prevent the spread of respiratory infections through droplet.
● Disinfect hands/ handwashing
● Wearing of PPE
● Proper disposal of contaminated objects
Before:
● Proper donning of PPE (especially the gloves)
During:
● Use patient dedicated or disposable equipment
After:
● Proper disposal of contaminated articles
● Contaminated articles should be discarded or bagged and labelled.
8. Reverse
Purpose
● To prevent infections in people with weakened immune systems, such as those
undergoing certain medical procedures or medications that inhibit the
immunological response.
Diseases
● Bone Marrow Transplantation - patients undergoing bone marrow or stem cell
transplants have compromised immune systems due to the conditioning
regimens and transplantation process. Reverse isolation helps prevent infections
during the critical period of immune suppression.
● Hematologic Malignancies - Immune systems are reduced in patients with
diseases like leukemia, lymphoma, or myelodysplastic syndromes because of the
underlying illness and the therapy (chemotherapy or radiation therapy).
● Neutropenia - neutrophils, a type of white blood cell essential for battling
infections, are abnormally low in people with the illness. Reverse isolation may
be necessary for patients with neutropenia due to their greater risk of infection.
● Burn Patients - patients with severe burns may be more vulnerable to infections
because the skin's barrier function has been compromised.
● Severe Combined Immunodeficiency (SCID)
Specifications:
● Single-patient room with restroom and sink for handwashing and proper air
supply (more air supply than exhaust)
- Positive pressure rooms
● Disinfect hands/ hand washing
● Wearing of PPE
● Restricted/ limited visitors and items brought into the isolation room
● Proper disposal of contaminated objects
● Maximum protection, including sterile linen, food and other supplies,
● Anyone who is sick should not enter the room.
Before:
● Proper donning of PPE
● Limit visitors and items brought into the isolation room
During:
● Use patient-dedicated or disposable equipment
After:
CLO#6: outline the color-coding scheme for healthcare wastes and healthcare waste
management.
Learner: Mr Son, Vaughn Joshua G.
Color-coding scheme for Hospital Wastes:

- Black- Non-infectious dry waste
- Green- Non-infectious wet waste
- Yellow- infectious and pathological
- Yellow with black band-Chemical waste
- Orange- Radioactive waste
- Red- Sharps and pressurized containers
COLOR AND WASTE PURPOSE EXAMPLES
Black - Non-infectious dry ● This kind of garbage Paper and paper products
waste doesn’t provide a ● Used papers
threat and any unique ● Newspapers
handling challenges ● Tetra packs, paper
or dangers to human cups
health or the ● Boxes/cartons
environment. It is Bottles
primarily generated by ● Glass & plastic
the administrative and Packaging materials
housekeeping ● Styropore
functions of ● Aluminum
healthcare facilities. ● Plastic, candy/food
● This can be disposed wrapper
of by landfill or EFW.
Green - Non-infectious wet ● These are wastes that ● Kitchen left-over food
waste pose no health risk. ● Used cooking oil
This covers items ● Fish entrails, scale
such as fluids, and fins
tissues, or other ● Fruits and vegetables
biological substances peelings
that are known to be ● Rotten fruits and
without contamination. vegetables
This comprises ● Noninfectious left-over
biodegradable. Moist foods
wastes.
Yellow - infectious and ● This trash was ● PPE(gloves, masks,

pathological generated during the aprons)
treatment of infected ● Wipes, dressings,
patients, as well as plasters and
those who were bandages
contaminated with ● Incontinence waste
drugs or chemicals ● Empty saline or
and were thought to glucose IV bags, and
be infected. tubing (no active
medicines added)
● IV Bags, lines and
tubing that have had
medicine added
● Chemically
contaminated waste
● Used gloves
● Used foley catheters
● Used tubing - IV,
nebulizer
● Used diapers, sanitary
napkins
● Used suction tubes
● Used NGT
● Used test strips
● Used urine bags
● Used drains-penrose
● Used cord clamp
● Used plaster
● Empty colostomy bag
● Used swabs
● Heplock
endo-tracheal tubes
● Used tongue guard
● Used oxygen tubing
● Used gladwrap
● Used mask/face mask
● Used thoracic tube
● Used hemovac
● Used
sensor/electrode
● Used bandages
● Used rubber sheet
● Amputated limbs,
toes, fingers, organs,
extracted tooth
● Tissues from
minor/major Operation
● Specimen containers
of blood and body
fluids
● Used culture media
● Used test strips
● Used blood products
bags and tubing
Yellow with black band - ● For trash generated ● Empty bottles of acids
Chemical waste during the care of - HCl. H2SO4, HNO3,
non-infected patients etc.
that could contain ● Empty bottles of
bodily fluids. betadine, Iodine,
● This contains KMNO3
pharmaceutical and ● Empty bottles of
chemical wastes such laboratory
as defective reagents(Formalin,
thermometer, busted Toluene, Xylene)
fluorescent bulb, and ● Empty bottles/cans of
empty bottles of acids, Kerosene, Acetone,
betadine, iodine, Alcohol, Anaesthetic,
alcohol, anesthetic, lacquer
and laboratory ● Empty bottles of
reagents. disinfectants
● This waste may be ● Busted Fluorescent
sent to landfill, or bulb
incineration, or AT. ● Defective
thermometer
● Empty cans of glue,
epoxy and floor wax
● Expired and
adulterated drugs and
medicines
● Used batteries
Orange - Radioactive waste ● Radioactive waste is a Things contaminated with

byproduct from these radio-active materials
nuclear reactors, fuel ● Gloves
processing plants, ● Tissue papers
hospitals and ● Cotton swabs
research facilities. ● Aluminum foil
The solid waste ● Gauze
containing traces of ● Test tubes
radioactivity is in the ● Pipette tips
form of syringes, ● Repetitive syringes
needles, cotton ● Technetium 99m
swabs, vials, ● Tridium
contaminated gloves ● Used x-ray film,
and absorbent developers, and fixers
materials. Clothing
and utensils of
patients administered
high doses of
radioisotopes like
I-131 constitute the
solid radioactive
waste material.
Red - Sharps and ● This includes metals, ● Needles & syringes
pressurized containers as well as almost ● Scalpel blades
anything with a ● Glass vials
“sharp” edge that may tuberculin/insulin
cause punctures ● Stylet
and/or cuts on ● Capillary tubes
unsuitable containers. ● Ampules
Needles, blades, and ● Test tubes
scalpels fall under this ● Blood evacuation
category. tubes
● Due to the context in ● Pipette
which these tools are slides/coverslips
used, they are ● Aluminum cover
considered hazardous ● Blood Lancets
medical waste. ● Empty Aerosol Cans
● Rusty pins, nails, clips
and screws
● Broken glasses
Health care waste management:
- is a procedure that helps to maintain adequate hospital hygiene, community safety, and
the safety of medical personnel. Planning and purchasing, building, personnel training,
and conduct, appropriate use of equipment, machinery, and medications, appropriate
disposal procedures both within and outside the hospital, and evaluation are all included.
Types of waste treatment and disposal:
PROCEDURE ADVANTAGES DISADVANTAGES
burial, encapsulation (simple, ● Simple ● no disinfection

inexpensive) ● Inexpensive ● can handle small
volumes only
● potential of being
unburied (if pit is only
soil covered, or waste
not encapsulated)
● presents a danger to
community if not
properly buried
incineration ● Decreases QuantIty of ● may produce

(disinfects and greatly Waste emissions &
reduces volume, ● Efficient waste hazardous ash
produces secondary management containing dioxins,
waste streams) ● Reduction of pollution metals & furans
● Saves on depending on the type
transportation waste of waste burned
● Provides better ● may require pollution
control over odor and control equipment to
noise meet local
● Eliminates harmful environmental
germs and chemicals regulations
● public acceptance of
incineration tends to
be low
● expensive to build,
operate & maintain
steam autoclave ● Low cost ● mostly for reusable

(disinfects only, little ● Quick dry materials &
reduction of volume ● Short time instruments, and to
unless used with sterilize disposable
shredder, produces sharps before
secondary waste stream) disposal
● can only treat some
types of HCW
● some models cannot
handle high volumes
● requires electricity &
water
● some models have
high capital
maintenance &
operation costs
microwave ● Lower processing ● expensive, needs

(disinfects, some time good infrastructure
reduction of volume, ● Fast and uniform ● requires training &
produces secondary heating oversight for medium
waste stream) to high effectiveness
● Selective ● effectiveness very
heating/drying dependent on type of
● Direct utilization of technology used
large-sized
feedstock’s
● Better production
quality
● New materials and
products
● Improved process
control
● Ability to operate from
an electrical source
● Lower energy
consumption
● Clean and no
emission of any
gasses or residuals
● Highly controllable
● Compact in size
chemical/mechanical ● Can decolorize all ● can increase the

treatment (disinfects, no types of chemicals volume of waste
volume reduction, volume ● Rapid and proficient ● worker safety issues
can increase, produces process prominent
secondary waste streams) ● Effective and high ● personnel intensive
capacity ● may not adequately
● Economically feasible disinfect AD syringes,
disinfection process
needs to be verified
CLO#7: present the 2007 Guidelines for Isolation Precautions in the Health Care Settings
based on the Healthcare Infection Control Practices Advisory Committee / Centers for Disease
Control and Prevention.
The Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in

Healthcare Settings 2007 updates and expands the 1996 Guideline for Isolation Precautions in
Hospitals.
2007 Guidelines for Isolation Precautions in the Health Care Settings
A. Handwashing
B. Respiratory Hygiene / Cough Etiquette
C. Safe Injection Practices
D. Personal Protective Equipment (PPE)
Objectives and Methods
The objectives of this guideline are to:

1. provide infection control recommendations for all components of the healthcare delivery
system, including hospitals, long-term care facilities, ambulatory care, home care, and
hospice;
2. reaffirm Standard Precautions as the foundation for preventing transmission during
patient care in all healthcare settings;
3. reaffirm the importance of implementing Transmission-Based Precautions based on the
clinical presentation or syndrome and likely pathogens until the infectious etiology has
been determined; and
4. provide epidemiologically sound and, whenever possible, evidence-based
recommendations.
This guideline is designed for use by individuals who are charged with administering
infection control programs in hospitals and other healthcare settings. The information also will
be useful for other healthcare personnel, healthcare administrators, and anyone needing
information about infection control measures to prevent transmission of infectious agents.
A. Hand Hygiene
The term “hand hygiene” includes both handwashing with either plain or
antiseptic-containing soap and water, and the use of alcohol-based products (gels, rinses,
foams) that do not require the use of water. In the absence of visible soiling of hands, approved
alcohol-based products for hand disinfection are preferred over antimicrobial or plain soap and
water because of their superior microbiocidal activity, reduced drying of the skin, and
convenience.
The effectiveness of hand hygiene can be reduced by the type and length of fingernails.
Individuals wearing artificial nails have been shown to harbor more pathogenic organisms,
especially gram-negative bacilli, and yeasts, on the nails and in the subungual area than those
with native nails. In 2002, CDC/HICPAC recommended (Category IA) that artificial fingernails
and extenders not be worn by healthcare personnel who have contact with high-risk patients
(e.g., those in ICUs, ORs).
➔ Perform hand hygiene in the following clinical situations:

◆ Before having direct contact with patients.
◆ After contact with blood, body fluids or excretions, mucous membranes, nonintact
skin, or wound dressings.
◆ After contact with a patient’s intact skin (e.g., when taking a pulse or blood
pressure or lifting a patient).
◆ If hands will be moving from a contaminated-body site to a clean-body site during
patient care.
◆ After contact with inanimate objects (including medical equipment) in the
immediate vicinity of the patient.
◆ After removing gloves.
B. Respiratory Hygiene / Cough Etiquette
The term “cough etiquette” is derived from recommended source control measures for
M. tuberculosis.
➔ The elements of Respiratory Hygiene/Cough Etiquette include
◆ education of healthcare facility staff, patients, and visitors;

◆ posted signs, in language(s) appropriate to the population served, with
instructions to patients and accompanying family members or friends;
◆ source control measures (e.g., covering the mouth/nose with a tissue when
coughing and prompt disposal of used tissues, using surgical masks on the
coughing person when tolerated and appropriate);
◆ hand hygiene after contact with respiratory secretions; and
◆ spatial separation, ideally >3 feet, of persons with respiratory infections in
common waiting areas when possible.
C. Safe Injection Practices
Four large outbreaks of HBV and HCV among patients in ambulatory care facilities in the
US identified a need to define and reinforce safe injection practices. Four outbreaks occurred in
private medical practice, a pain clinic, an endoscopy clinic, and a hematology/oncology clinic.
The primary breaches in infection control practices that contributed to these outbreaks were:
● reinsertion of used needles into a multiple-dose vial or solution container (e.g., saline
bag) and
● use of a single needle/syringe to administer intravenous medication to multiple patients.
In one of these outbreaks, the preparation of medications in the same workspace where
used needles/syringes were dismantled also may have been a contributing factor. These and
other outbreaks of viral hepatitis could have been prevented by adherence to basic principles of
aseptic technique for the preparation and administration of parenteral medications. Whenever
possible, the use of single-dose vials is preferred over multiple-dose vials, especially when
medications will be administered to multiple patients.
➔ The following recommendations apply to the use of needles, cannulas that replace
needles, and, where applicable, intravenous delivery systems:
◆ Use an aseptic technique to avoid contamination of sterile injection equipment
◆ Do not administer medications from a syringe to multiple patients, even if the
needle or cannula on the syringe is changed. Needles, cannulae, and syringes
are sterile, single-use items; they should not be reused for another patient nor to
access a medication or solution that might be used for a subsequent patient
◆ Use fluid infusion and administration sets (i.e., intravenous bags, tubing, and
connectors) for one patient only and dispose appropriately after use. Consider a
syringe or needle/cannula contaminated once it has been used to enter or
connect to a patient’s intravenous infusion bag or administration set
◆ Use single-dose vials for parenteral medications whenever possible
◆ Do not administer medications from single-dose vials or ampules to multiple
patients or combine leftover contents for later use
◆ If multidose vials must be used, both the needle or cannula and syringe used to
access the multidose vial must be sterile
◆ Do not keep multidose vials in the immediate patient treatment area and store in
accordance with the manufacturer’s recommendations; discard if sterility is
compromised or questionable
◆ Do not use bags or bottles of intravenous solution as a common source of supply
for multiple patients
➔ Infection control practices for special lumbar puncture procedures:

◆ Wear a surgical mask when placing a catheter or injecting material into the spinal
canal or subdural space (i.e., during myelograms, lumbar puncture, and spinal or
epidural anesthesia).
➔ Worker Safety
◆ Adhere to federal and state requirements for the protection of healthcare
personnel from exposure to bloodborne pathogens.
D. Personal Protective Equipment (PPE)
“PPE” refers to a variety of barriers and respirators used alone or in combination to

protect mucous membranes, airways, skin, and clothing from contact with infectious agents. The
selection of PPE is based on the nature of the patient interaction and/or the likely mode(s) of
transmission.
➔ Observe the following principles of use:

◆ Wear PPE, when the nature of the anticipated patient interaction indicates that
contact with blood or body fluids may occur.
◆ Prevent contamination of clothing and skin during the process of removing PPE.
◆ Before leaving the patient’s room or cubicle, remove and discard PPE.
➔ Examples of PPE:
1. GLOVES
For touching blood, body fluids, secretions, excretions, or contaminated

items; for touching mucous membranes and nonintact skin
(a) Gloves can protect both patients and healthcare personnel from exposure to
infectious material that may be carried on hands.
(b) Nonsterile disposable medical gloves made of a variety of materials (e.g.,
latex, vinyl, nitrile) are available for routine patient care
(c) The selection of glove type for non-surgical use is based on a number of
factors, including the task that is to be performed, anticipated contact with
chemicals and chemotherapeutic agents, latex sensitivity, sizing, and facility
policies for creating a latex-free environment
(d) When gloves are worn in combination with other PPE, they are put on last.
(e) Hand hygiene following glove removal further ensures that the hands will not
carry potentially infectious material that might have penetrated through
unrecognized tears or that could contaminate the hands during glove removal
Recommendations:
○ Wear gloves when it can be reasonably anticipated that contact with
blood or other potentially infectious materials, mucous membranes,
nonintact skin, or potentially contaminated intact skin (e.g., of a patient
incontinent of stool or urine) could occur
○ Wear gloves with fit and durability appropriate to the task:
- Wear disposable medical examination gloves for providing direct
patient care.
- Wear disposable medical examination gloves or reusable utility
gloves for cleaning the environment or medical equipment
○ Remove gloves after contact with a patient and/or the surrounding

environment (including medical equipment) using proper technique to
prevent hand contamination. Do not wear the same pair of gloves for the
care of more than one patient. Do not wash gloves for the purpose of
reuse since this practice has been associated with the transmission of
pathogens
○ Change gloves during patient care if the hands will move from a
contaminated body site (e.g., perineal area) to a clean body site
2. GOWN
During procedures and patient-care activities when contact of
clothing/exposed skin with blood/body fluids, secretions, and excretions
is anticipated.
(a) To protect the HCW’s arms and exposed body areas and prevent
contamination of clothing with blood, body fluids, and other potentially
infectious material
(b) The need for any type of isolation gown selected is based on the nature of
the patient interaction, including the anticipated degree of contact with
infectious material and potential for blood and body fluid penetration of the
barrier.
(c) Clinical and laboratory coats or jackets worn over personal clothing for
comfort and/or purposes of identity are not considered PPE.
(d) Isolation gowns are always worn in combination with gloves, and with other
PPE when indicated.
(e) Gowns are usually the first piece of PPE to be donned.
Recommendations:
○ Wear a gown, that is appropriate to the task, to protect skin and prevent
soiling or contamination of clothing during procedures and patient-care
activities when contact with blood, body fluids, secretions, or excretions is
anticipated.
- Wear a gown for direct patient contact if the patient has
uncontained secretions or excretions
- Remove the gown and perform hand hygiene before leaving the
patient’s environment
○ Do not reuse gowns, even for repeated contact with the same patient.
○ Routine donning of gowns upon entrance into a high-risk unit (e.g., ICU,
NICU, HSCT unit) is not indicated
3. FACE PROTECTION: MASKS, GOGGLES, FACE SHIELDS

During procedures and patient-care activities likely to generate
splashes or sprays of blood, body fluids, and secretions, especially
suctioning, and endotracheal intubation.
During aerosol-generating procedures on patients with suspected or

proven infections transmitted by respiratory aerosols wear a fit-tested
N95 or higher respirator in addition to gloves, gown, and face/eye
protection
During aerosol-generating procedures (e.g., bronchoscopy, suctioning of the

respiratory tract [if not using in-line suction catheters], endotracheal intubation) in
patients who are not suspected of being infected with an agent for which
respiratory protection is otherwise recommended (e.g., M. tuberculosis, SARS or
hemorrhagic fever viruses), wear one of the following:
- a face shield that fully covers the front and sides of the face,
- a mask with attached shield,
- or a mask and goggles (in addition to gloves and gown)
(a) Masks
- should not be confused with particulate respirators that are used

to prevent inhalation of small particles that may contain infectious
agents transmitted via the airborne route as described below.
- used in 3 primary purposes in healthcare settings:
1. placed on healthcare personnel to protect them from
contact with infectious material from patients e.g.,
respiratory secretions and sprays of blood or body fluids,
consistent with Standard Precautions and Droplet
Precautions;
2. placed on healthcare personnel when engaged in
procedures requiring sterile technique to protect patients
from exposure to infectious agents carried in a healthcare
worker’s mouth or nose, and
3. placed on coughing patients to limit potential dissemination
of infectious respiratory secretions from the patient to others
(i.e., Respiratory Hygiene/Cough Etiquette).
(b) Googles & Face Shields
- The eye protection chosen for specific work situations (e.g.,

goggles or face shields) depends upon the circumstances of
exposure, other PPE used, and personal vision needs.
- Personal eyeglasses and contact lenses are NOT considered
adequate eye protection
- eye protection must be comfortable, allow for sufficient peripheral
vision, and must be adjustable to ensure a secure fit.
- Disposable or non-disposable face shields may be used as an
alternative to goggles
- As compared with goggles, a face shield can provide protection to
other facial areas in addition to the eyes.
- Removal of a face shield, goggles, and mask can be performed
safely after gloves have been removed, and hand hygiene
performed.
- The ties, earpieces, and/or headband used to secure the
equipment to the head are considered “clean” and therefore safe
to touch with bare hands. The front of a mask, goggles, and face
shield are considered contaminated.
HOW TO DON PPE CORRECTLY
YouTube Link (Doning):

https://www.youtube.com/watch?v=xpCNsyIk2vI&ab_channel=CentersforDiseaseControlandPre
vention%28CDC%29
HOW TO DOFF PPE CORRECTLY
YouTube Link (Doffing):
https://www.youtube.com/watch?v=z9X-fBQud4s&ab_channel=HRLND
CLO#8: demonstrate beginning skills in double bagging.
DOUBLE BAGGING
Definition:
Double bagging is an infection control measure in which one bag containing
contaminated articles or materials, such as soiled linen, is placed within another.
Purpose:
1. To reduce contamination of the external surface of the bag that could be transmitted to
hospital personnel subsequently handling them.
2. To prevent contamination of the surroundings.
Materials:
2 Disposable Caps (1 nurse, 1 patient) 2 yellow garbage bags

Disposable Clean Gloves 1 name tag
Gown 2 linens
2 Disposable Masks (1 nurse, 1 patient) surgical tape
PROCEDURE RATIONALE
Double Bagging (Nourse-in-charge in the

Isolation Room) when informed of coming
transfer:
1. Prepare the necessary materials in the 1. to conserve time and resources while the
assigned isolation room. beginning of the process.
2. Wear gown, mask, cap, and gloves. 2. to set up a barrier that actually hinders
the body from making contact with
infectious substances.
3. Prepare the 2 garbage bags, and fold 3. the 1st bag is contaminated and the 2nd
back the opening for a bigger/wider bag is deemed clean. These two bags
opening. The 1st bag is placed in the are put up together to ensure safety and
patient’s room and the 2nd bag is prevent further contamination.
placed near or outside the patient’s
door.
4. When the patient is wheeled into the 4. since the outer covering is contaminated,
room, remove the linen covering the this is done to reduce transferring of
patient, touching only the outer part of pathogens.
aligning and placing it inside the first
bag.
5. Transfer the patient to the bed from the 5. to assist in the stabilization of the
wheelchair. Place the wheelchair wheelchair and prevent it from moving to
parallel to the bed facing the foot part. promote patient safety.
Check if the wheelchair is locked.
6. Remove the linen covering the 6. to reduce the possibility of

wheelchair. Untie first the lower, not cross-contamination, the wheelchair's
making sure not to touch the linen should be bagged since it is thought
contaminated part, And place it inside to be contaminated.
the first bag.
7. Remove the patient's cap followed by 7. the patient’s materials are deemed
the mask. Place it inside the first bag. contaminated so it should be placed on
Learning by twisting its upper end. the first bag to uphold precaution.
8. Place the first bag inside the second 8. give an additional layer of protection for
bag, which is outside the room. incidences of sharp objects penetrating
the first bag.
9. Remove the cap, mask, and gloves 9. as they are already deemed
together with the gown and place them contaminated.
inside the second bag.
10. The bag with the tape and label it with a 10. to let the other healthcare team members
room number and type of isolation. know information about what to do with
(Indicate if the article is contaminated the bag, thus ensuring the right
with blood and other drainage or precautions.
secretions).
Revised August 2021

References
Bjørg Marit Andersen. (2019). Strict Isolation. Springer EBooks, 197–211.
https://doi.org/10.1007/978-3-319-99921-0_19
Center for Disease Control and Prevention. (2019, July 22). Precautions | Isolation
Precautions|GuidelinesLibrary|InfectionControl|CDC.https://www.cdc.gov/infectioncontrol
/guidelines/isolation/precautions.html
Centers for Disease Control and Prevention. (2021). Protecting healthcare personnel. Centers
for Disease Control and Prevention. Retrieved August 17, 2023, from
https://www.cdc.gov/hai/prevent/ppe.html
Contact Precautions - Minnesota Dept. of Health. (n.d.). Www.health.state.mn.us.
https://www.health.state.mn.us/facilities/patientsafety/infectioncontrol/pre/contact.html
Dugdale, D. (2021, October 24). Isolation precautions. MedlinePlus. Retrieved August 18, 2022,
from https://medlineplus.gov/ency/patientinstructions/000446.html
Kieth, V. (2017, August 31). What are Universal Precautions? What are Bloodborne Pathogens?
| Aftermath Services. Health Care Waste Management manual - doh.gov.ph. (n.d.).
Retrieved August 18, 2022, from
https://doh.gov.ph/sites/default/files/publications/Health_Care_Waste_Management_
Manual.pdf
Maki, D., Alvarado, C., & Hassemer, C. (1986). Double-Bagging of Items from Isolation Rooms
is Unnecessary as an Infection Control Measure: A Comparative Study of Surface
Contamination with Single- and Double-Bagging. Infection Control, 7(11), 535-537.
doi:10.1017/S0195941700065279
RxList. (2021). Medical definition of quarantine. RxList.
https://www.rxlist.com/quarantine/definition

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Cebu Doctors’ University

Miasco, Herra - CLO #3

Ms. Patricia Mae Gabaca, RN

August 19, 2023

● Black- Non-infectious dry waste

CLO#8: demonstrate beginning skills in double bagging.

• health care waste

- It is a protective barrier to one’s individual most especially to Medical Health

1.2. A nurse assigned to patients with bloodborne pathogens which could

2.1 A nurse assigned to patients diagnosed with an infectious disease that

2.2 A nurse assigned to a patient infected with a type of microorganism

2.3. A nurse assigned to patients diagnosed with an infectious disease that

3.2. To safely dispose of linens soiled by bodily waste/fluids.

3.3. To avoid contamination in each single bag being used.

Anatomy and physiology – Healthcare professionals should be prepared and educated

Safety and security – By preventing cross-contamination, this principle guarantees the

Microbiology – This principle ensures isolation precautions are observed to prevent an

Types of Isolation Techniques

Type of Isolation Room

Type of Isolation Room

Type of Isolation Room

Type of Isolation Room

6. Blood and Body Fluids

Type of Isolation Room Specifications:

7. Drainage and Secretions

Type of Isolation Room Specifications:

Color-coding scheme for Hospital Wastes:

COLOR AND WASTE PURPOSE EXAMPLES

Yellow - infectious and ● This trash was ● PPE(gloves, masks,

Orange - Radioactive waste ● Radioactive waste is a Things contaminated with

Health care waste management:

Types of waste treatment and disposal:

PROCEDURE ADVANTAGES DISADVANTAGES

burial, encapsulation (simple, ● Simple ● no disinfection

incineration ● Decreases QuantIty of ● may produce

steam autoclave ● Low cost ● mostly for reusable

microwave ● Lower processing ● expensive, needs

chemical/mechanical ● Can decolorize all ● can increase the

The Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in

2007 Guidelines for Isolation Precautions in the Health Care Settings

Objectives and Methods

The objectives of this guideline are to:

➔ Perform hand hygiene in the following clinical situations:

➔ The elements of Respiratory Hygiene/Cough Etiquette include

◆ education of healthcare facility staff, patients, and visitors;

➔ Infection control practices for special lumbar puncture procedures:

“PPE” refers to a variety of barriers and respirators used alone or in combination to

➔ Observe the following principles of use:

For touching blood, body fluids, secretions, excretions, or contaminated

○ Remove gloves after contact with a patient and/or the surrounding

3. FACE PROTECTION: MASKS, GOGGLES, FACE SHIELDS

During aerosol-generating procedures on patients with suspected or

During aerosol-generating procedures (e.g., bronchoscopy, suctioning of the

- should not be confused with particulate respirators that are used

(b) Googles & Face Shields

- The eye protection chosen for specific work situations (e.g.,

YouTube Link (Doning):

2 Disposable Caps (1 nurse, 1 patient) 2 yellow garbage bags

Double Bagging (Nourse-in-charge in the

6. Remove the linen covering the 6. to reduce the possibility of

Revised August 2021

Bjørg Marit Andersen. (2019). Strict Isolation. Springer EBooks, 197–211.

Contact Precautions - Minnesota Dept. of Health. (n.d.). Www.health.state.mn.us.