[GWVRNS]

I transported an ICU patient who's sputum cultures hadn't come back yet. He was in respiratory isolation so I gowned, gloved and put a mask on. The ID nurse saw me on the way back and had a FIT! She said we were not to wear gloves, gown and mask in the hallways because it's against JACHO rules. This doesn't sound right to me, is it?

Thanks,
Deb

[Nurse1966]

At our hospital if you're transporting an isolation patient in a bed, you wear gown and gloves. Especially if there's any risk that you'll need to "readjust" or give care on the trip. If a patient needs droplet or airborne, THEY wear the surgical mask. If they're intubated, no mask is needed. If we transport an isolation patient via stretcher or wheelchair, normally only gloves. It's tough to walk that fine line of taking precautions without making the patient feel like HIV patients did in the 80's.

[caroladybelle]

By respiratory, do you mean airborne or do you mean droplet precautions?

As far as I know, airborne precautions, such as for TB only require standard precautions plus either a N95 or PAPR mask for the caregiver in the room, or when transporting the patient - the pt wears the mask.

For most airborne precaution patients, gown and gloves would not be required unless they were leaking bodily fluids somehow. Just as you would use for any patient where fluids would be a problem.

[Nurse1966]

Yep, that's what I meant. The gloves and gown are for transporting patients with MRSA, VRE and/or MDRAB, etc and the gown only if you were physically in contact with the pt and/or their bedding. For example, pt from ICU w/ infections being transported in their bed for a special procedure. If you needed to readjust a line, manually bag or even code them, you'd need the appropriate PPE, and unless you carry gowns and gloves in your pocket..pt care could be delayed.

We've just started a MRSA proactive program, and I think we could go over the edge with isolation practices (someone wanted to put color coded tags on IV pumps so when the pt wanders into the cafeteria, they could be ID'd and removed, can you hear the HIPAA roar?) It's an interesting problem. I don't know if MRSA is as bad in Georgia as it is here the East coast, but it's quite a challenge.

As for TB, care givers use N-95 (Paprs available but not used), when transporting, the pt wears a surgical mask. Most of our r/o TB's are also +MRSA. The community we serve has a high census of homeless and/or IVDA. Like I said early, it's quite a challenge.

[SEOBowhntr]

Originally Posted by Nurse1966

..........and I think we could go over the edge with isolation practices

I tend to disagree with this statement. Maybe I misunderstood the intent, but the more lax we are about isolation, and infection control, the higher likelihood we have of an increased number of MDR-bacteria appearing.

I don't know about you, but this disgusts and scares me..........

[Nurse1966]

"and I think we could go over the edge with isolation practices (someone wanted to put color coded tags on IV pumps so when the pt wanders into the cafeteria, they could be ID'd and removed, can you hear the HIPAA roar?)" I did not say we shouldn't wear gloves, gowns or whatever APPROPRIATE PPE is called for...the point intended was that everyone is coming up with suggestions to further expand policy and protocol. Such as clearly labeling patients and their equipment, wearing tags that say "HI, I have MRSA, don't get too close" And what about the family members and visitors? Shall we meet them at the door with gowns and gloves, before letting them enter the hospital? I take this very seriously, my mother died of HAI MRSA, but I still have to remember to use a little common sense. Don't you think that more education (staff, pt, family and community) or for heaven's sake, how about private rooms for everyone??? would be more advantagous than labeling someone's IV pole?

[-Midget-]

Yikes! What does that person have that caused the skin on their leg to do that?