Questions about isolation patients and procedures..

emily_mom · Apr 5, 2003

originally posted by deespoohbear
i have some questions regarding different facilities isolation policies and procedures. our ic nurse is implementing new iso policies and i wanted to see what other facilities are doing. i work for a small rural hospital. here are some of our policies.

1. anyone with a history of mrsa will be placed in contact isolation and their nares cultured for mrsa. they will remain in contact iso until determined if they have an active mrsa infection or if they are colonized. if active mrsa then proper antibiotic will be ordered and protocol began. (also if hx if vre or any resistant infection).

in our hospital, once you've had mrsa, you are always in isolation. doesn't matter how many (-) cultures you've had.

2. any patient that presents with diarrhea and history of c. diff will be put in contact isolation and tested for c. diff. also any incontinent pt with diarrhea and recent antibiotic use will also be placed in contact isolation and tested for c. diff.

same here, although we don't isolate the latter until they have been (+) cultured.

3. anybody with chickenpox will be placed in a negative pressure room and in contact and airborne isolation.

ours aren't put in negative pressure rooms, but have signs posted that no one is to enter if they haven't had them. same with shingles.

what are the policies for rsv pts? i have heard so many conflicting reports about what type of iso they need to be in. i have heard everything from no iso to the whole nine yards. our policy will be for contact iso.

these are the biggies i can think of right now. also do other facilities use disposable dishes for iso patients anymore? we don't.

we don't use disposables either. our trays are wrapped in plastic to differentiate them for dietary.

looking forward to hearing what other facilities are doing in regards to iso policies and procedures.

altomga, ADN, BSN, MSN, DNP, RN, APRN · Apr 5, 2003

Okay,

At my facility we have something called a Problem Pathogen Pilot (PPP) for short.

Any pt from a nursing home, dialysis pt, outside hospital and on abx's for 4 days, and/or hx of VRE/MRSA are all put on contact isolation and swabbed (rectum and nares). They remain on isolation until their cx's are negative.

Every Tuesday we have weekly sweeps. Any pt that has been in the hospital and on ABX's for 4 days will get swabbed. They are not put on isolation until their cx's are negative.

What we have found is that pt's are coming to us with MRSA/VRE. We do have pt's that convert and are captured on the weekly sweeps.

They were hoping that with the pilot the transmission of MRSA and VRE would decrease.

We have a 1:4 ratio and at times every pt in your pod can be on contact isolation.

The hospital ID doctor watches the numbers and is tracking the results. We've been doing this for over a year.

C-Diff is cx'd only on those pt's that we suspect may have it. Most of us know before the cx is done or back from micro just by looking at the .......well.......you know:)

Agnus · Apr 6, 2003

You might want to consider checking the CDC site for their recomendations. If you do not find what you are looking for there ask them they are very good at getting back with information to direct questions.

The site is very large and it is likely that you will find what you need easily without asking. The CDC guidelines are the first thing that I would look at in determining the best procedure to adopt.