Tips for isolation rooms?

  1. Hi Everyone,

    I am still in nursing school and was hoping for some tips/tricks when you go into an isolation room.

    I know the correct order for donning/removal of PPE and that isn't really my issue. My issue is when it comes to my stethoscope, notepad/pen, and also the computer.

    I know that a lot of rooms have their own stethoscopes for pt's who are on isolation, but a lot of times, those stethoscopes are lower quality and you can't hear well.

    All the doctors and nurses I've seen tend to use their own.

    How do you go about using your stethoscope and then cleaning it afterwards when in an isolation room? Do you keep it tucked down under your gown until you need to use it and then pull it out when you need it and then tuck it back in when you're done? Or do you keep it on the outside the whole time? Is there a "graceful" way to pull it out from the gown and tuck it back in? I feel like every time I've done this, I look like a complete freak who is fighting with an invisible ghost underneath my gown, lol.

    When done, what's your process for cleaning it and washing your hands in order to avoid contamination, etc? Do you do it while you're still in the room or wait until you leave? Do you put on new gloves before wiping it down? Or do you not need to do that as long as you wash your hands after?

    What type of wipe should you be using to wipe down your stethoscope? The one with the blue top or the red top? I feel like the red-top one is stronger and I'm not sure if this will damage my stethoscope.

    In regards to note-pad/pen, sometimes I need to write something down, then I feel like I'm contaminating those things if I've already touched the patient and then I have to wipe down my pad/pen when I leave.

    Should I take off my gloves, hand sanitize, write, then sanitize, then put on new gloves? That seems excessive and very "interruptory" (I know that's not a word). However, I am worried if I wait until I'm done that I'm going to forget what I needed to write down.

    Also, do you take off your gloves and then put on clean gloves before typing something into the computer if there is a computer in the room? Or do you use the same gloves (I'm thinking this is def a no-no and I def don't do that) or do you take off your gloves and just use your bare hands? How often does environmental services tend to clean the keyboards? Or, again, does it even matter as long as you're washing your hands/sanitizing when you leave?

    I just get all confused/tripped up when it comes to this area. I see people doing so many different things and I want to do it the right way to protect both myself and all of the patients on the floor.

    Sorry if this seems stupid/common sense, but I just can't get down a good routine for this. Any advise or tips/tricks would be very welcome.

    P.S - I know I mentioned above that I don't have an issue with donning/removal of PPE, but now that I think of it, sometimes I see people take off their gloves last, so that they don't have to touch their gown. I see why this would make sense, especially if you don't have to wear a mask, since it seems like the only reason they want you to take off the gloves first is so that you aren't touching your face mask and getting close to your face with a dirty glove. Even with a face-mask, sometimes I am tempted to leave my gloves on until the end, so that I don't have to touch the gown, especially if the gown is a bit soiled or the linen thing in the room is full and you end up touching the other gowns in there by accident when putting yours in.

    Again, any advice/help is greatly appreciated!

    Thank you!
    Last edit by Philly85 on Feb 11
    •  
  2. Visit Philly85 profile page

    About Philly85

    Joined: May '15; Posts: 64; Likes: 61

    6 Comments

  3. by   Guy in Babyland
    When I am in an isolation room, the pad of paper and pen stay in the room. I write down my assessment and vitals and then enter them into the computer in the room keeping my gown and gloves on. The computer is in the patient's room so it is considered dirty. I would not take my gloves off to chart.
  4. by   smf0903
    We keep a computer in the room when we have isolations. The computer gets cleaned when the patient leaves and the room is cleaned (we have one of the UV dooflitchies that is used in addition to standard cleaning).

    I use my own steth and wipe it down when I am leaving the room. The type of wipe depends on the precautions. I always wipe down between patients anyhow so it's really nothing special unless I need to use a different wipe because of the type of precaution. I just keep a pen in the room and enter whatever I need to while in there.

    As far as hand washing, just make sure you're washing before you're leaving the room/on your way out. If the computer is staying in the room there's no need to remove gloves and don new ones and all of that jazz...you are wearing PPE to keep from spreading junk from that patient to other patients and yourself, if that makes sense. Biggest thing is hand washing when you're done.

    I wear gloves a lot, way more than other nurses I work with because I've developed excema on my hands. Just be mindful that wearing gloves isn't protecting the patient as much as it is protecting you. Nothing bugs me more than seeing someone change and attends/clean stool/do peri care/cath care and then see them do something like go to wipe the patient's face or do oral care with those same darn gloves on. That's disgusting. If you'd wash your hands if you DIDN'T have gloves on then change the gloves. Drives me crazy and I'm that person who'll tell you to change your gloves. Ok, that rant's over with LOL
  5. by   FSZ Student Nurse
    As far as stethoscopes go, I've seen some nurses put a plastic glove over the diaphragm/bell of the stethoscope when examining a patient on contact precautions. But I don't know what the does to the sound quality; I've never tried it. I believe you can bring it in without doing that if you just wipe it down with an appropriate cleanser afterwards.
  6. by   Crush
    As far as the stethoscope goes I always wipe mine down w/ appropriate cleanser wipe ( per hospital policy cleaner disinfecting wipes ) between each patient anyways. But, if there is a stethoscope in the isolation room I use that one unless there is an issue with not being able to hear properly through it. Your facility (clinical site) should have an infection control policy about this too. Best thing would be to ask your instructor about policies at that clinical site. Good question. Hope you find the answers you are looking for.
    Last edit by Crush on Feb 19
  7. by   KelRN215
    Quote from Philly85
    Hi Everyone,

    I am still in nursing school and was hoping for some tips/tricks when you go into an isolation room.

    I know the correct order for donning/removal of PPE and that isn't really my issue. My issue is when it comes to my stethoscope, notepad/pen, and also the computer.

    I know that a lot of rooms have their own stethoscopes for pt's who are on isolation, but a lot of times, those stethoscopes are lower quality and you can't hear well.

    All the doctors and nurses I've seen tend to use their own.

    How do you go about using your stethoscope and then cleaning it afterwards when in an isolation room? Do you keep it tucked down under your gown until you need to use it and then pull it out when you need it and then tuck it back in when you're done? Or do you keep it on the outside the whole time? Is there a "graceful" way to pull it out from the gown and tuck it back in? I feel like every time I've done this, I look like a complete freak who is fighting with an invisible ghost underneath my gown, lol.

    When done, what's your process for cleaning it and washing your hands in order to avoid contamination, etc? Do you do it while you're still in the room or wait until you leave? Do you put on new gloves before wiping it down? Or do you not need to do that as long as you wash your hands after?

    What type of wipe should you be using to wipe down your stethoscope? The one with the blue top or the red top? I feel like the red-top one is stronger and I'm not sure if this will damage my stethoscope.

    In regards to note-pad/pen, sometimes I need to write something down, then I feel like I'm contaminating those things if I've already touched the patient and then I have to wipe down my pad/pen when I leave.

    Should I take off my gloves, hand sanitize, write, then sanitize, then put on new gloves? That seems excessive and very "interruptory" (I know that's not a word). However, I am worried if I wait until I'm done that I'm going to forget what I needed to write down.

    Also, do you take off your gloves and then put on clean gloves before typing something into the computer if there is a computer in the room? Or do you use the same gloves (I'm thinking this is def a no-no and I def don't do that) or do you take off your gloves and just use your bare hands? How often does environmental services tend to clean the keyboards? Or, again, does it even matter as long as you're washing your hands/sanitizing when you leave?

    I just get all confused/tripped up when it comes to this area. I see people doing so many different things and I want to do it the right way to protect both myself and all of the patients on the floor.

    Sorry if this seems stupid/common sense, but I just can't get down a good routine for this. Any advise or tips/tricks would be very welcome.

    P.S - I know I mentioned above that I don't have an issue with donning/removal of PPE, but now that I think of it, sometimes I see people take off their gloves last, so that they don't have to touch their gown. I see why this would make sense, especially if you don't have to wear a mask, since it seems like the only reason they want you to take off the gloves first is so that you aren't touching your face mask and getting close to your face with a dirty glove. Even with a face-mask, sometimes I am tempted to leave my gloves on until the end, so that I don't have to touch the gown, especially if the gown is a bit soiled or the linen thing in the room is full and you end up touching the other gowns in there by accident when putting yours in.

    Again, any advice/help is greatly appreciated!

    Thank you!
    Why are you thinking it's a definite no-no to use the contaminated computer with the gloves you're already wearing?
  8. by   OneWhisper
    For gloves, when I did my practicum, my preceptor took a glove and put it tight over the diaphragm/bell. I thought that was interesting and asked what it did to the sound. She said that she didn't notice a difference at all. It was a habit I picked up, and I have never had an issue with sound either. I still clean it after though, I use the wipes that are used for the room.

close