Question ....Using gown during transfering patient with infection

Double-Helix, BSN, RN · Aug 7, 2012

according to the cdc, for patients on contact precautions, ppe is to be removed after the patient is ready for transport (i.e., in a wheelchair). the nurse does not need to wear ppe for transport because there is no patient contact. clean ppe should be worn when you have reached the destination and are going to provide care for the patient again.

when a patient on droplet precautions is being transported, that patient needs to wear a mask.

http://www.cdc.gov/hicpac/2007ip/2007ip_part4.htm

contact precautions

v.b.4. patient transportv.b.4.a. in acute care hospitals and long-term care and other residential settings, limit transport and movement of patients outside of the room to medically-necessary purposes. category ii

v.b.4.b. when transport or movement in any healthcare setting is necessary, ensure that infected or colonized areas of the patient's body are contained and covered. category ii

v.b.4.c. remove and dispose of contaminated ppe and perform hand hygiene prior to transporting patients on contact precautions. category ii

v.b.4.d. don clean ppe to handle the patient at the transport destination. category ii

droplet precautions

v.c.4. patient transport

v.c.4.a. in acute care hospitals and long-term care and other residential settings, limit transport and movement of patients outside of the room to medically-necessary purposes. category ii

v.c.4.b. if transport or movement in any healthcare setting is necessary, instruct patient to wear a mask and follow respiratory hygiene/cough etiquette. category ib

v.c.4.c. no mask is required for persons transporting patients on droplet precautions. category ii

airborne precautions

v.d.5. patient transport

v.d.5.a. in acute care hospitals and long-term care and other residential settings, limit transport and movement of patients outside of the room to medically-necessary purposes. category ii

v.d.5.b. if transport or movement outside an aiir is necessary, instruct patients to wear a surgical mask, if possible, and observe respiratory hygiene/cough etiquette 12. category ii

v.d.5.c. for patients with skin lesions associated with varicella or smallpox or draining skin lesions caused by m. tuberculosis, cover the affected areas to prevent aerosolization or contact with the infectious agent in skin lesions [108, 1025, 1026, 1029-1031]. category ib

v.d.5.d. healthcare personnel transporting patients who are on airborne precautions do not need to wear a mask or respirator during transport if the patient is wearing a mask and infectious skin lesions are covered. category ii

mariebailey, MSN, RN · Aug 9, 2012

I noticed the link was broken in the last post, so here are a couple of references: CDC - 2007 Isolation Precautions:Part 3 - HICPAC & CDC - 2007 Isolation Precautions:Table 4 - HICPAC

Wearing a gown during transfer of a patient on contact or droplet precautions is really part of standard precautions taken on any patient in a healthcare facility "during procedures and patient-care activities when contact of clothing/exposed skin with blood/body fluids, secretions, and excretions is anticipated" (Table 4, CDC Recs). It seems intuitive that someone on contact precautions with something like C. Diff. would warrant a gown during transfer. Someone on droplet precautions needs the same treatment b/c spatial separation of at least 3 feet is recommended to prevent coming into contact with organisms like Bordetella pertussis from droplets produced in sneezes/coughs.

angle85 · Aug 10, 2012

Thank you Mis Ashley for your helpfull answer .........

sbruc002 I think according to CDC no need for PPE during transfering any patient if the colonized areas of the patient’s body are contained

Thank you all

mariebailey, MSN, RN · Aug 10, 2012

I totally agree that it is unnecessary if the respiratory secretions are contained, but I think the precautions would apply if it is anticipated that clothing may become soiled with respiratory secretions.

Double-Helix, BSN, RN · Aug 10, 2012

I totally agree that it is unnecessary if the respiratory secretions are contained, but I think the precautions would apply if it is anticipated that clothing may become soiled with respiratory secretions.

The PATIENT should be wearing a mask during transport. Therefore, respiratory secretions cannot soil the clothing.

mariebailey, MSN, RN · Aug 11, 2012

The original question and further comments posed were referring to the "transferring" a patient and not "transporting" a patient. Perhaps I misinterpreted it. I would also expect that a patient on droplet precautions should be wearing a surgical mask to be "transported"; that is stated verbatim in the CDC guidelines. I could have easily misunderstood the question to mean the actual physical transfer of a patient (e.g., from a bed to a chair); if so, I apologize.

sauconyrunner · Aug 16, 2012

The CDC guidelines are what is in my hospital and our parent hospital. They are extremely clear, and appropriate. THe OP however, will need to find the Policy and procedure in place for their facility and follow it, or propose changes to it, depending on why they are asking this question!!! :)