Reverse/Protective Isolation

Hi Theophorus

Remember the trick to nursing school is keeping it patient oriented. What are you going to do for the patient and how are you going to do it?

Reverse isolation is when you are protecting your patient from infection either from the staff or from other patients, or both. Such patients include immunocompromised individuals undergoing some kind of treatment that suppresses the immune system. Some of those treatments include chemotherapy. Transplant patients are given immunosuppressive drugs to prevent organ rejection. Heavy doe schedules of steroids used to treat diseases like Addison's Disease and Asthma can mask signs of infection because of their anti-inflammatory effects. HIV patients can also be immunocompromised since the virus attacks lymphatic T cells. If the condition is serious enough and the situation necessitates it, a patient could be put into isolation with a negative airflow that filters the room air at least 10 times per hour. You also have to provide a safe environment, like avoiding flowers in the room, removing fruits or uncooked foods from the meals, and quickly removing any bodies of standing water since the breed micro-organisms.

Protective isolation is preventing the spread of the client's disease to anyone else. Nasty infections from C. Difficile and MRSA can put someone in isolation. Airborn precautions are used for things like Herpes Zoster (chickenpox) and disseminated Herpes Zoster (Shingles), rubella, and meningitis. Some patients can be put in protective isolation for 24 hours or until a culture and sensitivity test is completed. It all kind of depends.

Hope that helps.

The CDC is your friend. It's all right here.

CDC - 2007 Isolation Precautions - HICPAC

Do a skit where the patient needs to have an explanation of why everyone who comes into her room is all dressed up funny. Don't forget the psychosocial component of care-- it's scary and, well, isolating. Put that in your nursing plan of care too.