To place pneumonia patients on Iso or not?

[SunshineAnytime]

Why aren't pneumonia patients placed on isolation precautions in the hospital? My med-surg books are telling me it's spread through contact and respiratory droplets, and even some of the NCLEX pneumonics say it's contact or resp iso. But we NEVER put pts w/ pneumonia on iso in the hospital so I'm just a little confused.

[PeepnBiscuitsRN]

I think if we put our pneumonia patients on iso, just about every patient on my floor would be on iso! Not to mention, in addition to our contact patients for MRSA and VRE and our Enteric iso patients for c-diff. Special resp precautions require a special room (I think in all cases if I'm not mistaken) and I know our floor only has 7 rooms of that sort.

[SunshineAnytime]

Yeah very true. I work on a respiratory med surg floor so just about half of our patients are being treated for pneumonia. But many times family or friends of patients will ask me if they need to wear a mask to protect themselves when they visit... technically they should be since some pneumonia is spread by respiratory droplets, but nobody does so...? I never know what to tell them.

[turnforthenurse, MSN, NP]

We get pneumonia patients all of the time. No one is ever placed on isolation precautions. I noticed that at the other hospital I worked at, too.

The only time they will be placed on precautions is if they have hemoptysis and other sx of possible TB; we'll put them on airborne precautions until they are ruled out. We only have 2 airborne precaution rooms on my unit, though.

[ParvulusPuella]

We wear masks until they have been on antibiotics for 24 hours.

[sapphire18]

Pneumonia is caused by many different types of bacteria. We don't put everyone with any type of infection in isolation, so it's no different with pneumonia. If you have a healthy immune system and use universal precautions, there is no reason to worry about "catching" pneumonia. And just to clarify- droplet precautions (flu, bac meningitis, etc) do not require a negative-pressure room like airborne precautions (TB) does.

[canoehead, BSN, RN]

The trouble with pneumonia is not the bacteria (those bacteria are sitting around in the air and on any surface), it's the inflammation and resulting gunky build-up in the lung. That's what makes it pneumonia. So caregivers are exposed to the same old bacteria- no issue.

[Esme12, ASN, BSN, RN]

Pneumonia means inflammation of the lung with consolidation. The consolidation refers to fluid or other materials which build up in the air spaces of the lungs, the alveoli, and cause the affected part of the lung to appear white on a standard x-ray.

Pneumonia can be caused by all types of infectious agents, bacterial, viral, fungal, and others; so knowing the precise infectious agent is important. Other important factors include where the pneumonia is caught, whether at home or when one is already in the hospital; whether there are other cases of pneumonia in the community that have a common source; whether there is another disease going around, such as the flu; whether the patient has an underlying condition such as alcoholism or AIDS; and whether the patient is exposed to any particular dusts or aerosols.

Pneumonias caused by the bacterium Streptococcus pneumoniae, the cause of the old 'lobar pneumonia' are not considered contagious, since S. pneumoniae is a ubiquitous organism, present throughout the environment and in many healthy people. One does not catch lobar pneumonia by being around someone who has it, and such patients do not need to be isolated. Similarly, other types of pneumonia-those caused by Staph. aureus, common in sick hospitalized patients; pneumonia caused by pneumocystis carinii, seen in people with AIDS or other severely immune depressed people; or bronchopneumonia, often seen in alcoholics or people immobilized in bed-do not require isolation, since they are all caused by organisms commonly found in the environment and carried by many healthy people.

So the decision to isolate or not depends on the causative agent. The following link will give you CDC guidelines and recommendations and the second link, although older material, will give you the reasoning behind the CDC guidelines and is very informative. It will help you gain understanding. :paw:

Guidelines for Isolation Precautions in Hospitals Type and Duration of Precautions Needed for Selected Infections and Conditions

Guidelines for Isolation Precautions in Hospitals SYNOPSIS OF TYPES OF PRECAUTIONS AND PATIENTS REQUIRING THE PRECAUTIONS

Guidelines for Isolation Precautions in Hospitals Guidelines for Isolation Precautions in Hospitals Hospital Infection Control Advisory Committee