Used hospital linen may be contaminated with micro-organisms that cause infections.
The most important measures to prevent the transfer of these organisms are: -
The Business Support team are responsible for the maintenance & surveillance of the healthcare environment.
‘Isolation precautions’ is another term for barrier nursing. It is considered best practice to isolate patients with infections in a single side room with the door closed to form a barrier, (hence the term barrier nursing). Where this poses the risk of physical or emotional harm to a patient, a risk assessment must be carried out and any deviation from best practice must be documented in the patient’s case notes. Isolation precautions are additional precautions and are recommended for infections or micro organisms transmitted by the following routes: -
Infections transmitted by the inhalation of micro-organisms on droplet nuclei. These particles are expelled from the respiratory tract and may remain suspended in air for a long time. Isolate patients in single side rooms with the door closed. Limit patient movement. Masks recommended for some procedures. Gloves and aprons should to be worn when handling respiratory secretions.
Infections transmitted by contact with respiratory secretions, including particles produced during coughing and sneezing. These particles do not travel far or remain airborne. Many of these infections are also spread by direct contact with infective material. Isolate in a single room with the door closed. Limit patient movement. Wear gloves and aprons. Masks may also be required.
Infections transmitted by direct contact with patients (e.g. by touching their skin, lesions or nasal secretions). Some micro-organisms may also be able to survive in the immediate environment and be transferred by contact with surfaces or equipment. Isolate in single side rooms preferably or cohort. Limit patient movement. Use gloves and aprons for all contact with the patient and their immediate environment.
Some microbes, when ingested, cause gastrointestinal infection which is excreted in faeces. Transmission to another person occurs when these micro-organisms contaminate hands or surfaces, through inadequate hand hygiene, which in turn contaminate the next person’s hands and are then ingested.
Staphylococcus Aureus lives harmlessly on the skin and the nose of about one third of people. Staph aureus can be sensitive (MSSA) or resistant (MRSA) to Meticillin which is an antibiotic used for testing purposes.
MRSA is resistant to some of the commonly used antibiotics eg. Flucloxacillin and is therefore often more difficult to treat. Staph aureus tends to live in the nose, arm pit, groin and wounds of people. It can also be found in the environment in dust and has been found in the community as well as hospitals. Staph aureus usually spreads from person to person by direct skin contact or by contaminated equipment or surfaces.
It can ‘hitch a ride’ to the next patient on the hands of health care workers that have not been effectively decontaminated. People carrying Staph aureus on their skin are said to be colonised, but not infected. If this bacterium is allowed to enter body tissues, it can cause abscesses, boils and local infections. If Staph aureus is allowed to enter the blood steam it can cause septicaemia (blood poisoning).
Presence of MRSA in blood cultures is known as MRSA bacteraemia.