Page 26 - policy and procedure infection control

Policies and Procedures on Infection Control

3.2 Transmission-based

These precautions apply to selected patients, based on a suspected or confirmed clinical
syndrome, a specific diagnosis, or colonization or infection with epidemiologically important
organisms. These precautions are to be implemented in conjunction with standard precautions.
Three types of transmission-based precautions have been developed; airborne, droplet and
contact. Few diseases (e.g. varicella, influenza) may require more than one isolation category.
(See table 1 & 2). Essential elements of each isolation category are outlined below;

Airborne Precautions

Designed to prevent the transmission of diseases by droplet nuclei (particles <5 μm) or
dust particles containing the infectious agent. These particles can remain suspended in
the air and travel long distances. If the particles are inhaled, a susceptible host may
develop infection. Airborne precautions are indicated for patients with documented or
suspected tuberculosis (pulmonary or laryngeal), measles, varicella, or disseminated
zoster.

Patient Placement In descending order of preference;
1. Negative pressure room en-suite bath
2. Single room (nursed with door closed) and en-suite bath
3. Single room
4. Cohort (not recommended unless absolutely necessary)
– consult Physicians /microbiologists

Respiratory protection Wear respiratory protection when entering the room of a
patient with known or suspected infectious pulmonary
tuberculosis. Susceptible persons should not enter the room
of patients known or suspected to have measles or (rubeola)
or varicella (chickenpox) if other immune caregivers are
available. If susceptible persons must enter the room of a
patient known or suspected to have measles (rubeola) or
varicella, they should wear respiratory protection. Persons
immune to measles (rubeola) or varicella need not wear
respiratory protection
Face shield/eye As per standard precautions
protection
(For procedures/activities likely to generate splashes/sprays
of blood, body fluids, secretions and excretions)

Gloves and Hand As per standard precautions
washing
(When touching blood, body fluids secretions, excretions,
contaminated items, mucous membranes, non intact skin)

Ministry of Health Malaysia 15