|
Responsibility |
Comments |
| Assignments |
- Patients must have one to one nursing unless patients with MDR-AB are cohorted and the
nurse is assigned to care for two or more MDR-AB patients.
- Nurses caring for MDR-AB patients should not care for non-MDR-AB patients
- If the nurse absolutely must enter the room of a non-MDR-AB patient, the nurse should practice
“reverse isolation” with the other patient. The nurse should wear a clean gown and gloves
into the other patient’s room.
- Nurses caring for MDR-AB patients should not enter the room of a non-MDR-AB patient who is
immunocompromised or who has a tracheostomy or wounds.
|
The RN assigned to the patient should not help out in other patient’s rooms unless absolutely
necessary.
Staff not assigned to the patient, but who enter the room to assist the RN or patient, are NOT
required to practice reverse isolation on all other patients. They should follow routine isolation
procedure for Maximum Precautions-wear gown and gloves to enter room, mask/faceshield if the patient
has the organism in the sputum. Remove gown, gloves, and mask when exiting room, and wash or sanitize
hands. The rational for this is related to the amount of exposure-someone going in just once or twice a
shift has low exposure compared to the RN assigned to the patient.
|
| Isolation |
Maximum Precautions (gowns and gloves on entry). Mask should be used if the patient has the
organism in the sputum. Mask whenever contact with respiratory fluids or secretions can be reasonably
anticipated, such as disconnecting ventilator, suctioning or if possibility of splashing or exposure
to secretions, i.e., productive cough, emptying ventilator tubing condensation. |
|
| Sign in Sheets on Door of Patient’s Room |
Not required on routine basis |
May be requested by HEIC for special circumstances |
| Personnel Entering Rooms |
— Respiratory Therapy/Physical Therapy:
- Designated personnel should care for all patients with MDR Acinetobacter if possible and these
personnel should not care for non-MDR-AB patients.
- Patients with MDR-AB should be scheduled for PT at the end of the day.
— Support Associates:
- Designated personnel should care for all rooms of patients with MDR Acinetobacter if possible
and these personnel should not enter rooms of non-MDR-AB patients. Records of who was assigned
the patient’s room should be kept.
|
Records of the therapist, equipment and treatment should be kept by the departments.
SA assignment sheets are kept on file for at least 2 years. When a patient is discharged from the room,
all special precaution rooms are terminally cleaned per routine.
|
| Surveillance Cultures |
As requested by infection control department |
| Visitors |
Educate visitors about use of gown and gloves and Hand Hygiene and use of mask if necessary |
| Cleaning Procedures |
Rooms should be cleaned everyday by the same personnel when possible.
Change water after each patient room is completed.
Following discharge of the patient, aggressive cleaning must occur before another patient occupies
the room. Room MUST be terminally cleaned- includes changing the curtains and wet disinfectant
mopping of walls, bed, bedside table, telephone, IV poles, etc.
|
Use hospital approved disinfectant.
Mop handle should be left in the patient’s room.
Dedicated equipment where possible, disposable equipment as much as possible.
All equipment must be cleaned between use.
|
| Testing Procedures |
Ideally done at bedside where possible or at least at the end of the day. Procedure same
as transporting VRE patient. |
Notify testing area prior to transporting. |
| Scan Modules/Supply Cabinets |
If diagnosis is known prior to admission to MICU, place scan module or any supply cabinets outside
of room. Take in minimum amount of supplies needed.
Discard equipment out on bed table or in wire bins with terminal cleaning. |
If diagnosed after admission, discard all supplies in scan module and in wire baskets after discharge.
SA will wipe out scan after everything is thrown out-this is part of terminal cleaning. |
| Ambulation of Patients |
PT or RN may ambulate patient with physician order. Patient and assisting staff will wear gown and
gloves (mask if risk of splash). Patient should use dedicated equipment (i.e. wheelchair, cane, walker,
etc.) and equipment should be stored in patient’s room. Patient must return to room immediately
after ambulating. |
All wounds should have drainage contained by dressings. Pt should wear a clean gown and a mask if
the organism has been found in sputum. |
| ICO Code |
Patients with Acinetobacter will have a ICO 9 Code. HEIC should be notified when
a patient with the ICO 9 code is admitted. |
