LACK OF PHYSICAL CONTACT FOR PATIENT'S IN ISOLATION

Lack of Physical Contact for Patient's in Isolation

Lack of Physical Contact for Patient's in Isolation

Introduction

Isolation for the control of infection is used to prevent infected patients from infecting others (source isolation) , and/or prevent susceptible patients from being infected (protective isolation). The methods of physical protection are:-

Barrier nursing - special nursing procedures which reduce the risks of person to person transmission, especially by direct contact or by fomites.

Segregation into single rooms, cubicles, or plastic isolators - which reduces airborne spread to from patients, and facilitates nursing techniques.

Mechanical ventilation - which reduces the risks of airborne spread by removing bacteria from the patient's room and by excluding bacteria present in the outside air from the room.

The transfer of infection by the airborne route can be controlled only by confining the patients in a single room, whether source or protective isolation. On the other hand, diseases spread by contact, such as enteric fever, depends primarily on barrier nursing. The term isolation is commonly used in the sense of segregation of the patient in a single room. Barrier nursing is one of the basic components of patient isolation and can be used on its own or together with the other components. There are various types of isolation offering different degrees of protection;-

High security isolation units - these are usually part of an infectious diseases hospital. Total environmental control is usually achieved by the use of negative pressure plastic isolators. Theses units are designed for treating Hazard Group 4 viral pathogens such as Lassa, Marburg, and Ebola fevers.

Infectious diseases hospitals - these units are usually separate from other hospitals but may be situated in the grounds of a general hospital with separate ventilation and nursing staff.

General hospital isolation units - these provide source isolation facilities for hospital-acquired infections; they also provide facilities for protective isolation and for the screening of patients with suspected infections before admission to a general ward or transfer to a communicable diseases unit.

Single rooms of a general ward - these provide less secure source isolation than the above because of the close proximity to other patients and sharing of nursing and domestic staff with a general ward. Their value in protective isolation depends on the type of patient in the general ward, on the thoroughness of barrier nursing, on whether the room is self-contained (with w.c.), and on the type of ventilation used.

Barrier nursing in open ward - this can be effective in controlling infections transferred by contact but not by air.

Isolators in open wards - plastic enclosures for individual patients have been shown to be of value as a form of protective isolation for high risk patients and of source isolation for infected patients.

Ultra-clean wards - experimental units have been set up in special centres for organ transplantation, treatment of leukaemia and other diseases associated with extreme susceptibility to infection.

Categories of Isolation

The term strict isolation is used to describe the ...