D u k e Details - Advanced Clinical Practice - Duke University

sWhat types of precautions are usedat DUH?Standard precautions should be used with allpatients when the possibility of contact with bloodor body fluids exists.Isolation:• Contact isolation is used for patients withresistant organisms such as MRSA and VRE.On pediatric services, the precaution methodis also used for Adenovirus and RespiratorySynctival Virus (RSV). Gowns and gloves arethe minimal protective equipment needed.• Droplet isolation is used for diseases spreadthrough the droplet route including meningitis,pertussis and Influenza. Patients are placed in aprivate room and a regular surgical mask is usedwhen entering the room.• Airborne isolation is used for patients withsymptoms suspicious of tuberculosis andpatients with varicella zoster. Wear N95 maskto enter patient’s room. Fit testing is requiredto use the N95 particulate respirator mask. Ifyou have not been fit-tested, you should use apowered air purifying respirator (PAPR).• Strict Precautions are used for patientswith highly resistant organisms such as VISA/VRSA and KPCs. Use gown and gloves to enterpatient’s room, and a surgical mask whenindicated.Can a nurse initiate isolation?A nurse can initiate isolation if:1. The patient has signs or symptoms of acommunicable disease such as Tuberculosis,Varicella Zoster, etc., or2. A patient has a history of a resistant organismsuch as MRSA or VRE, or3. A patient has a culture result indicative of aresistant organism.The nurse should consult with the physicianbefore writing the order for the specific isolationprecaution.Infection Control – Isolation29