AFFECTED STAKEHOLDERS

Transcription

1 POLICY STATEMENT All patients will be assessed for infectious diseases or pathogens upon presentation in all settings. Proper transmission-based precautions will be initiated based on clinical presentation and likely pathogens; then, maintained until a diagnosis is confirmed or ruled out. AFFECTED STAKEHOLDERS Indicate all entities and persons within the Enterprise that are affected by this policy: Administrative Services Hired Staff Housestaff/Residents & Clinical Fellows Leased staff Medical Staff (includes Physicians, PAs, APNs) Patient Care Services (Nursing, PCT s, Unit Clerks) Professional Services (Laboratory, Radiology, Respiratory, Pharmacy; etc.) Vendors/Contractors Other: Include any other stakeholders not listed above. DEFINITIONS Empiric Precautions Pathogen Transmissionbased precautions Simple and consistent strategies (i.e. transmission-based precautions) implemented upon presentation or development of certain clinical conditions that will prevent further spread of disease to others. Bacteria, virus, fungi or other agent that is infectious or capable of causing disease. Interventions designed for patients documented or suspected to be infected or colonized with pathogens that require additional precautions beyond standard precautions to stop transmission; includes Contact, Enteric Contact, Droplet and Airborne precautions and may be combined depending of the clinical syndrome or condition. PROCESS & PROCEDURES Hospital Epidemiology is responsible for communicating current recommendations by the Centers for Disease Control and Prevention to prevent the spread of infectious diseases. The following table will be used to guide empiric precautions and will be

2 updated as needed. Upon diagnosis confirmation, the Alphabetical Disease/Organism Listing for Transmission Based Precautions will be followed as indicated. All healthcare workers are responsible for following and implementing the proper transmission-based precautions. Diarrhea Acute diarrhea with likely infectious cause in an incontinent or diapered patient Meningitis Enteric pathogens Neisseria meningitidis Enteroviruses tuberculosis Contact for Adults and Pediatrics Droplet for 24 hours after start or effective antimicrobial therapy; mask and face protection for intubation Contact for infants and children Airborne if pulmonary infiltrate present; airborne and contact if potentially infectious draining body fluid present

3 Rash or exanthems, generalized, etiology unknown Petechial/ecchymotic with fever (general) If positive history of travel to an area with an ongoing outbreak of viral hemorrhagic fever in 10 days before fever onset Vesicular Maculopapular with cough, coryza and fever Respiratory Infections Cough/fever/upper lobe infiltrate in a HIV negative patient or a patient at low risk for HIV infection Neisseria meningitides Ebola, Lassa, Marburg viruses Varicella-zoster, herpes simplex, variola (smallpox), and Vaccinia viruses Rubeola (measles) virus tuberculosis, respiratory viruses, Streptococcus pneumonia, Droplet for 24 hours after start of effective antimicrobial therapy Droplet plus contact with face/eye protection, emphasizing sharp safety, barrier precautions when blood exposure likely. Use N- 95 or higher respiratory protections when aerosolgenerating procedures performed. Airborne and Contact; contact only if herpes simplex, localized zoster in an immunocompetent host or vaccinia viruses most likely Airborne Airborne and Contact

4 aureus Cough/fever/pulmonary infiltrate in any lung location in a HIV infected patient or a patient at high risk for HIV Cough/fever/pulmonary infiltrate in any lung location in a patient with a history of recent travel (10-21 days) to countries with active outbreaks of SARS, avian influenza or reported novel infection and/or known exposure to pathogen Paroxysmal or severe persistent cough during periods of pertussis activity Respiratory infections, particularly bronchiolitis and pneumonia in infants and young children Skin or Wound Infections tuberculosis, respiratory viruses, Streptococcus pneumonia, aureus SARS CoV/novel/newly emerging infections Bordetella pertussis Respiratory syncytial, parainfluenza, (RSV) adenovirus, influenza viruses Airborne and Contact Use eye/face protection if aerosol-generating procedure performed or contact with respiratory secretions anticipated. Airborne and Contact; notify Epidemiology for the need of eye protection Droplet Contact and Droplet; droplet for duration of illness

5 Abscess or draining wound that cannot be covered or contained aureus, group A streptococcus Contact; add droplet for first 24 hours after start of effective antimicrobial therapy if invasive Group A streptococcal disease suspected. REFERENCES, SUPPORTING DOCUMENTS, AND TOOLS Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, , RELATED POLICIES NA APPROVED BY Chief Executive Officer, Georgia Regents Medical Center Date: 01/13/2016