ISOLATION TECHNIQUE IN NURSING or BARRIER NURSING

DEFINITION

• Isolation is the separation of infected person from the non-infected person for the period of communicability under conditions which will prevent the transmission of infection to others
• Isolation technique means observing all those practices that are designed to prevent the transmission of specific pathogens from one person to another directly or indirectly. It is also called barrier nursing technique
• Isolation is the separation of the patient and his unit from others to prevent the direct or indirect contact of infectious agent to susceptible person, e.g. droplet infection, clothing, etc
• Barrier nursing or isolation technique is intended to confine the microorganisms within a given and recognized area

PURPOSE

• To confine the pathogens within a given and recognized area
• To prevent direct contract with the infectious person
• To protect the hospital staff and other patients from infection
• To prevent cross infection on different diseases
• To protect nurses and others from possible communication of diseases by protecting nurses uniform from contamination

GENERAL INSTRUCTIONS

• Isolation technique is synonym for communicable disease technique and is required to be maintained to prevent the transmission of communicable diseases between the individuals
• Keep the patient in isolation room which may be a unit type or disease type according to physical set-up
• Receive necessary immunization before nursing the patient
• Inform your supervisor when you have skin lesions, sore throat or other evidence of lowered resistance
• Maintain proper aseptic practices

Isolation techniques in nursing, also known as infection control precautions, involve practices and measures to prevent the spread of infectious diseases among patients, healthcare workers, and visitors. These techniques are crucial in maintaining a safe healthcare environment. Different types of isolation precautions are used based on the mode of transmission of the infectious agent. The main types include:

1. Standard Precautions:

• Standard precautions are the baseline practices used for the care of all patients, regardless of their infectious status. They include:
  • Hand hygiene.
  • Use of personal protective equipment (PPE) like gloves, gowns, masks, and eye protection.
  • Safe injection practices.
  • Proper handling and disposal of contaminated equipment.

2. Transmission-Based Precautions:

• Transmission-based precautions are implemented based on the mode of transmission of a specific infectious agent. There are three types:
  • Contact Precautions:
    • Used for patients with known or suspected infections spread by direct or indirect contact.
    • Examples include Clostridioides difficile (C. diff), methicillin-resistant Staphylococcus aureus (MRSA), and multidrug-resistant organisms.
  • Droplet Precautions:
    • Used for patients with known or suspected infections transmitted through respiratory droplets.
    • Examples include influenza, pertussis, and bacterial meningitis.
  • Airborne Precautions:
    • Used for patients with known or suspected infections transmitted via small respiratory particles.
    • Examples include tuberculosis, chickenpox, and measles.

3. Protective Environment:

• Protective environment is a specialized form of isolation used for immunocompromised patients, such as those undergoing bone marrow transplantation. It includes measures to minimize exposure to environmental pathogens.
  • Use of positive-pressure rooms.
  • Restricted visitation.
  • Strict hand hygiene and infection control measures.

Key Practices in Isolation Techniques:

1. Hand Hygiene:
   • Handwashing with soap and water or using alcohol-based hand sanitizers is a fundamental practice in preventing the spread of infections.
2. Personal Protective Equipment (PPE):
   • Proper use of PPE, including gloves, gowns, masks, and eye protection, is essential when providing care to patients in isolation.
3. Environmental Cleaning:
   • Regular and thorough cleaning and disinfection of patient rooms and equipment to prevent the transmission of infectious agents.
4. Patient Placement:
   • Assigning patients to appropriate rooms or areas based on their infection status and the type of precautions required.
5. Educating Patients and Visitors:
   • Providing education to patients and visitors on infection prevention practices and the importance of adherence to precautions.
6. Respiratory Hygiene/Cough Etiquette:
   • Encouraging patients and healthcare workers to practice proper respiratory hygiene, including covering the mouth and nose when coughing or sneezing.
7. Waste Disposal:
   • Proper disposal of contaminated materials and waste to prevent the spread of infectious agents.
8. Restricted Movement:
   • Limiting the movement of patients within the healthcare facility to prevent the potential spread of infections.

BARRIER NURSING

Barrier nursing is a set of infection control practices aimed at preventing the transmission of infections, particularly highly contagious diseases, between healthcare workers, patients, and the environment. The primary goal of barrier nursing is to create physical barriers that reduce or eliminate the risk of direct or indirect contact with infectious agents. This approach is crucial in protecting both healthcare providers and patients. Here are key components of barrier nursing:

1. Personal Protective Equipment (PPE):

• Healthcare workers use appropriate PPE to create a barrier between themselves and potentially infectious materials. Common PPE includes:
  • Gloves: to protect hands.
  • Gowns: to protect clothing and skin.
  • Masks: to prevent the inhalation of infectious respiratory droplets.
  • Eye protection: such as goggles or face shields, to shield the eyes.

2. Hand Hygiene:

• Strict hand hygiene practices are maintained, including regular handwashing with soap and water or the use of alcohol-based hand sanitizers. Hand hygiene is crucial before and after patient contact and after removing PPE.

3. Isolation Techniques:

• Patients may be placed in isolation based on the type of infection and its mode of transmission. This could involve contact isolation, droplet isolation, or airborne isolation, each requiring specific PPE and precautions.

4. Environmental Controls:

• Strict cleaning and disinfection protocols are followed to ensure the cleanliness of the patient’s environment and prevent the spread of infectious agents.

5. Patient Placement:

• Patients with contagious diseases may be placed in separate rooms or areas to limit the risk of transmission to other patients and healthcare workers.

6. Restricted Visitation:

• Limiting or restricting visitor access to prevent the spread of infections. Visitors may be required to wear PPE and follow specific infection control measures.

7. Education and Training:

• Healthcare workers receive education and training on proper barrier nursing techniques, including the correct use of PPE, hand hygiene, and isolation protocols.

8. Respiratory Hygiene/Cough Etiquette:

• Encouraging patients and healthcare workers to practice proper respiratory hygiene to prevent the spread of respiratory infections.

9. Waste Management:

• Proper disposal of contaminated materials and waste to prevent the transmission of infectious agents.

10. Strict Adherence to Protocols:

• Healthcare workers adhere strictly to established infection control protocols and guidelines to minimize the risk of cross-contamination.