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5 Don eye protection if instructed by infection prevention and control team (e.g. for pandemic influenza) or if conducting an aerosol-generating procedure (e.g. bronchoscopy or intubation) in a patient requiring airborne/droplet precautions. To prevent infection via the conjunctiva (DH 2010b, C).

6 Clean hands with soap and water or alcohol handrub. Hands must be cleaned before patient contact (WHO 2009, C).

7 Don disposable gloves if you are intending to deal with blood, excreta or contaminated material, or if providing close personal care where contact precautions are required. To reduce the risk of hand contamination (Pratt et al. 2007, C).

8 Enter the room, shutting the door behind you. To reduce the risk of airborne organisms leaving the room (Kao and Yang 2006, R1a) and to preserve the patient’s privacy and dignity.

Procedure guideline 3.12 Source isolation: leaving the isolation room

Essential equipment

Orange waste bag

Hand hygiene facilities

Procedure

Action Rationale

1 If wearing gloves, remove and discard them in the orange waste bag. To avoid transferring any contamination on the gloves to other areas or items (Pratt et al. 2007, C).

2 Remove apron by holding the inside of the apron and breaking the ties at neck and waste. Discard it into the orange waste bag. To avoid transferring any contamination on the apron to other areas or items (Pratt et al. 2007, C).

3 Clean hands with soap and water or alcohol handrub. Do not use alcohol handrub when patients require enteric precautions: wash with soap and water. Hands must be cleaned after contact with the patient or their immediate environment (WHO 2009); alcohol is less effective against Clostridium difficile spores and some enteric viruses and in the presence of organic material such as faeces (Fraise and Bradley 2009, E).

4 Leave the room, shutting the door behind you. To reduce the risk of airborne spread of infection (Kao and Yang 2006, R1a).

5 Clean hands with soap and water or alcohol handrub. If the patient requires enteric precautions, hands should be cleaned with soap and water. Hands must be cleaned after contact with the patient or their immediate environment (WHO 2009, C). Alcohol is not effective on all organisms that cause enteric infections (Fraise and Bradley 2009, E).

Procedure guideline 3.13 Source isolation: transporting infected patients outside the source isolation area

Procedure

Action Rationale

1 Inform the department concerned about the procedure required, the patient’s diagnosis and the infection control precautions required at the earliest opportunity. To allow the department time to make appropriate arrangements. E

2 If possible and appropriate, arrange for the patient to have the last appointment of the day. The department concerned and any intervening areas will be less busy, so reducing the risk of contact with other vulnerable individuals, and additional cleaning required following any procedure will not disrupt subsequent appointments. E

3 Inform the portering service of the patient’s diagnosis and the infection control precautions required; ensure that this information has been passed to any porters involved in transfer and reinforce the precautions required. Explanation and reinforcement will minimize the risk of cross-infection through failure to comply with infection control precautions (Fraise and Bradley 2009, E).

4 Escort the patient if necessary. To attend to the patient’s nursing needs and to remind others of infection control precautions if required. E

5 If the patient has an infection requiring droplet or airborne precautions that may present a risk to people encountered in the other department or in transit, they will need to wear a mask or respirator of the appropriate standard. Provide the patient with the mask and explain why it is required and how and when it is to be worn (i.e. while outside their single-occupancy room) and assist them to don it if necessary. To prevent airborne cross-infection. E

Providing the patient with relevant