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Hand hygiene facilities inside and outside the room

Patient information material detailing the other infection prevention precautions required

Cleaning materials for the room

Preprocedure

Action Rationale

1 Identify the most suitable room available for protective isolation, taking into account the risk to the patient, the patient’s other nursing needs and other demands on the available single rooms. To ensure the best balance between minimizing the risk of infection, maintaining the safety and comfort of the isolated patient and the availability of single rooms for other purposes. E

Procedure

2 Remove all non-essential furniture and equipment from the room. The remaining furniture should be easy to clean. Ensure that the room is stocked with any equipment required for patient care and sufficient numbers of any disposable items that will be required. To ensure the availability of everything required for patient care while minimizing the amount of cleaning required and the amount of traffic of people and equipment into and out of the room. E

3 Ensure that all PPE required is available outside the room. Wall-mounted dispensers offer the best use of space and ease of use but if necessary, set up a trolley outside the door for PPE and alcohol handrub. Ensure that this does not cause an obstruction or other hazard. To have PPE readily available when required. E

4 Ensure that the room is thoroughly cleaned before the patient is admitted. Effective cleaning will remove infectious agents that may pose a risk to the patient (NPSA 2009, C).

5 Explain the reason for isolation and the precise precautions required to the patient, their family and other visitors, providing relevant patient information material where available. Allow the patient to ask questions and ask for a member of the infection prevention and control team to visit the patient if ward staff cannot answer all questions to the patient’s satisfaction. Compliance is more likely if patients and their visitors understand the reasons for isolation; the patient’s anxiety will be reduced if they have as much information as possible about their condition. E

6 Fix a suitable notice outside the room where it will be seen by anyone attempting to enter the room. This should indicate the special precautions required while preserving the patient’s confidentiality. To ensure all staff and visitors are aware of the need for additional infection control precautions. E

7 Move the patient into the single-occupancy room.

8 Ensure that surfaces and furniture are damp-dusted daily using disposable cleaning cloths and detergent solution, and the floor is mopped daily using soap and water. Damp-dusting and mopping remove micro-organisms without distributing them into the air. E

Procedure guideline 3.15 Protective isolation: entering the isolation room

Essential equipment

Hand hygiene facilities

Disposable plastic apron

Additional equipment, including PPE, for any procedure to be undertaken

Preprocedure

Action Rationale

1 Collect all equipment needed. To avoid entering and leaving the room unnecessarily.

Procedure

2 Ensure you are ‘bare below the elbow’ (see Procedure guideline 3.1). To facilitate hand hygiene and to avoid transferring any contamination to the patient from long sleeves or cuffs. E

3 Put on a disposable plastic apron. To provide a barrier between the front of the uniform or clothing, which is the most likely area to come in contact with the patient. E

4 Clean hands with soap and water or alcohol handrub. To remove any contamination from the hands which could be transferred to the patient (WHO 2009, C).

5 Close the room door after entering. To reduce the risk of airborne transmission of infection from other areas of the ward and ensure that air conditioning and filtration work as efficiently as possible. E

Visitors

1 Ask the patient to nominate close relatives and friends who may then, after instruction (see steps 1–5, above), visit freely. The patient or their representative should ask other acquaintances and non-essential visitors to avoid visiting