Transmission-based (Isolation) precautions in the Surgical Setting

Transmission-based (Isolation) precautions in the Surgical Setting

Although the CDC Guidelines for Isolation Precautions were published in 2007, many questions remain in clinician’s minds when trying to determine if a patient should be placed into precautions.  To add to the confusion, not all hospitals or ambulatory surgery centers place a patient with a given organism into precautions and there is wide variation among facilities for patients that have a history of a multiple drug resistant organism – some will place those patients into precautions while others do not.  Start by reviewing your isolation policy as a baseline.  Even in the OR, the facility (ASC or hospital) isolation policy must be followed.

Standard Precautions form the basis of protection for the healthcare worker and involve wearing a gown, gloves, mask, and/or eye protection to reduce the potential to transmit organisms from a patient or the patient’s environment to staff and subsequently, other patients.  With standard Precautions the personal protective equipment (PPE) used depends on the potential for blood or body fluid to splash, spray or otherwise contact the healthcare worker.

However, sometimes Standard Precautions aren’t enough to prevent transmission of a pathogenic organism from a patient to a healthcare worker or, indirectly, to another patient. This is when Isolation Precautions are needed.  However, the surgical setting provides a unique set of circumstances to apply the CDC’s isolation guidelines.  For example, what part of the setting would be considered the ‘patient’s environment’, who should wear personal protective equipment (PPE), what kind of PPE should the circulator or anesthesia personnel wear, if any, and when?  These are some of the considerations when trying to apply the guidelines to this challenging setting.

Contact Infection Control Results for help to detangle the guidelines, regulations, and standards; protect your staff and your patients, and safely interpret and apply isolation precautions in your setting.    


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