What Are the Guidelines for Patient Placement & Visitor Management to Prevent Infections?

patient placement & visitor management

What Are the Guidelines for Patient Placement & Visitor Management to Prevent Infections?

In healthcare settings, ensuring the safety and well-being of patients, staff, and visitors is of utmost importance. Patient placement and visitor management play a crucial role in preventing the spread of infections within hospitals and other healthcare facilities. By implementing effective guidelines and protocols, healthcare organizations can minimize the risk of cross-transmission of infectious agents and create a safe environment for everyone.

The Importance of Patient Placement and Visitor Management

patient placement & visitor management

Hospitals and other healthcare facilities are dynamic environments with a constant flow of people, including patients, visitors, and healthcare workers. This bustling environment presents unique challenges when it comes to infection prevention and control. Effective patient placement and visitor management are essential to address these challenges and maintain a safe healthcare environment.

Proper patient placement ensures that individuals with known or suspected infections are isolated appropriately to prevent the spread of infectious agents. Visitor management, on the other hand, involves implementing measures to regulate the entry and movement of visitors within the healthcare facility, reducing the risk of introducing infections from external sources.

Security Challenges in Healthcare Settings

Hospitals face numerous security challenges that can compromise patient safety and contribute to the spread of infections. These challenges include physical assaults, theft of medical supplies and drugs, and unauthorized access to vulnerable patients and sensitive areas. Hospital security professionals and administrators must find a balance between maintaining a safe environment and preserving an open and inviting atmosphere that promotes healing.

To address these security challenges effectively, hospitals need to implement robust visitor management solutions specifically tailored to their unique needs. Unfortunately, many existing systems on the market do not adequately meet the requirements of healthcare settings. Hospitals require solutions that can manage access for a diverse range of individuals whose needs may change rapidly, prevent the spread of infectious diseases, and ensure a smooth check-in process for visitors.

Transmission-Based Precautions

Transmission-based precautions (TBPs) are additional measures employed by healthcare staff when caring for patients with known or suspected infections or colonization. These precautions go beyond standard infection prevention and control practices and are based on the specific infectious agent, its transmission route, the care setting, and the severity of the illness.

There are different categories of TBPs based on the route of transmission of infectious agents:

  • Contact Precautions: These precautions are used to prevent and control infections spread through direct contact with the patient or the patient’s immediate care environment, which is the most common route of transmission.
  • Droplet Precautions: These precautions are used to prevent and control infections that spread over short distances via droplets from an individual’s respiratory tract. Droplets can penetrate the respiratory system to a certain depth.
  • Airborne Precautions: These precautions are used to prevent and control infections spread without close patient contact via aerosols from an individual’s respiratory tract. Aerosols can penetrate the respiratory system more deeply and travel much further than large droplets.

It is important for healthcare staff to assess the transmission route of a specific infectious agent and apply the appropriate TBPs to minimize the risk of transmission. Guidelines and resources are available to support healthcare professionals in implementing TBPs effectively.

Patient Placement and Assessment for Infection Risk

Upon admission to a healthcare facility, patients should undergo an assessment to determine their potential for transmitting infections. This assessment should be continuously reviewed throughout the patient’s stay to ensure appropriate placement decisions are made based on clinical and care needs. Patients who may present a cross-infection risk include those with symptoms such as unexplained loose stools, vomiting, fever, or respiratory symptoms.

Patients with known or suspected infectious pathogens that require specific precautions should also be assessed for appropriate placement. Additionally, patients who have been hospitalized outside the healthcare facility in the last 12 months should be considered for placement assessment.

Isolation facilities should be prioritized based on the known or suspected infectious agent. When single-bed rooms are limited, patients with conditions that facilitate the transmission of infection or those at increased risk of adverse outcomes should be given priority for placement in single-bed rooms. Cohorting of patients should be considered only when single rooms are in short supply and in consultation with the local infection prevention and control team (IPCT).

In acute care hospitals, patients requiring contact or droplet precautions are placed in a private room. However, in nursing homes, private rooms may not be available. When a private room isn’t available:

  • Maintain at least 3 feet of spatial separation between residents
  • Use privacy curtains to limit direct contact between residents or to remind healthcare personnel to doff PPE and perform hand hygiene before caring for the other resident
  • Clean and disinfect any reusable equipment
  • Room the infected resident with a roommate at lower risk for acquiring the pathogen (e.g., roommate is not immunocompromised, roommate doesn’t have an indwelling urinary catheter or a wound).

Airborne precautions require an airborne infection isolation room (AIIR) that has been built in keeping with current guidelines. If an AIIR isn’t available:

  • Keep the door to the room closed
  • Have the resident wear a mask
  • Staff wear an N95 to enter the room
  • Transfer the resident to a facility with an AIIR as soon as possible
  • Deep clean the room after the resident is transferred

Safe Management of Patient Care Equipment in Isolation

In an isolation room or cohort area, the safe management of patient care equipment is crucial to prevent cross-contamination. Healthcare facilities should aim to use single-use items whenever possible. Reusable non-invasive care equipment should be dedicated to the isolation room or area. If this is not possible, the equipment must be decontaminated before use on another patient. Increased frequency of decontamination should be considered for reusable equipment used in isolation areas.

It is important to consult the manufacturer’s instructions for cleaning and disinfection requirements, which will include the type of disinfectant that can be used on the equipment. . Proper decontamination practices and the use of appropriate disinfectants should be followed to ensure the safety of patients and healthcare workers.

Safe Management of the Care Environment

Routine environmental decontamination is essential to maintain a clean and safe care environment. In inpatient settings, patient isolation rooms or cohort areas should be decontaminated at least daily. This frequency may increase based on the advice of the IPCT or infection preventionist. Decontamination can be achieved using a combined detergent/disinfectant solution or a general-purpose neutral detergent followed by a disinfectant. Certain areas, such as toilets, frequently touched surfaces, and areas with higher environmental contamination rates may require more frequent decontamination.

After patient transfer, discharge, or when the patient is no longer considered infectious, terminal or deep room cleaning should be performed. This includes the removal and disposal of healthcare waste, disposable items, and the cleaning of reusable non-invasive care equipment. The room should be cleaned following specific protocols, from the highest to lowest point and from the least to most contaminated point.

Some disinfectants are not effective against all pathogens. Healthcare facilities should have policies addressing the appropriate disinfectant to use for difficult to kill pathogens such as Clostridioides difficile (C. diff) and Candida auris.

Personal Protective Equipment

Using personal protective equipment (PPE) is crucial for preventing infection transmission. Wear surgical or procedure masks for droplet-transmitted infections and combine them with eye/face protection for symptomatic patients. For airborne infections, use eye/face protection and a respirator (e.g. N95). Healthcare workers caring for patients in airborne precautions require respiratory protection (e.g. N95) and must be medically cleared prior to fit testing.

Gowns and gloves are needed for antibiotic-resistant bacteria. Follow proper glove guidelines and change immediately if needed.

Infection Prevention in Healthcare Environments

patient placement & visitor management

In healthcare, patient placement and visitor management play crucial roles in infection prevention. Following guidelines ensure proper isolation of infected individuals, regulates visitor entry, and employs transmission-based precautions. Healthcare professionals must prioritize guidelines for patient placement, infection risk assessment, equipment management, and use of protective gear. This safeguards both healthcare workers and patients, creating a secure environment and supporting community well-being. For further education or to schedule an on-site infection assessment, contact Infection Control Results today.