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(CONTACT PRECAUTIONS)
INTRODUCTION
In addition to Standard Precautions, Special Organisms Precautions are initiated and maintained
to interrupt the transmission of epidemiologically significant microorganisms known to be
spread by contact. These precautions are intended to reduce the colony count of bacteria on
horizontal surfaces and in the immediate vicinity of the patient.
Special Organism Precautions (SOP) will be instituted on a case-by-case basis at the discretion
of the Infection Control staff, Infectious Disease staff and/or Medical or Nursing staff. Instances
in which special organism precautions apply are as follows:
•When a patient is colonized and/or infected with multiple drug-resistant organisms, or
organisms that are not treatable with the usual antibiotics, i.e., vancomycin-resistant
enterococcus (VRE), multi-drug resistant gram-negative rods, etc.
•When a particular organism is identified as being potentially hazardous because of its
pathogenicity, virulence, or epidemiologic characteristics. e.g. rotavirus, Salmonella sp.,
Shigella sp . etc.
•For other organisms, these procedures may be instituted or modified at the discretion of IC
staff (e.g. smallpox/vaccinia, Severe Acute Respiratory Syndrome (SARS).
I. POLICY for patients with diseases requiring ONLY the institution of Special
Organism Precautions/Contact Precautions. NOTE: Infection Control will
be notified by phone by Microbiology when a specimen is positive for VRE
or rotavirus. The Microbiology Lab will screen for vancomycin resistance in
enterococcus isolates from in-patients and selected out-patient services.
A. HANDWASHING
Handwashing for at least 10 seconds with an antimicrobial soap, or
alcohol gel use is required:
2. Wear a disposable gown for direct contact with the patient or the
environment if the patient is incontinent, or has diarrhea or a
draining wound.
a. Gowns may be worn one time only, then disposed of in the
regular (non-biohazardous) waste.
b. Cloth gowns may be substituted if there is no risk of splash
C. PATIENT PLACEMENT
3. A negative air pressure room is not required. The door may remain
open.
D. ENVIRONMENT
6. Waste disposal, spill management, linen and food trays are handled
in the same way for all patients, regardless of precaution category.
Isolation trays are not required. After patient use, both linen and food
trays are sent directly for cleaning and disinfection.
E. PATIENT TRANSPORT/AMBULATION
2. Patients may walk in hall wearing a clean cover gown if they have
been instructed in handwashing, are continent, and able to cooperate
with procedures.
b. Pediatric patients may go to the playroom, the teen room and the
schoolroom with Infection Control/Child Life approval.
a. Wear gloves only if you are physically moving the patient from
the bed or gurney. Wear gloves and a gown only if the patient
is incontinent, or has diarrhea or a draining wound.
b. You must remove the gown and gloves in the room, wash your
hands, and then bring the patient to the receiving unit.
F. VISITORS/STAFF
G. PATIENT TRANSFER/DISCHARGE
b. Obtain a culture from previous VRE (+) site. If this culture is (-)
proceed to the next step.
a. Patient Name
b. Patient medical record number
c. Patient is to be put on Special Organism Precautions upon arrival
on the unit.
HICPAC (Hospital Infection Control Practices Advisory Committee), CDC: "Guideline for
Isolation Precautions in Hospitals", American Journal of Infection Control, February
1996;24(1):24.
"Special Organism Isolation: Attempting to Bridge the Gap". Infection Control and Hospital
Epidemiology, May 1994, 15(5):335