Sterile Procedures
LESSON 5: Isolation
5-5
5-5. HOSPITAL PERSONNEL
a. Masks. Individual mask technique is recommended. Masks should cover the nose and mouth. The high-efficiency disposal masks are more effective than the standard cotton gauze or paper tissue masks in preventing airborne and droplet spread. Masks should be used only once. They may become ineffective when moist and should be discarded in an appropriate receptacle before the user leaves the contaminated area. Masks must never be lowered around the neck and reused. Supplies of masks should be readily available outside the patient area when isolation procedures require their use.
b. Gowns. Individual gown technique is recommended; that is, gowns should be used only once and then discarded in an appropriate receptacle before the user leaves the contaminated area. Supplies of gowns must be readily available outside the patient area when isolation procedures require their use. Sterile gowns may be used in caring for some patients in protective isolation. In other instances, such as patients with extensive burns or extensive wound infections, it may be desirable to use sterile gowns when changing dressings. Clean, freshly laundered, or disposable gowns may be used for all other categories.
c. Caps and Booties. Caps and booties are not necessary in any of the categories of isolation. When used, the cap should cover all scalp hair, and the booties should cover the open ends of trousers. They should be used only once and then packaged for reprocessing or disposal.
d. Hands. Hand washing before and after contact with each patient is the single most important means of preventing the spread of infection. Hand washing is mandatory even when gloves are used. In addition, personnel must wash their hands after any contact with excretions (feces, urine, or soiled material) or secretions (drainage from wounds, skin infections, and so forth) of the patient before touching that patient again.
(1) Liquid, powder, or bar soaps can be used for normal hand washing; however, an antiseptic cleansing agent should be used by personnel caring for patients in isolation. Vigorous scrubbing for at least 15 seconds and thorough rinsing are essential for hand washing to be effective since much of the benefit results from physical removal of contaminants.
(2) Sinks for hand washing and hand washing supplies should be conveniently available near every patient.
e. Gloves. Gloves should be used only once and then discarded into an appropriate receptacle before the user leaves the contaminated area. Supplies of gloves should be readily available outside the patient area
when the isolation procedure requires their use. Disposable single-use gloves (sterile or nonsterile, depending on the specific use) are available and may be used.
(1) In administering to a patient, personnel should change to new gloves after direct contact with that patient's excretions or secretions, even if you have not completed your nursing care procedures for that patient.
(2) The use of gloves is stressed because even with good hand washing techniques, potentially infectious material may be left on the hands (under fingernails, for example). Such residue cannot be removed without special attention.
