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Don appropriate personal protective equipment (PPE) based on the patient’s signs and symptoms and indications for isolation precautions.
Avoid physical contact with the patient with suspected or confirmed tuberculosis (TB) or other airborne pathogen before donning appropriate PPE.
Perform hand hygiene with soap and water or use an alcohol-based hand rub (ABHR) immediately after removing all PPE.
Infection-control practices that reduce and eliminate sources of infection transmission help to protect patients and health care team members from disease. The health care team member is responsible for educating a patient about infection control. Knowledge of the infectious process, disease transmission, and critical-thinking skills associated with use of aseptic techniques and barrier protection is essential for both health care team members and patients.
According to the World Health Organization (WHO), airborne transmission of infectious pathogens occurs when droplets from the pathogen disseminate and remain infectious when suspended in the air over long distance and time.undefined#ref6">6 These pathogens can be spread via fine mist, dust, aerosols, or liquids. In most cases, the pathogen causes an inflammatory reaction of the upper airways, infecting the nose, sinuses, throat, and lungs.6 The result of this inflammatory reaction may cause sinus congestion, sore throat, and lower respiratory tract symptoms.
One of the most common airborne pathogens is TB. Current guidelines for preventing and controlling TB focus on detecting the infection early, preventing close contact with a patient who has active TB, and applying effective infection-control measures in the health care setting.2 Other airborne pathogens include chickenpox, measles, and disseminated herpes zoster.
Health care team members who care for patients with suspected or confirmed infectious illness transmitted via the airborne route should ensure that these measures are taken to prevent airborne transmission:
Health care team members who don N95 respirator masks must be fit-tested in a reliable way to determine which size mask is appropriate and to ensure that the wearer knows when a good seal is achieved. Fit-testing must be performed before health care team members are required to wear the respirator in the workplace and must be repeated at least annually.4 Fit-testing must also be conducted whenever respirator design or facial changes that may affect a proper fit take place.4 A respirator that has not been fitted properly may leave unprotected gaps between it and the face, impairing its effectiveness.
Rationale: The mode of transmission for an infectious microorganism determines the type and degree of precautions used.
Rationale: An AIIR has at least 6 to 12 air exchanges per hour.2
Rationale: Single-use medication containers minimize the transfer of microorganisms.
Rationale: Gloves act as a barrier to reduce the risk of exposure to blood.
Ensure that linens and waste are totally contained to protect health care team members from exposure to infectious organisms.
Rationale: Disinfecting equipment after use decreases the risk of infection transmission.5
Rationale: Covering the mouth with a tissue when coughing helps prevent the spread of infection to other patients and to health care team members. The mask prevents particles from the patient’s respiratory tract from being released into shared air. Patients should not wear a respirator because it does not prevent expulsion of droplet nuclei into shared air.
If hands become contaminated at any time during PPE removal, immediately perform hand hygiene with soap and water or use an ABHR.
Do not touch the outer surface of the gloves; it is considered contaminated.
If a PAPR with a self-contained blower unit inside the helmet is used, remove the surgical hood and wait until later in the procedure to remove the integrated components.
Rationale: The front of the gown and sleeves are contaminated.
Rationale: The final inspection is a key step to ensuring health care team members’ safety.
Avoid pinching the nosepiece, which may result in an improper fit.
Rationale: Donning eye protection properly reduces the risk of exposure to microorganisms that may occur from splashing fluids.
Ensure that linens or waste are totally contained to protect health care team members from exposure to infectious organisms.
Do not touch the outer surface of the eye protection or face shield; it is considered contaminated.
Rationale: The front of the N95 respirator is considered contaminated.
Centers for Disease Control and Prevention (CDC). (2020). Implementing filtering facepiece respirator (FFR) reuse, including reuse after decontamination, when there are known shortages of N95 respirators. Retrieved October 13, 2022, from https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.html
*In these skills, a "classic" reference is a widely cited, standard work of established excellence that significantly affects current practice and may also represent the foundational research for practice.
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