Transmission Precautions

by Rhonda Lawes, PhD, RN

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    00:01 So, as we've already introduced to you, transmission precautions are specific to how the disease spreads.

    00:08 Now, we'll look at these and break them down but before we go through these individually, look at the top.

    00:14 The first box on every one of these posters. What's the common denominator? Right, clean hands.

    00:21 It's amazing how well we can stop the transmission of diseases if everyone was diligent about hand hygiene.

    00:29 So, that's why it's a part of standard and universal contact, droplet, and airborne precautions.

    00:36 Now, let's take a look at contact precautions. Now, this one is kind of the most straightforward.

    00:43 We already talked about hand hygiene which you'll see the two stop signs on the side of each side of this poster that says stop.

    00:51 Everyone has to clean their hands before they go in the room and when they're leaving the room.

    00:57 Now, if you're gonna be providing care as a staff member or a healthcare provider, you're also gonna need to put on gloves before you go in the room and take the gloves off before you leave the room.

    01:08 So, think about all the germs that are in the room when someone's on contact precautions.

    01:13 So, you wanna go in there with gloves on so you're protected and you don't wanna carry any of those germs out of the room.

    01:21 So, you take them off before you leave the room. Now, the gown, same deal.

    01:26 You wanna put it on before you go in the room but take the gown off in the room and throw it away.

    01:32 Remember, you don't wanna wear the same gown or gloves for the care of more than one person.

    01:36 Eww, that's disgusting. So, gloves and gown, you put them on before you go in the room, you take them off and throw them away before you leave the room.

    01:49 Now, when it comes to equipment, you don't wanna share equipment with this patient and other patients if they're on contact precautions.

    01:56 So, you wanna use dedicated equipment or disposable equipment.

    02:00 That means this blood pressure cuff stays in this room. Nobody else uses it.

    02:05 Or you use disposable equipment.

    02:07 Once you throw it away or just use it for that patient and then, it's thrown away.

    02:12 If it's reusable equipment, you have to be meticulous about cleaning it and disinfecting it according to your hospital's policy and directions before you would ever use it on another patient.

    02:24 Okay, so, that's contact precautions, right? We know hand hygiene is gonna be the same for everybody, clean your hands before you enter and when you leave the room, put your stuff on, your gown and gloves before you go in, and then, take it off in the rooms so you don't carry those bugs back out.

    02:42 Make sure you don't expose another patient to equipment that's been used on a patient with contact precautions.

    02:48 Either use dedicated or disposable or if it's reusable, make sure you are meticulous about cleaning it before you use it on another patient.

    02:57 Now, droplet precautions, there we go. You've got hand-hygiene.

    03:02 I know, you're gonna get tired of me saying that but that's critically important.

    03:06 The worst job I ever had in doing quality was they made me stand in the hallway and note how often staff was using hand hygiene and I could not believe it.

    03:19 So, we can't ever get apathetic or get too comfortable and get lax on washing hands.

    03:26 You've gotta do it for yourself, for the safety of your family, and particularly, for the safety of your patients.

    03:33 But droplet precautions are a little different.

    03:36 You wanna make sure that the eyes, nose, and mouth are covered before you go in the room because these are droplets, I don't -- I want my face protected.

    03:46 So, I wanna make sure my eyes, nose, and mouth, which were points where droplets could enter my body, I wanna make sure that those are protected from the patient's droplets.

    03:56 So, you wanna make sure that's on before you go in the room and you take it off as you leave the room.

    04:03 So, just like with gloves and gown, put it on to protect yourself before you go in the room, take it off before you leave the room so you don't carry those germs out to the rest of the unit, patients and staff.

    04:16 Alright, so, we've looked at contact precautions and droplet precautions.

    04:20 Now, what can you remember is different for droplet precautions versus contact precautions? Right, good, droplet precautions don't necessarily need a glove and gown but you must use things that cover your eyes, nose and mouth and that's why you're gonna have an eye-shield or goggles, and a mask.

    04:43 Airborne precautions is our third and final category of transmission precautions today.

    04:50 Now, everyone has to, I know, I know, wash your hands, you've got it, before entering and when leaving the room.

    04:58 But here's where it gets really interesting.

    05:01 Because we're on airborne precautions, we're talking about those bacteria and virus that can hang out in the air.

    05:07 So, you need to wear a fit tested N95 or higher level respirator.

    05:12 Now, there's a difference in the mask and there's a difference when you take it off, let's look at that.

    05:17 In airborne precautions, we've got these bacteria and virus literally in the air.

    05:23 So, you need a special mask that's called a respirator that fits very tight to your face.

    05:29 It filters out about 95% of the things that we're trying to protect you from.

    05:35 So, it's a pretty good and effective mask, much better for airborne precautions where a surgical mask would not provide you that type of protection.

    05:45 So, but look at when you take this off, now, the other stuff, we took it off in the room and threw it away.

    05:51 With airborne precautions, in order for you to be safe, you put this respirator on before you go in the room and it's been fit tested before you even start taking care of a patient, these are fit tested in another part of the hospital to make sure yours fits correctly.

    06:08 You put that on before you go into the room.

    06:11 Then, as you're leaving the room, you don't take that off because you don't want to be unprotected.

    06:17 You leave that mask on, exit the room, close the door, then, it's safe for you to take the respirator off.

    06:26 So, that's why I've got that at the bottom for you.

    06:29 The door to the room after you close it needs to remain closed because that patient inside there has these bacteria or virus that are in the air of their room.

    06:39 You wanna keep that door closed so those bugs and bacteria don't come out into the other patient care areas.

    06:46 Alright, so, there's our three, contact, droplet, and airborne.

    06:50 Take a minute and make sure you're very clear on the similarities and differences between these three types of transmission precautions.

    About the Lecture

    The lecture Transmission Precautions by Rhonda Lawes, PhD, RN is from the course COVID-19 Safety for Health Care Professionals (HCP).

    Included Quiz Questions

    1. Put gloves on before entering the room
    2. Put on a gown before entering the room
    3. Wash hands before entering and before exiting the room
    4. Take gloves off after exiting the room
    5. Use disposable stethoscopes for all clients on contact precautions
    1. A client who is being treated for pneumonia
    2. A client who has a staph infection on their leg
    3. A client who has a urinary tract infection
    4. A client who has a gangrenous diabetic ulcer on the foot
    1. Ensure that the N95 mask has been fit tested
    2. Keep the door to the room closed
    3. Put an N95 mask on before entering the room
    4. Take the N95 mask off before exiting the room
    5. A gown must be worn during care

    Author of lecture Transmission Precautions

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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