Isolation procedures may be implemented to prevent the spread of infection from patient to patient, from the patient to health care workers, or from health care workers to the patient. They may also be used to reduce the risk of infection in immunocompromised patients. Central to the success of these procedures is the selection of the proper equipment and the adequate training of those who use it.
Equipment
Materials required for isolation typically include barrier clothing, an isolation cart or anteroom for storing equipment, and a door card announcing that isolation precautions are in effect.
Barrier clothing:
Gowns • gloves • goggles • masks. Each staff member must be trained in their proper use.
Isolation supplies:
Labels • tape • laundry bags (and water-soluble laundry bags, if used) • plastic trash bags.
An isolation cart may be used when the patient's room has no anteroom. It should include a work area (such as a pull-out shelf), drawers or a cabinet area for holding isolation supplies and, possibly, a pole on which to hang coats or jackets.
Preparation of equipment
Remove the cover from the isolation cart if necessary, and set up the work area. Check the cart or anteroom to ensure that correct and sufficient supplies are in place for the designated isolation category.
Implementation
  • Remove your watch (or push it well up your arm) and your rings according to facility policy. These actions help to prevent the spread of microorganisms hidden under your watch or rings.
  • Wash your hands before putting on gloves to prevent the growth of microorganisms under gloves.
Putting on isolation garb
  • Put the gown on and wrap it around the back of your uniform. Tie the strings or fasten the snaps or pressure-sensitive tabs at the neck. Make sure your uniform is completely covered to prevent contact with the patient or his environment.
  • Place the mask snugly over your nose and mouth. Secure ear loops around your ears or tie the strings behind your head high enough so the mask won't slip off. If the mask has a metal strip, squeeze it to fit your nose firmly but comfortably. (See Putting on a face mask.) If you wear eyeglasses, tuck the mask under their lower edge. If goggles are worn, put them on at this time.
  • Put on the gloves. Pull the gloves over the cuffs to cover the edges of the gown's sleeves.

Removing isolation garb
  • Remember that the outside surfaces of your barrier clothes are contaminated.
  • While wearing gloves, untie the gown's waist strings.
  • With your gloved left hand, remove the right glove by pulling on the cuff, turning the glove inside out as you pull.
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    Don't touch any skin with the outside of either glove. (See Removing contaminated gloves.) Then remove the left glove by wedging one or two fingers of your right hand inside the glove and pulling it off, turning it inside out as you remove it. Discard the gloves in the trash container.
  • Untie the neck straps of your gown. Grasp the outside of the gown at the back of the shoulders and pull the gown down over your arms, turning it inside out as you remove it to ensure containment of the pathogens.
  • Holding the gown well away from your uniform, fold it inside out. Discard it in the laundry or trash container as necessary.
  • If the sink is inside the patient's room, wash your hands and forearms with soap or antiseptic before leaving the room. Turn off the faucet using a paper towel and discard the towel in the room. Grasp the door handle with a clean paper towel to open it, and discard the towel in a trash container inside the room. Close the door from the outside with your bare hand.
  • Remove the mask last to prevent contaminating your face or hair in the process. Untie your mask, holding it only by the strings. Discard the mask in the trash container. Remove goggles.
  • If the sink is in an anteroom, wash your hands and forearms with soap or antiseptic after leaving the room.

Special considerations
  • If airborne precautions are required, a particulate respirator should be worn rather than a surgical mask.
  • Use gowns, gloves, goggles, and masks only once, and discard them in the appropriate container before leaving a contaminated area. If your mask is reusable, retain it for further use unless it's damaged or damp. Be aware that isolation garb loses its effectiveness when wet because moisture permits organisms to seep through the material. Change masks and gowns as soon as moisture is noticeable or according to the manufacturer's recommendations or your facility's policy.
  • At the end of your shift, restock used items for the next person. After patient transfer or discharge, return the isolation cart to the appropriate area for cleaning and restocking of supplies. An isolation room or other room prepared for isolation purposes must be thoroughly cleaned and disinfected before use by another patient.