Hospitals

Strict isolation

Infection Prevention Working Party
Published: November 2006
Revision: November 2011


Strict isolation

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Strict isolation


Table of contents

1 Indications..........................................................................................................1
2 Room..................................................................................................................1
3 Patients clothing................................................................................................1
4 Linen...................................................................................................................1
5 Crockery.............................................................................................................1
6 Personal protective equipment............................................................................1
7 Leaving the isolation room.................................................................................1
8 Transport of the patient ......................................................................................2
9 Visitors...............................................................................................................2
10 Cleaning..............................................................................................................2
11 Waste..................................................................................................................2
12 End of isolation...................................................................................................2
Appendix A References.................................................................................................3






Strict isolation 1
This guideline describes the measures that must be taken in addition to the general
precautions.
1 Indications
Strict isolation combines the measures of contact isolation with those of airborne
isolation.
See Indications for isolation: Infectious diseases and isolation measures.
2 Room
The patient is cared for in an isolation room.
For the requirements that an isolation room must satisfy, see the WIP guideline
Isolation department structural and design requirements; Ventilation of isolation
rooms [1].
The type of isolation is indicated on the door of the room.
Everything required for the care and simple examination of the patient must be
present in the room. Bandages and other sterile materials should be kept in a
closed cupboard (in a quantity for a maximum of one week). It is advisable not to
build up large stocks of supplies.
3 Patients clothing
The patient wears his/her own clothing.
For clothing of patients with viral haemorrhagic fever, see the WIP guidelines
Hygiene measures for viral haemorrhagic fevers and Linen [2,3].
4 Linen
There are no special measures to be taken for linen.
5 Crockery
No measures have to be taken for crockery.
6 Personal protective equipment
Gloves are put on before entering the room.
Long-sleeved protective clothing is put on before entering the room.
A mask is put on before entering the room.
The type of mask (EN 149-2001, FFP1 or FFP2) depends on the microorganism. A
surgical mask is worn in the event of MRSA.
Head covering must be worn in the event of strict isolation for MRSA.
7 Leaving the isolation room
The procedure for leaving the isolation room is as follows:
The gloves are taken off in the room, after which the hands are rubbed with
hand alcohol.
The apron is then taken off in the anteroom, folded inside-out before being
disposed of, or hung up inside-out for reuse.

Strict isolation 2
The cap (if worn) and the mask are then removed and disposed of.
Finally, the hands are rubbed with hand alcohol.
8 Transport of the patient
The transport service and the department to which the patient is being taken must
be informed of the isolation and any measures to be taken in advance.
The patient is transported with clean clothing and clean bedding.
The patient wears a surgical mask to prevent contamination of others during
transport (only for airborne transmission).
The department receiving the patient must take the same measures as described
here.

No special measures are required for the transport of a deceased patient, with the
exception of patients who have suffered from Lassa fever, Ebola haemorrhagic fever
or another related disease (See the WIP guideline Hygiene measures for viral
haemorrhagic fevers) [3].
9 Visitors
Visitors must report to the nursing staff beforehand.
The nursing staff must instruct visitors on the measures to be taken and must see to
it that these measures are observed properly. Children are only permitted into the
room in consultation with staff.
Visitors must put on a mask before entering the room. The type of mask (EN 149-
2001, FFP1 or FFP2) depends on the microorganism. A surgical mask is worn in
the event of MRSA. Protective clothing is also worn.
Visitors follow the same procedure as staff when leaving the room.
Visitors must disinfect their hands, and may not visit other patients immediately
afterwards.
10 Cleaning
The room and the anteroom are cleaned daily and before a new patient is admitted
to the room.
11 Waste
See the WIP guideline Infection prevention during the removal of waste from health
care institutions [4].

12 End of isolation
Medical and nursing material that has been in the room must be cleaned and
disinfected.
Materials that cannot be cleaned and disinfected must be disposed of.
The room is disinfected in accordance with the procedure described in the WIP
guideline Cleaning, disinfection and sterilisation of rooms, furniture and objects
[5].

Strict isolation 3
Appendix A References


1 WIP Isolation department structural and design requirements; Ventilation of
isolation rooms. 2004.
2 WIP Linen.
3 WIP Hygiene measures for viral haemorrhagic fevers. 2004.
4 WIP Infection prevention during processing and removal of waste from health
care institutions. 2004.
5 WIP Cleaning, disinfection and sterilisation of rooms, furniture and objects. 2000.