A client is diagnosed with methicillin-resistant staphylococcus aureus pneumonia. What type of isolation is most appropriate for this client?
A. Reverse isolation
B. Respiratory isolation
C. Contact isolation
D. Standard precautions
Correct Answer: C. Contact isolation
Contact or Body Substance Isolation (BSI) involves the use of barrier protection (e.g. gloves, mask, gown, or protective eyewear as appropriate) whenever direct contact with any body fluid is expected. When determining the type of isolation to use, one must consider the mode of transmission. The hands of personnel continue to be the principal mode of transmission for methicillin-resistant staphylococcus aureus (MRSA). Because the organism is limited to the sputum in this example, precautions are taken if contact with the patient’s sputum is expected. A private room and BSI, along with good hand washing techniques, are the best defense against the spread of MRSA pneumonia.
Option A: Reverse isolation refers to the practice of healthcare workers and visitors wearing barriers (i.e., gown, gloves, mask, etc.) routinely upon entry to the client room, for the purpose of preventing client exposure to external microbes. Certain immunocompromised clients have been shown to benefit from specific additional “interventions”. These interventions create a “Protective Environment”.
Option B: Respiratory isolation is used for diseases that are spread through particles that are exhaled. Those having contact with or exposure to such a patient are required to wear a mask. Respiratory isolation guidelines for patients admitted from the ED with pneumonia were developed and validated in a study. These guidelines provide satisfactory guidance for isolation of patients at risk for PTB in a high-TB-prevalence population.
Option D: Standard Precautions are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is delivered. These practices are designed to both protect DHCP and prevent DHCP from spreading infections among patients.