Four clients with infections arrive at the emergency department with some existing infection, however, only one private room is available. Which of the following clients is the most appropriate to assign to the private room?
A. A client with toxic shock syndrome and a temperature of 102.4°F (39.1°C).
B. A client with diarrhea caused by C. difficile.
C. A client with a wound infected with VRE.
D. A client with a cough who may have Koch disease.
Correct Answer: D. A client with a cough who may have Koch disease.
Clients with infections that require airborne precautions (such as TB) need to be in private rooms. Secondary environmental controls consist of controlling the airflow to prevent contamination of air in areas adjacent to the source airborne infection isolation (AII) rooms, and cleaning the air by using high-efficiency particulate air (HEPA) filtration, or ultraviolet germicidal irradiation.
Option A: Standard precautions are required for the client with toxic shock syndrome. At a minimum, standard precautions should be used in the hospital setting to prevent transmission to patients and staff. The CDC has recommended for the first 24 hours of effective antibiotics to have the patient in both contact and droplet isolation.
Option B: Use contact precautions for patients with known or suspected CDI. Place these patients in private rooms. If private rooms are not available, they can be placed in rooms (cohort) with other CDI patients. Wear gloves and a gown when entering CDI patient rooms and during their care.
Option C: Clients with infections that require contact precautions (such as C.difficile and VRE infections) should ideally be placed in private rooms; however, they can be placed in rooms with other clients with the same diagnosis. Wear gloves (clean, non-sterile gloves are adequate) when entering the room of a VRE-infected or colonized patient because VRE can extensively contaminate such an environment. When caring for a patient, a change of gloves might be necessary after contact with a material that could contain high concentrations of VRE.