Word: Droplet Precautions
IC.04.07StandardIn addition to Routine Practices, Droplet Precautions will be used for patients known or suspected of having an infection with a microorganism that can be transmitted by large respiratory droplets.A prescriber’s order is not required to initiate Droplet Precautions.Droplet Precautions will be discontinued only in consultation with Infection Prevention & Control (IPAC).Examples of conditions and microorganisms requiring Droplet Precautions are: respiratory tract viruses or bacteria (e.g., rubella, mumps and pertussis.) Refer to the table in Section 5 for Infection Control Precautions on specific infectious diseases, conditions and/or microorganisms for children, adult and maternal-infant population. Description of Droplet TransmissionDroplet transmission occurs when droplets carrying an infectious agent exit the respiratory tract of a person. These droplets may be produced during coughing, sneezing or certain procedures such as suctioning. These droplets are propelled a short distance and may enter the susceptible host’s eyes, nose or mouth or fall onto surfaces. Studies suggest that droplets forcibly expelled by a cough or sneeze travel for up to two meters. Droplets do not remain suspended in the air. Microorganisms contained in these droplets are deposited on surfaces in the patient’s immediate environment and some microorganisms remain viable for extended periods of time. Contact transmission can then occur by touching surfaces and objects contaminated with respiratory droplets.Interventions for Droplet PrecautionsRoutine Practices are used by all Health care workers (HCW) for all patients.The following additional precautions will be used for all patients on Droplet Precautions.Accommodation or Patient PlacementAcute CareSingle room with patient sink and toilet, bathing facilities, and dedicated staff hand washing sink is preferred.If a private bathroom is not available, then a commode must be dedicated to the patient during the entire stay.Patient must not visit shared patient care areas (playroom, school room or family kitchens)Negative pressure is not required.Door may remain open.If a single room is not possible, consult IPAC. Ambulatory Care/EmergencyPatients should not wait in a common area/waiting room. Patients should be placed into an examining room as soon as possible, maintaining a 2 meter separation between patients. SignageA “Droplet Precautions Sign” must be placed at the entrance of the patient room that is visible to all those who enter the room. Personal Protective Equipment Refer to IC.03.05 Personal Protective Equipment for more information)Acute Care:Masks and Eye Protection or Face ShieldA surgical or procedure mask and eye protection must be worn by any individual who is within two meters of the patient on Droplet Precautions.Ambulatory Care/Emergency Mask and eye protection must be worn within 2 meters of the patient.Other Personal Protective Equipment such as gloves and gown may be used based on the risk assessment (e.g., nature of interaction, status of patient). Please refer to IC.03.04 Routine Practices - Risk Assessment.EquipmentPlease refer to “IC.04.01 Principles Of Additional Precautions”Environmental CleaningPlease refer to “IC.04.01 Principles Of Additional Precautions”Dishes, Glasses, Cups and Eating UtensilsPlease refer to “IC.04.01 Principles Of Additional Precautions”Patient Transport/Transfer/DischargeAvoid transfer within and between facilities if possible unless medically necessary.Receiving department must be notified of the precautions in place, prior to transport. Notation of precautions is required when preparing the requisition.The patient must wear a mask during transport if tolerated. If the patient cannot tolerate wearing a mask, the transport staff should wear a mask and eye protection. On discontinuation of Additional Precautions and discharge:All disposable patient equipment and supplies must be disposed of and not returned to general stock. Supplies may be sent with patients who are transferred.All reusable equipment must be cleaned and reprocessed as per established guidelinesContact Environmental Services for room cleaning.VisitorsVisitors of patients on Additional Precautions in health care facilities should be kept to a minimum.HCW must inform patients and visitors about the reason for implementing Droplet Precautions and should provide instruction on how to enter and leave the room safely, hand hygiene, respiratory etiquette, and a demonstration in putting on, taking off and disposing of PPE, if required.Household members may choose to wear PPE.Visitors, other than household members, must wear required PPE.For rubella, mumps or pertussis, visitors who are susceptible to the disease or unaware of their immune status should not visit unless absolutely necessary. Family and visitors must not go to shared patient care areas DocumentationIn progress notes, enter date and time that Droplet Precautions were started and discontinued.Related DocumentsDroplet Precaution Sign – PHSA344 – available through Print Shop.References Association for Professionals in Infection Control and Epidemiology (APIC). Chapter 29: Isolation Precautions. APIC Text of Infection Control and Epidemiology. October, 2014.Provincial Infectious Diseases Advisory Committee (PIDAC). Routine Practices and Additional Precautions in All HealthCare Settings. 3rd edition. Ontario Agency for Health Protection and Promotion. Toronto, ON, November 2012. Health Agency of Canada (PHAC). Routine Practices and Additional Precautions for Preventing the Transmission of Infection in HealthCare Settings. Ontario, 2013. ByInfection Prevention & Control – Infection Control PractitionerVersion HistoryDATEDOCUMENT NUMBER and TITLEACTION TAKEN26-Sept-2019C-0506-15-60384 Droplet PrecautionsApproved at: Infection Control Committee13-Mar-2020“Updates from IPAC Directors; Approved by C&W Professional Practice DirectorDisclaimerThis document is intended for use?within?BC Children’s and BC Women’s Hospitals only. Any other use or reliance is at your sole risk. The content does not constitute and is not in substitution of professional medical advice. Provincial Health Services Authority (PHSA) assumes no liability arising from use or reliance on this document.?This document is protected by copyright and may only be reprinted in whole or in part with the prior written approval of PHSA.? ................
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