Acute care: Infection Control

When a patient has MRSA (methicillin-resistant Staphylococcus aureus), it is important to use contact precautions. Contact precautions are infection control measures taken to prevent the spread of infectious agents through direct or indirect contact. This includes wearing gloves and gowns when in contact with the patient, using dedicated equipment for the patient, and ensuring proper hand hygiene. Using contact precautions helps to minimize the risk of transmission of MRSA to other patients and healthcare workers.

Standard precautions apply to all bodily fluids/secretions/excretions, including blood, saliva, urine, feces, vomit, semen, vaginal secretions, and any other fluid that may contain infectious agents. However, sweat is not considered a high-risk fluid for transmitting infectious diseases. While sweat can contain some bacteria, viruses, and other microorganisms, the risk of transmission through sweat is very low compared to other bodily fluids. Therefore, standard precautions do not specifically apply to sweat.

Hand washing is considered the most effective way to prevent the spread of infection. Regular and thorough hand washing helps to remove germs and bacteria from the hands, reducing the risk of transmitting them to others or introducing them into the body through touching the face or consuming food. It is recommended to wash hands with soap and water for at least 20 seconds, especially before eating, after using the restroom, or when hands are visibly dirty. Hand washing is a simple yet powerful practice that can significantly contribute to maintaining personal and public health.

Chicken pox does not require contact precautions because it is primarily spread through respiratory droplets. Contact precautions are necessary for diseases that are spread through direct contact with infected skin, body fluids, or contaminated objects. Impetigo, scabies, and hepatitis A all require contact precautions as they can be transmitted through direct contact with infected individuals or their belongings. However, chicken pox is mainly transmitted through airborne droplets when an infected person coughs or sneezes, making contact precautions unnecessary.

The term "nosocomial" refers to infections that are acquired within a healthcare setting, such as a hospital. These infections are typically caused by bacteria, viruses, or fungi that are present in the hospital environment and can be spread through contact with contaminated surfaces, equipment, or healthcare personnel. The term "nosocomial" is used to emphasize that the infection was acquired during the patient's hospital stay, as opposed to being present before admission. Therefore, the correct answer is "nosocomial, nosocomial."

Neutropenic precautions are used for the patient's protection. Neutropenia refers to a low white blood cell (WBC) count, specifically a low neutrophil count. Neutrophils are a type of white blood cell that play a key role in fighting off infections. When a patient is undergoing chemotherapy, their WBC count can decrease, leaving them more susceptible to infections. Neutropenic precautions involve strict infection control measures to minimize the risk of exposure to pathogens, such as wearing masks, practicing good hand hygiene, and limiting visitors who may carry infectious agents.