Isolation Policy
SUMMARY
Updated 11/04 |
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Introduction
It is the policy of the Johns Hopkins Hospital (JHH) to isolate
patients assessed to have communicable diseases whether diagnosed
or being ruled-out.
The Centers for Disease Control and Prevention (CDC) published the
most widely used isolation/precautions guidelines for hospitals in
the United States. The JHH Isolation Policy has been adapted
from the 1996 CDC guidelines. Differences in the policy reflect the most
current information on communicable diseases transmission.
In addition, the JHH guidelines are tailored to the local prevalence
of some diseases (e.g. tuberculosis) and existing, effective
infection control practices of the Hospital.
Standard Precautions is the Standard for ALL Patients
Standard Precautions means that the blood, all body fluids
(except sweat), secretions and excretions, mucous membranes and
non-intact skin of all patients are treated as potentially
infectious. EVERY PATIENT IS ON STANDARD PRECAUTIONS, but MAY
ALSO have additional categories of precautions dependent upon the
patient's clinical situation.
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OF NOTE:
Reportable Diseases: The physician responsible for the patient MUST report “Reportable Diseases”
to the local health department (Baltimore City Health Department – BCHD). Some disease require
notification by mail; others by phone (410) 396-4454 (see policy IFC003 – Reportable Diseases
and Conditions). HEIC staff will report know clusters of diseases and cases infection with
agents potentially associated with bioterrorism.
Links to other related policies are available below.
New Isolation Category:
- Maximum Precautions is a new category of isolation created for highly resistant organisms of
epidemiologic significance. Examples are multi-drug restistant (MDR) AcinetobacterSee and VISA/VRSA
isolates. See Appendix III for Nursing Staffing
Guidelines for Maximum Precautions.
- Appendix II of the policy provides an overview of organism based isolation requirement.
Table of Precautions by Specific Disease (Appendix II)
Flagging System
- Patients with multi-drug resistant organisms defined below will be isolated on admission or re-admission to the Johns Hopkins Hospital.
- Addressograph cards are utilized to inform healthcare workers of the need for isolation on readmission to JHH based on the following code system:
- IC01 – Vancomycin Resistant Enterococcus (VRE)
- IC02 – Methicillin Resistant Staphylococcus aureus (MRSA)
- IC03 – Vancomycin Resistant Staphylococcus aureus (VRSA) or Vancomycin Intermediate Staphylococcis aureas (VISA)
- IC04 – Chickenpox (Exposure for readmission)
- IC05 – Tuberculosis, Multi-drug resistant
- IC06 – Infection Control use only
- IC07 – Both VRE and MRSA
- IC08 – Burkholderia cepacia
- IC09 - Multidrug Resistant Acinetobacter
- IC10 - Mutlidrug Resistant Gram-Negative Organisms
Discontinuation of Isolation
- Isolation of patients with known or suspected organisms with durations delineated in Appendix II may be discontinued after meeting specified requirements without specific approval from HEIC.
- Isolation shall not be removed for organisms with multiple drug resistance (e.g. VRE, MRSA, MDR Acinetobacter, VISA/VRSA) until after consultation with and approval from HEIC.
- Authorized prescriber or registered nurse may remove isolation on patients related to a suspected organism, if that organism is not found on microbiology results, without discussion with HEIC unless it is otherwise delineated in Appendix II.
- Call HEIC (5-8384) with questions regarding the removal of isolation precautions.
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Relevent Policies
Please download the pdf (above) for a list of Negative Pressure Rooms
Available in JHH. If you have any questions about a negative pressure
room in the hospital, please call HEIC @ x5-8384.
Please download the printer friendly version of the Isolation Color chart above.
JHH practices Standard Precautions
for ALL patients but additional precautions may be added when deemed necessary.
An isolation sign(s) and cart are required for all patients on any additional precautions.
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