AORN Journal
Volume 87, Issue 3 , Pages 534-546 , March 2008

Application of the Updated CDC Isolation Guidelines for Health Care Facilities

  • Shauna Ely Tarrac, RN, MSN, CIC, CNOR, CPAN

      Affiliations

    • Shauna Ely Tarrac, RN, MSN, CIC, CNOR, CPAN, is an infection prevention and clinical epidemiology practitioner at Sharp Grossmont Hospital, La Mesa, CA. Ms Tarrac has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.

References 

  1. Siegel JD, Rhinehart E, Jackson M, Chiarello L; Healthcare Infection Control Practices Advisory Committee. Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings 2007. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007.pdf. Accessed January 3, 2008.
  2. Garner JS . Guideline for isolation precautions in hospitals. The Hospital Infection Control Practices Advisory Committee . Infect Control Hosp Epidemiol . 1996;17(1):53–80
  3. Siegel JD , Rhinehart E , Jackson M , Chiarello L , Healthcare Infection Control Practices Advisory Committee  . Management of multidrug-resistant organisms in healthcare settings, 2006. Centers for Disease Control and Prevention . http://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf Accessed January 3, 2008.
  4. Harris AD , Bradham DD , Baumgarten M , Zuckerman IH , Fink JC , Perencevich EN . The use and interpretation of quasi-experimental studies in infectious diseases . Clin Infect Dis . 2004;38(11):1586–1591
  5. Bent S , Shojania KG , Saint S . The use of systematic reviews and meta-analyses in infection control and hospital epidemiology . Am J Infect Control . 2004;32(4):246–254
  6. Harris AD , Lautenbach E , Perencevich E . A systematic review of quasi-experimental study designs in the fields of infection control and antibiotic resistance . Clin Infect Dis . 2005;41(1):77–82
  7. Centers for Disease Control and Prevention  . Transmission of hepatitis B and C viruses in outpatient settings—New York, Oklahoma, and Nebraska, 2000-2002 . MMWR Morb Mortal Wkly Rep . 2003;52(38):901–906
  8. Regulations (Standards—29 CFR). Bloodborne pathogens—1910.1030. Occupational Safety and Health Administration. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051. Accessed January 17, 2008.
  9. Interim recommendations for infection control in healthcare facilities caring for patients with known or suspected avian influenza. Centers for Disease Control and Prevention. http://www.cdc.gov/flu/avian/professional/infect-control.htm. Accessed January 3, 2008.
  10. Philips BJ , Fergusson S , Armstrong P , Anderson FM , Wildsmith JA . Surgical face masks are effective in reducing bacterial contamination caused by dispersal from the upper airway . Br J Anaesth . 1992;69(4):407–408
  11. O'Grady NP , Alexander M , Dellinger EP , et al.   Guidelines for the prevention of intravascular catheter-related infections . MMWR Recomm Rep . 2002;51(RR-10):1–29
  12. Sehulster L , Chinn RY , CDC  , Healthcare Infection Control Practices Advisory Committee (HICPAC)  . Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the HICPAC . MMWR Recomm Rep . 2003;52(RR10):1–42
  13. Jensen PA , Lambert LA , Iademarco MF , Ridzon R , CDC  . Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005 . MMWR Morb Recomm Rep . 2005;54(17):1–141
  14. Facility Guidelines Institute  , American Institute of Architects Academy of Architecture for Health  , US Department of Health and Human Services  . 2006 Guidelines for Design and Construction of Hospital and Health Care Facilities . Washington, DC: American Institute of Architects Press; 2006; https://aia-timssnet.uapps.net/timssnet/products/TNT_Products.cfm?SR=1&action=long&primary_id=157165013X Accessed January 3, 2008.
  15. Srinivasan A , McDonald LC , Jernigan D , et al.   Foundations of the severe acute respiratory syndrome preparedness and response plan for healthcare facilities . Infect Control Hosp Epidemiol . 2004;25(12):1020–1025
  16. Valenti WM , Pincus PH , Messner MK . Nosocomial pertussis: possible spread by a hospital visitor . Am J Dis Child . 1980;134(5):520–521
  17. Christie CD , Glover AM , Willke MJ , Marx ML , Reising SF , Hutchinson NM . Containment of pertussis in the regional pediatric hospital during the greater Cincinnati epidemic of 1993 . Infect Control Hosp Epidemiol . 1995;16(10):556–563
  18. Donskey CJ . The role of the intestinal tract as a reservoir and source for transmission of nosocomial pathogens . Clin Infect Dis . 2004;39(2):219–226
  19. Bhalla A , Pultz NJ , Gries DM , et al.   Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients . Infect Control Hosp Epidemiol . 2004;25(2):164–167
  20. Duckro AN , Blom DW , Lyle EA , Weinstein RA , Hayden MK . Transfer of vancomycin-resistant enterococci via health care worker hands . Arch Intern Med . 2005;165(3):302–307
  21. Peques DA , Lasker BA , McNeil MM , Hamm PM , Lundal JL , Kubak BM . Cluster of cases of invasive Aspergillosis in a transplant intensive care unit: evidence of person-to-person airborne transmission . Clin Infect Dis . 2002;34(3):412–416
  22. Seto WH , Tsang D , Yung RW , et al.   Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS) . Lancet . 2003;361(9368):1519–1520
  23. Bassetti S , Bischoff WE , Walter M , et al.   Dispersal of Staphylococcus aureus into the air associated with a rhinovirus infection . Infect Control Hosp Epidemiol . 2005;26(2):196–203
  24. Eichenwald HF , Kotsevalov O , Fasso LA . The “cloud baby:” an example of bacterial-viral interaction . Am J Dis Child . August 1960;100
  25. Sheretz RJ , Reagan DR , Hampton KD , et al.   A cloud adult: the Staphylococcus aureus-virus interaction revisited . Ann Intern Med . 1996;124(6):539–547
  26. McFarland LV , Mulligan ME , Kwok RY , Stamm WE . Nosocomial acquisition of Clostridium difficile infection . N Engl J Med . 1989;320(4):204–210
  27. Wilcox MH , Fawley WN , Wigglesworth N , Parnell P , Verity P , Freeman J . Comparison of the effect of detergent versus hypochlorite cleaning on environmental contamination and incidence of Clostridium difficile infection . J Hosp Infect . 2003;54(2):109–114
  28. Mayfield JL , Leet T , Miller J , Mundy LM . Environmental control to reduce transmission of Clostridium difficile . Clin Infect Dis . 2000;31(4):995–1000
  29. Rutala WA, Weber DJ. Disinfection and sterilization guidelines: what you need to know. Presented at: The 2007 Conference of the Association for Professionals in Infection Control & Epidemiology; June 2007; San Jose, CA. http://www.unc.edu/depts/spice/dis/slides4.html. Accessed January 22, 2008.
  30. Pépin J , Valiquette L , Alary ME , et al.   Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity . CMAJ . 2004;171(5):466–472
  31. Outbreak of Clostridium difficile infection in a hospital in south east England . CDR Weekly . 2005;15(24): http://www.hpa.org.uk/cdr/archives/archive05/News/news2405.htm Accessed January 3, 2008.
  32. Ansari SA , Springthorpe VS , Sattar SA . Survival and vehicular spread of human rotaviruses: possible relation to seasonality of outbreaks . Rev Infect Dis . 1991;13(3):448–461
  33. Centers for Disease Control and Prevention  . Surveillance for Creutzfeldt-Jakob Disease—United States . MMWR Morb Mortal Wkly Rep . 1996;45(31):665–668
  34. Llewelyn CA , Hewitt PE , Knight RS , et al.   Possible transmission of variant Creutzfeldt-Jakob disease by blood transfusion . Lancet . 2004;363(9407):417–421
  35. Johnson RT , Gibbs CJ . Creutzfeldt-Jakob disease and related transmissible spongiform encephalopathies . N Engl J Med . 1998;339(27):1994–2004
  36. Brown P , Gajdusek DC , Gibbs CJ , Asher DM . Potential epidemic of Creutzfeldt-Jakob disease from human growth hormone therapy . N Engl J Med . 1985;313(12):728–731
  37. Frasier SD , Foley TP . Clinical review 58: Creutzfeldt-Jakob disease in recipients of pituitary hormones . J Clin Endocrinol Metab . 1994;78(6):1277–1279
  38. el Hachimi KH , Chaunu MP , Cervenakova L , Brown P , Foncin JF . Putative neurosurgical transmission of Creutzfeldt-Jakob disease with analysis of donor and recipient: agent strains . C R Acad Sci III . 1997;320(4):319–328
  39. Will RG , Matthews WB . Evidence for case-to-case transmission of Creutzfeldt-Jakob disease . J Neurol Neurosurg Psychiatry . 1982;45(3):235–238
  40. Bernoulli C , Siegfried J , Baumgartner G , et al.   Danger of accidental person-to-person transmission of Creutzfeldt-Jakob disease by surgery . Lancet . 1977;1(8009):478–479
  41. Rutala WA , Weber DJ . Creutzfeldt-Jakob disease: recommendations for disinfection and sterilization . Clin Infect Dis . 2001;32(9):1348–1356
  42. Peiris JS , Yuen KY , Osterhaus AD , Stöhr K . The severe acute respiratory syndrome . N Engl J Med . 2003;349(25):2431–2441
  43. Olsen SJ , Chang HL , Cheung TY , et al.   Transmission of the severe acute respiratory syndrome on aircraft . N Engl J Med . 2003;349(25):2416–2422
  44. Centers for Disease Control and Prevention  . Update: severe acute respiratory syndrome—worldwide and United States, 2003 . MMWR Morb Mortal Wkly Rep . 2003;52(28):664–665
  45. Loeb M , McGeer A , Henry B , et al.   SARS among critical care nurses, Toronto . Emerg Infect Dis . 2004;10(2):251–255
  46. Fowler RA , Guest CB , Lapinsky SE , et al.   Transmission of severe acute respiratory syndrome during intubation and mechanical ventilation . Am J Respir Crit Care Med . 2004;169(11):1198–1202
  47. Scales D , Green K , Chan AK , et al.   Illness in intensive care staff after brief exposure to severe acute respiratory syndrome . Emerg Infect Dis . 2003;9(10):1205–1210
  48. Christian MD , Loutfy M , McDonald LC , et al.   Possible SARS coronavirus transmission during cardiopulmonary resuscitation . Emerg Infect Dis . 2004;10(2):287–293
  49. Wilder-Smith A , Leong HN , Villacian JS . In-flight transmission of severe acute respiratory syndrome (SARS): a case report . J Travel Med . 2003;10(5):299–300
  50. Booth TF , Kournikakis B , Bastien N , et al.   Detection of airborne severe acute respiratory syndrome (SARS) coronavirus and environmental contamination in SARS outbreak units . J Infect Dis . 2005;191(9):1472–1477
  51. Yu IT , Li Y , Wong TW , et al.   Evidence of airborne transmission of the severe acute respiratory syndrome virus . N Engl J Med . 2004;350(17):1731–1739
  52. Centers for Disease Control and Prevention  . Cluster of severe acute respiratory syndrome cases among protected health-care workers—Toronto, Canada, April 2003 . MMWR Morb Mortal Wkly Rep . 2003;52(19):433–436
  53. Sims LD , Ellis TM , Liu KK , et al.   Avian influenza in Hong Kong 1997–2002 . Avian Dis . 2003;47(3 Suppl):832–838
  54. Guan Y , Peiris JSM , Lipatov AS , et al.   Emergence of multiple genotypes of H5N1 avian influenza viruses in Hong Kong SAR . Proc Natl Acad Sci U S A . 2002;99(13):8950–8955
  55. Avian influenza (bird flu). Centers for Disease Control and Prevention. http://www.cdc.gov/Flu/avian. Accessed January 22, 2008.
  56. Sturm-Ramirez KM , Ellis T , Bousfield B , et al.   Reemerging H5N1 influenza viruses in Hong Kong in 2002 are highly pathogenic to ducks . J Virol . 2004;78(9):4892–4901
  57. Peiris JSM , Yu WC , Leung CW , et al.   Re-emergence of fatal human influenza A subtype H5N1 disease . Lancet . 2004;363(9409):617–619
  58. Webster RG , Hulse DJ . Microbial adaptation and change: avian influenza . Rev Sci Tech . 2004;23(2):453–465
  59. Subbarao K , Klimov A , Katz J , et al.   Characterization of an avian influenza A (H5N1) virus isolated from a child with a fatal respiratory illness . Science . 1998;279(5349):393–396
  60. Parashar U , Quiroz ES , Mounts AW , et al.   “Norwalk-like viruses.” Public health consequences and outbreak management . MMWR Recomm Rep . 2001;50(RR-9):1–17
  61. Wu HM , Fornek M , Schwab KJ , et al.   A norovirus outbreak at a long-term-care facility: the role of environmental surface contamination . Infect Control Hosp Epidemiol . 2005;26(10):802–810
  62. Zingg W , Colombo C , Jucker T , Bossart W , Ruef C . Impact of an outbreak of norovirus infection on hospital resources . Infect Control Hosp Epidemiol . 2005;26(3):263–267
  63. Calderon-Margalit R , Sheffer R , Halperin T , Orr N , Cohen D , Shohat T . A large-scale gastroenteritis outbreak associated with Norovirus in nursing homes . Epidemiol Infect . 2005;133(1):35–40
  64. Marx A , Shay DK , Noel JS , et al.   An outbreak of acute gastroenteritis in a geriatric long-term care facility: combined application of epidemiological and molecular diagnostic methods . Infect Control Hosp Epidemiol . 1999;20(5):306–311

  indicates that continuing education contact hours are available for this activity. Earn the contact hours by reading this article and taking the examination on pages 543–544 and then completing the answer sheet and learner evaluation on pages 545–546.You also may access this article online at http://www.aornjournal.org.The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.

PII: S0001-2092(07)00827-7

doi: 10.1016/j.aorn.2007.12.001

AORN Journal
Volume 87, Issue 3 , Pages 534-546 , March 2008