Infection Control

Educating visitors about isolation precautions

Briefings on Infection Control, December 1, 2009

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With Joint Commission standards requiring patient and visitor education on HAIs, coupled with the emergence of H1N1, hospital visitation policies have become a hot topic for IPs.

Although the CDC and OSHA offer guidelines for employees caring for patients under isolation precautions, neither agency gives concrete recommendations for visitors who will be in the same room as the patients. Depending on the nature of the interaction with the patient, employees will wear gloves, isolation gowns, surgical masks, or N95 respirators. However, because visitors are not typically providing care, isolation gowns and gloves are largely unnecessary, says Terry Burger, BSN, RN, CIC, CNA, BC, director of infection prevention and control at Lehigh Valley Hospital in Allentown, PA.

“If a visitor is going to go in the room and visit with a loved one and will not be touching everything, touching their wounds, or touching any open or draining secretions, from our perspective, it is not imperative that they sit there during their visit in isolation with [personal protective equipment (PPE)],” Burger says. Instead, educating visitors about isolation precautions allows them to fully understand their role in preventing infections.

Protecting other patients
Burger says because most visitors are healthy, she is far more concerned about transmitting infections to other patients in the hospital who may have compromised immune systems. Rather than forcing everyone to wear PPE at Lehigh, it’s more important to educate visitors on proper hand hygiene and restrict them from visiting other patients in the hospital.

“It’s not like because they kiss them they now have MRSA,” Burger says. “What we really instruct them to do is [practice] good hand hygiene. If they are going to be touching their loved one, then they have to make sure they are washing their hands before they go to the cafeteria or they go to the gift shop or anywhere else.”

For patients who are on droplet precautions, such as influenza or meningitis, visitors are offered PPE. For tuberculosis patients, visitors are required to wear an N95 respirator. “In terms of contact, we’re a little bit more lenient with that,” Burger says. “By and large, most [visitors] have been around these [patients] day in and day out. What we are much more adamant about is that they not leave that patient and go to another patient room.”

Communicating with the visitor
Many visitors who walk into a medical facility may not be aware of the precautions a friend or family member is under or understand why those precautions are in place.

The most important thing is to educate them on IC policies and have PPE available for them, says Patty Burns, BSN, RN, CIC, the infection control coordinator at St. Elizabeth Medical Center in Edgewood, KY. “We talk to them about how it is transmitted, how they want to stand back and not be right in front of the patient, and definitely to use hand hygiene when they leave,” Burns says. “Also, when they themselves have any sort of respiratory illness, they should not be visiting.”

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