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behaviour status inventory
Behavioural Science Institute
body substance isolation
bound serum iron
Brief Symptom Inventory Psychology
British Society for Immunology (Medspeak-UK)
British Standards Institute (Medspeak-UK)
Standard precautions are used to care for all patients to prevent nosocomial infections and apply to contact with blood, body fluids, secretions and excretions (except sweat), nonintact skin, and mucous membranes. Transmission-based precautions (second-tier precautions) are used for patients known to be or suspected of being infected with a highly transmissible infection. The rules to be followed for achieving isolation are based on the mode of transmission of the particular organism: airborne, droplet, and contact. Thus, if the organism is spread by droplet (such as tuberculosis), then all items that come in contact with the patient's upper respiratory tract are isolated and destroyed or disinfected. Those in contact with the patient are also protected from droplet transmission by wearing protective barriers such as special masks (and, if necessary, gowns, caps, boots, and gloves), by careful and thorough hand hygiene, and by keeping the hands away from the nose and mouth to prevent transmission of infections. Most agencies use disposable equipment as much as possible in the care of an isolated patient. Contaminated disposables are double-bagged for safe disposal, usually by incineration. Contaminated linens and other nondisposable equipment are also double-bagged and marked “isolation, ” so that they will be properly decontaminated or disinfected on receipt by the laundry or supply service. Laboratory specimens also are double-bagged and marked with the particular type of isolation, so that personnel handle them appropriately. CDC recommendations and institutional procedure are followed for the specific type of isolation that is in effect. The purpose of the isolation precautions is explained to the patient and family to decrease their fears and to increase their cooperation, and the family and other visitors are taught how to use and discard the required barriers and esp. how to thoroughly cleanse their hands. When an at-risk patient (such as an immunosuppressed patient) requires protection from others (reverse isolation), equipment brought to the patient's room is disposable or sterilized, and human contacts wear barriers that must be clean or sterile depending on the circumstances and protocol. After use, these items are handled in the agency's usual manner, with no special care necessary beyond those specified for the care of every patient.
Patients are placed in a private room, preferably one with negative air pressure and between 6 and 12 changes of air each hour. Hospital workers should wear respirator masks when in the room. If transport is necessary, the patient should wear a surgical mask. Patients with diseases such as active tuberculosis, SARS, varicella, and measles are placed on airborne precautions.
body substance isolationAbbreviation: BSI
Patients with diarrhea caused by Clostridium difficile, hepatitis A, rotavirus, or multidrug-resistant organisms, with wounds infected with vancomycin-resistant enterococcus, or children infected with respiratory syncytial or parainfluenza virus should be placed on contact precautions. Infection with some viruses, such as varicella or adenovirus, require droplet or airborne precautions in addition to contact precautions. Caregivers should remove gloves and gown before leaving the patient’s room, avoid contact with potentially contaminated items or environmental surfaces, and wash hands immediately with an antimicrobial agent or waterless antiseptic agent after touching patients placed on contact isolation status.