room into the corridor whenever the door of the isolation room is opened. The
anteroom should be under slightly negative pressure with regard to the hall. It is
preferable for the anteroom, as well as the isolation room, to have its own supply and
c. The room design of many, especially older, hospitals may not allow for
adequate control of air movement. Therefore, complete control of droplet nuclei and
dust particles is not possible. If proper air-handling capabilities are lacking, a
commercially available window fan to exhaust air from the room may be used to control
airflow. It is far preferable, however, for the hospital to install permanent ventilation
systems in an adequate number of rooms specified for isolation. Window fans might be
installed in rooms of patients admitted with disease spread by the airborne route, such
as staphylococcal pneumonia, or chickenpox. Window fans may be of special use in
improving isolation of patients with pulmonary tuberculosis.
5-5.
HOSPITAL PERSONNEL
a. Masks. Individual mask technique is recommended. Masks should cover the
nose and mouth. The high-efficiency disposal masks are more effective than the
standard cotton gauze or paper tissue masks in preventing airborne and droplet spread.
Masks should be used only once. They may become ineffective when moist and should
be discarded in an appropriate receptacle before the user leaves the contaminated
area. Masks must never be lowered around the neck and reused. Supplies of masks
should be readily available outside the patient area when isolation procedures require
their use.
b. Gowns. Individual gown technique is recommended; that is, gowns should
be used only once and then discarded in an appropriate receptacle before the user
leaves the contaminated area. Supplies of gowns must be readily available outside the
patient area when isolation procedures require their use. Sterile gowns may be used in
caring for some patients in protective isolation. In other instances, such as patients with
extensive burns or extensive wound infections, it may be desirable to use sterile gowns
when changing dressings. Clean, freshly laundered, or disposable gowns may be used
for all other categories.
c. Caps and Booties. Caps and booties are not necessary in any of the
categories of isolation. When used, the cap should cover all scalp hair, and the booties
should cover the open ends of trousers. They should be used only once and then
packaged for reprocessing or disposal.
d. Hands. Hand washing before and after contact with each patient is the single
most important means of preventing the spread of infection. Hand washing is
mandatory even when gloves are used. In addition, personnel must wash their hands
after any contact with excretions (feces, urine, or soiled material) or secretions
(drainage from wounds, skin infections, and so forth) of the patient before touching that
patient again.
MD0540
5-6