(ī‵sŏ-lā'shŏn )

1. Solitude, or the psychological discomfort that accompanies it.

   SEE: loneliness.

2. The physical separation of those with certain infections (such as anthrax or tuberculosis) from other people to prevent or limit the transmission of disease. In contrast, quarantine applies to restriction on healthy contacts of an infectious agent.

   SEE: incubation for table; infectious isolation ; protective isolation ; quarantine .

   Patient Care: Stand ard 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 (as in tuberculosis), then all items that come in contact with the patient's upper respiratory tract are to be 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 hand s 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 hand le 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. The family and other visitors are taught how to use and discard the required barriers and esp. how to thoroughly cleanse their hand s. 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 hand led in the agency's usual manner, with no special care necessary beyond those specified for the care of every patient.
3. The identification of a cell, a chemical, or a microorganism in purified form.
4. In exercise physiology and rehabilitation medicine, movement of a single joint.

airborne i.Any of the techniques used in addition to stand ard precautions to decrease transmission of infectious agents less than 5 µ in size or those attached to dust particles. Airborne isolation techniques are used to prevent transmission of infections agents that remain viable while suspended in air, e.g., Mycobacterium tuberculosis or varicella virus. SYN: airborne precaution.

Patients are placed in a private room, preferably one with negative air pressure and between 6 and 12 changes of air each hr. The door to the isolation room should be kept closed except during necessary patient care encounters. Hospital workers should wear N95 respirator masks when in the room. If patient transport outside the isolation room is necessary, the patient should wear an approved respirator.

Patients and staff who are pregnant or who have known immune deficits should, whenever possible, avoid caring for patients in airborne isolation.

bedside i.Barrier nursing.

body substance i.

ABBR: BSI

contact i.Any of the techniques used in addition to stand ard precautions that decrease the likelihood of infection by microorganisms transmitted through direct or indirect contact with the patient or patient care items, e.g., methicillin-resistant Staphylococcus aureus and Clostridium difficile. Patients placed on contact isolation should preferably have a private room, but patients may be placed with others infected with the same organism (patient cohort). Hospital workers must wear gloves when entering the room for any reason and gowns if close patient contact is required, as when bathing or turning the patient or caring for wounds. Masks and eye shields are required only if there is a potential for splashing or splattering of body fluids onto the face. Stethoscopes and other noncritical patient care equipment should be dedicated to single-patient or patient-cohort use.SYN: contact precaution.

Patients with diarrhea caused by Clostridium difficile, hepatitis A, rotavirus, or multidrug-resistant organisms; or 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 hand s immediately with an antimicrobial agent or waterless antiseptic agent after touching patients placed on contact isolation status.

droplet i.Any of the infection control techniques that decrease transmission of organisms larger than 5 µ that are generated when an infected patient coughs or sneezes. It includes: placing a mask on the potentially infectious person; wearing personal protective equipment, such as medical masks, gloves, or gowns as indicated; and maintaining distances between people of 1 to 2 meters. These precautions are used in addition to the stand ard precaution procedures. SYN: droplet precaution .

infectious i.An isolation technique that protects both health care personnel and patients from anyone who has or is suspected of having an infectious disease.

protective i.Isolation in which a vulnerable patient is protected from potentially harmful microorganisms in the environment. This is particularly important in caring for immunodeficient patients, e.g., those who have received chemotherapy or organ transplants. SYN: reverse isolation .

pulmonary vein i.An invasive treatment for atrial fibrillation in which lesions are made around the pulmonary veins to block irregular electrical discharges to the left atrium. The treatment is performed by catheter ablation and is lastingly effective in 50% to 60% of patients.

reverse i.Protective isolation.

social i.Aloneness experienced by the individual and perceived as imposed by others and as a negative or threatening state.