Transport & Transfer: How to transport a patient in Contact Isolation Precautions

How do you properly transport a patient that is in Contact Isolation Precautions who requires a cart transport? I know you need clean linen under the patient, is there an easy way to get clean linen under the patient and what transport devices do you recommend, i.e. slide board, Air Pal etc. Thanks for your answer!

Donna Villagran
Yavapai Regional Medical Center

Dear Donna:

The stretcher should be pre-loaded with the clean linen prior to the lateral transfer. Lateral transfers are accomplished in a variety of ways including slide board and Air Pal as mentioned, as well as friction reducing devices, ceiling lifts, or floor lifts depending on equipment availability and the current policy/practice at the facility. Below are Standard and Contact Precautions from the CDC as well as links you may wish to consult.

V. Contact Precautions
In addition to Standard Precautions, use Contact Precautions, or the equivalent, for specified patients known or suspected to be infected or colonized with epidemiologically important microorganisms that can be transmitted by direct contact with the patient (hand or skin-to-skin contact that occurs when performing patient-care activities that require touching the patient's dry skin) or indirect contact (touching) with environmental surfaces or patient-care items in the patient's environment. Category IB

1. Patient Placement
   Place the patient in a private room. When a private room is not available, place the patient in a room with a patient(s) who has active infection with the same microorganism but with no other infection (cohorting). When a private room is not available and cohorting is not achievable, consider the epidemiology of the microorganism and the patient population when determining patient placement. Consultation with infection control professionals is advised before patient placement. Category IB


2. Gloves and Handwashing
   In addition to wearing gloves as outlined under Standard Precautions, wear gloves (clean, nonsterile gloves are adequate) when entering the room. During the course of providing care for a patient, change gloves after having contact with infective material that may contain high concentrations of microorganisms (fecal material and wound drainage). Remove gloves before leaving the patient's environment and wash hands immediately with an antimicrobial agent or a waterless antiseptic agent. (72,94) After glove removal and handwashing, ensure that hands do not touch potentially contaminated environmental surfaces or items in the patient's room to avoid transfer of microorganisms to other patients or environments. Category IB


3. Gown
   In addition to wearing a gown as outlined under Standard Precautions, wear a gown (a clean, nonsterile gown is adequate) when entering the room if you anticipate that your clothing will have substantial contact with the patient, environmental surfaces, or items in the patient's room, or if the patient is incontinent or has diarrhea, an ileostomy, a colostomy, or wound drainage not contained by a dressing. Remove the gown before leaving the patient's environment. After gown removal, ensure that clothing does not contact potentially contaminated environmental surfaces to avoid transfer of microorganisms to other patients or environments. Category IB


4. Patient Transport
   Limit the movement and transport of the patient from the room to essential purposes only. If the patient is transported out of the room, ensure that precautions are maintained to minimize the risk of transmission of microorganisms to other patients and contamination of environmental surfaces or equipment. Category IB


5. Patient-Care Equipment
   When possible, dedicate the use of noncritical patient-care equipment to a single patient (or cohort of patients infected or colonized with the pathogen requiring precautions) to avoid sharing between patients. If use of common equipment or items is unavoidable, then adequately clean and disinfect them before use for another patient. Category IB


6. Additional Precautions for Preventing the Spread of Vancomycin Resistance
   Consult the HICPAC report on preventing the spread of Vancomycin resistance for additional prevention strategies. (94)

• MMWR
• CDC Web Search