Pre‐procedure

ActionRationale

1. 1.Show
   Collect all equipment needed.
   To avoid entering and leaving the room unnecessarily. E

Procedure

1. 2.Show
   Ensure you are ‘bare below the elbow’ (see Procedure guideline 4.1: Hand washing).
   To facilitate hand hygiene and to avoid transferring any contamination to the patient from long sleeves or cuffs. E
2. 3.Show
   Put on a disposable plastic apron.
   To provide a barrier over the front of the uniform or clothing, which is the area most likely to come in contact with the patient. E
3. 4.Show
   Staff who have any coryzal symptoms should not enter the room. If this is unavoidable, they should wear a mask.
   To prevent unnecessary exposure of the patient to pathogenic organisms. E
4. 5.Show
   Clean hands with soap and water or an alcohol‐based handrub.
   To remove any contamination from the hands that could be transferred to the patient (WHO [124], C).
5. 6.Show
   Close the door after entering.
   To reduce the risk of airborne transmission of infection from other areas of the ward and ensure that the ventilation and air filtration systems work as efficiently as possible. E

Visitors

1. 7.Show
   Ask the patient to nominate close relatives and friends who may then, after instruction (see steps 1–6 above), visit freely. The patient or their representative should ask other acquaintances and non‐essential visitors to avoid visiting during the period of vulnerability.
   The risk of infection is likely to increase in proportion to the number of people visiting. Unlimited visiting by close relatives and friends may diminish any sense of isolation in the patient; however, large numbers of visitors may be difficult to screen and educate. E
2. 8.Show
   Exclude any visitor who has had symptoms of infection or been in contact with a communicable disease in the previous 48 hours.
   Individuals may be infectious both before and after developing symptoms of infection (Goering et al. [47], E).
3. 9.Show
   Educate all visitors to decontaminate their hands before entering the isolation room.
   Hands carry large numbers of potentially pathogenic micro‐organisms, but these can be easily removed (WHO [124], C).
4. 10.Show
   Visiting by children, other than very close relatives, should be discouraged.
   Children are more likely to have been in contact with infectious diseases but are less likely to be aware of this and are more likely to develop infections because they have less acquired immunity. E