Kombinierte Kontakt- & Tröpfchenisolation ambulant

• Corynebacterium diphtheriae (respiratory diphtheria, suspected or confirmed)
• Methicillin-resistant Staphylococcus aureus (MRSA)
• Methicillin-resistant Staphylococcus lugdunensis (M RSL)
• Carbapenemase-producing bacteria
• ESBL-producing enterobacterales
• Multi-resistant gram-negative pathogens
• Stenotrophomonas maltophilia

• Adenovirus (keratoconjunctivitis)
• Coxsackie A virus
• Norovirus (suspected or confirmed)
• Rabies virus (rabies)
• Poliomyelitis

• Extensively drug-resistant (XDR) Sprout and mold fungi (e.g. Candida auris)
• Repatriated patients

• Defined, appropriately prepared examination room
• Remove unnecessary material (incl. curtains if possible)
• Preferably use disposable material
• Cover seating and lying surfaces with disposable underlay/linen
• Attach "Isolation" sign to the room door
• Set up/label the room see work instructions for isolation
• Bring the patient directly into the examination room (alternatively define a separate waiting area, scrub-wipe-disinfect contact surfaces)
• Lock WC for patients who are required to isolate and disinfect after use

• Standard
• Exception Coxsackie A virus/poliomyelitis:
  • Switch to Skinman™ Soft Protect

• In the examination room and for entering and leaving the hospital: None
  • Exception: MNS type II/IIR for
    • adenovirus
    • norovirus
    • Coxsackie A virus
• For transportation/diagnostics/interventions outside the room: MNS type II/IIR, gloves, apron
• Instruction regarding hand disinfection
• Ban on visiting the cafeteria

• MNS type II/IIR
• gloves
• Over apron
• Additional safety goggles for:
  • Adenovirus (keratoconjunctivitis)
  • Coxsackie A virus (hand-foot-and-mouth disease)
• Rabies (rabies): see here

• If possible, diagnostics in the isolation room
• Urgent diagnostic measures possible outside the room after prior information about isolation (coordination by department); if possible, plan at the end of the program
• Avoid waiting times in front of treatment rooms/in the corridor

• If possible, postpone therapies until isolation is lifted
• No group therapies while in isolation
• Avoid waiting times in front of treatment rooms/in the corridor
• Use patient-related materials

• If possible, plan at the end of the program
• Advance information about reason for isolation when registering for surgery
• Repositioning in the designated isolation operating room
• Final cleaning/disinfection at the end of surgery
• Additional UVC disinfection for
  • Carbapenemase-producing pathogens
  • XDR sprout and mold fungi (e.g. C. auris)
  • Repatriated patients

• Department informs transport service about isolation upon registration
• Preparation by responsible nurse, patient documents in plastic bag
• Patients accompanied by instructed staff
• Clean pad for wheelchair
• Clean sheet for bed
• Holding areas of the bed/wheelchair are disinfected with ethanol 70% denat. before/after transport by the nursing staff
• Protective equipment for transporters: see above
• Protective equipment for walking/sitting patients: see above
• Lying patient: mask see above, no additional protective equipment

• Building B (K1): Single use patient lift
• Building C (K2): Emergency lift or single use of patient lift

• Generally valid:
  • Dispose of protective clothing on site (double bag system)
  • Disinfection of used items
  • Hand disinfection
• Additionally in the operating theater:
  • Removal and disposal of bed linen (double bag system)
  • Bed with "Disinfection" sticker in bed center

Large surfaces (floor, walls, etc.):

• Incidin™ Pro 0.5% (standard)
• Dismozon® plus 2.4% for:
  • Norovirus,
  • adenovirus
  • Coxsackie A virus
  • Poliomyelitis
  • XDR Sprout and mold fungus (e.g. C. auris)

Small surfaces:

• Meliseptol® Wipes sensitive 100
• SANITIZER SURFACES S1 wipes (for XDR shoot and mould fungi (e.g. C. auris))
• Ethanol 70% denat. (only for alcohol-resistant surfaces)

• After each consultation: disinfection of all contact surfaces in the room and WC using the scrub-wipe method
• After invasive diagnostics (e.g. endoscopies, induced sputum, surgical procedures): Final cleaning/disinfection using the scrub-wipe method

• Between two patients: One-off disinfection of all surfaces close to the patient
  • Floor only if visibly soiled
  • Twice for the following pathogens:
    • XDR Sprout and mold fungi (e.g. C. auris)
    • Carbapenemase-producing pathogens
    • Repatriated patients
      
• After invasive diagnostics*: Final cleaning/disinfection using the scrub-wipe method (incl. furniture and walls up to 1.80 m high)
  • Twice for the following pathogens:
    • XDR shoot and mold fungi (e.g. C. auris)
    • Carbapenemase-producing pathogens
    • Repatriated patients

*Examples of invasive diagnostics: endoscopy, bronchoscopy, induced sputum, punctures (except veins, arteries, bone marrow, lumbar), surgical procedures, wound irrigation

What else is important?

• Disinfect all objects used
• Dispose of non-disinfectable items (incl. opened or unsealed packs)
• Curtains (if not already removed before isolation) before final disinfection in pink bag (Bardusch AG No. 7119), then yellow-striped double bag

• Waste disposal in double bag system
• Disposal of laundry in a double bag system (red laundry bag no. 20, then yellow-striped bag)
• Disposal of potentially infectious waste in accordance with the disposal guidelines
• Dispose of sharp, pointed objects in puncture-proof containers in the room

• Use disposable material if possible
• Use medical devices with direct physical contact (e.g. ECG electrodes, stethoscopes, blood pressure cuffs) for specific patients
• Disinfection/reprocessing of all reusable materials in accordance with the disinfection plan
• Handling paper documents: The person concerned only touches paper documents after observed hand disinfection. Documents must then be placed in a sealed plastic bag and disinfected when leaving the room.

• Disinfection of the bed surface
• Mark bed with orange "Disinfection" sticker, disinfect bed frame (foot and head section) (ethanol 70% denat.) and take to the bed center

• Accompanying persons permitted
• Accompanying persons living in the same household do not require protective equipment (provided they are asymptomatic)
• External accompanying persons (e.g. interpreters): Protective equipment as for staff (see above)
• Hand disinfection when entering and leaving the hospital