A healthy degree of suspicion: A discussion of the implementation of transmission based precautions in the emergency department

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• 作者：Peta-Anne Zimmerman ; RN CICP DPH^a ; ^b ; ^{p.zimmerman@griffith.edu.au" class="auth_mail" title="E-mail the corresponding author} ; Matt Mason ; RN BN GradDipRemoteHealthPractice MAdvancedPrac(Infection Control) MRural Health^c ; Elizabeth Elder ; RN BN BA MAdvancedPrac(Emergency Nursing) MN(Hons)^a
• 关键词：Emergency department ; Triage practices ; Transmission based precautions ; Healthcare associated infections ; Infection control
• 刊名：Australasian Emergency Nursing Journal
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：19
• 期：3
• 页码：149-152
• 全文大小：179 K

文摘

Emergency department (ED) presentations have increased significantly domestically and internationally. Swift identification and implementation of transmission based precautions (TBP) for patients known or suspected of having an epidemiologically important pathogen is important. ED staff, particularly triage nurses, are pivotal in detecting and preventing infection, including healthcare associated infections (HAI).

Methods

MEDLINE, CINAHL, PubMed and Ovid were searched for articles published between 2004 and 2015 using key search terms: infection control/prevention and emergency department(s), triage, and transmission based precautions and emergency department(s), and triage, to identify common themes for discussion. Systematic review/meta-analysis was not in the scope of this exploration.

Findings

Themes were identified relating to HAI and ED practices and grouped into: assisted detection of conditions for which TBP is required, ED and TBP, mass-causality event/bioterrorism/pandemic/epidemic, infection control not TBP and multi-resistant organisms not TBP. The literature is heavily influenced by worldwide epidemic/pandemics and bioterrorist risks resulting in increased awareness of the importance of swift identification of syndromes that require TBP, but only in these situations.

Conclusion

Implementation of appropriate TBP, changing triage practices, training and measures to assist decision-making could assist in preventing HAI in the ED context. A systematic quantitative review of the literature is recommended to guide practice change research.