Protocol for Handling Patients with Antimicrobial-Resistant Infections

House under restricted stall conditions, not isolation.

The Clinical Microbiology Laboratory Supervisor will advise the Clinical Microbiologist and/or the Clinical Pharmacologist as well as the area supervisor of patients with resistant organisms, and the area supervisor will enact the following recommendations:

The supervisor of the clinical area will flag the patient’s stall with the following yellow label:

“Patient has an antibiotic resistant infection. Contact student or technician in charge before handling.”

A dated, yellow label will be placed on the cover of the permanent record by the service. This label may be removed if there is resolution of the patient’s infection.

Patient Handling:

• The patient will be removed from its stall only when necessary.
• If the patient’s stall requires frequent cleaning, additional stalls should be assigned for exclusive use by the patient.
• Standard Restriction PPE is required.

Patient Transportation Within Hospital:

The student, technician, or clinician in charge of the patient shall remain with the patient until it is returned to the original stall. When in another area of the hospital, the patient shall be kept isolated from other patients. The technician or supervisor responsible for areas where the patient has been treated shall be informed immediately so that the area can be properly disinfected with the appropriate solutions.

Patient Treatments:

• Before initiating a treatment, ensure that all items necessary to perform the treatment have been gathered to prevent spreading contamination during the treatment.
• If there is more than one patient to be treated at a time, whenever possible, treat the patient with the resistant infection last.
• Whenever possible, use disposable materials.
• Items that are not disposable shall be thoroughly disinfected immediately after use.

Handling Urine:

• Catheterized patients should have a closed collection system.
• Urine and urine collection materials shall be handled only by personnel wearing disposable gloves.
• Urine on floors shall be cleaned up promptly.

Gloves, paper towels used for cleaning, etc. shall be disposed of in a biohazard bag and placed in trash for incineration.

Animal technicians are to use cleaning equipment that is assigned to this patient when cleaning. To reduce contamination, the cleaning equipment shall not be used to clean any other areas.

When the patient is discharged or moved to another area of the hospital, the supervisor of that clinical area shall be notified so that the stall can be properly disinfected. When a patient is discharged, the supervisor of that area will be responsible for assuring that the stall has been properly cleaned and disinfected.

After discharge the supervisor will be responsible for culturing the stall following disinfection. The culture shall be submitted to the Clinical Microbiology Laboratory.

The stall will remain out of use until a negative culture result is obtained.