Beginning Oct. 1, visitors of patients who are on Contact Precautions will no longer be required to wear gloves and a gown while visiting in the Contact Precautions room. This policy change is consistent with the CDC recommendations for the control of multi-drug resistance bacteria.
Visitors must continue to follow all isolation requirements (e.g., gloves, gown, mask) when visiting within rooms of patients on Enteric, Droplet, Airborne, and Protective Precautions. Please note that this policy change applies only to visitors. The policy requiring staff to wear gloves when entering a Contact Precautions room and a gown for close contact with the patient or items/equipment in the room remains unchanged.
Rationale
The rationale for the policy revision is as follows:
- There is no CDC guideline or recommendation for visitors to wear isolation attire while visiting patients on Contact Precautions to reduce the risk of transmission of antibiotic resistant bacteria such as MRSA and VRE.
- Visitors do not go from patient-to-patient to provide patient care therefore they do not play a role in disease transmission in hospitals.
- Since a patient infected or colonized with antibiotic-resistant bacteria such as MRSA or VRE remains colonized for months to years and family members often live with the colonized patient, it is confusing for family members to wear isolation attire when visiting in the hospital.In addition, due to the increasing prevalence of bacteria such as MRSA in the community, it is likely that family members are colonized with the same bacteria as the patient. Colonization is not the same as infection and most healthy people who are colonized with antibiotic-resistant bacteria such as MRSA lose the colonization over time.
To avoid any increased risk of transmission of antibiotic -resistant bacteria, visitors must be taught the importance of hand hygiene before entering and upon leaving a Contact Precautions room. In addition, they must be instructed not to visit with other patients besides their family member or friend.
Visitors for patients with other types of precautions
Visitors must comply with isolation precautions (as indicated on isolation sign) for Enteric Precautions, Droplet Precautions, Droplet/Contact Precautions and Airborne Precautions. These precautions are necessary to protect the visitor from exposure to highly communicable diseases (e.g., tuberculosis, meningiococcal meningitis, pertussis, C. difficile, norovirus, rotavirus) that have a time limited period of communicability and for which visitors are likely susceptible to infection.
Visitors must comply with the visitor regulations included in administrative policy #0181, Visiting Hours and Regulations (available here on UNC Health Care’s Intranet) and refer to page 3 for infection control precautions.
How to explain this change to our visitors
Visitor may ask why staff wears gloves and gowns but they do not. The following is suggested scripting to help staff explain the visitor policy.
- “Since we provide care for different patients throughout the day, we must take extra precautions to make sure we do not carry germs from one patient to another. Wearing gloves and gowns as well as hand hygiene keeps us from spreading germs to other patients. Our policy for both our staff and our visitors are consistent with the recommendations from the CDC.”