COHORT NURSING

BY:- MR. FIROZ QURESHIDEPT. PSYCHIATRIC NURSING

INTRODUCTION

• Control of infection is an essential part notonly of healthcare but also of everydaylife.Maintenance of high standards ofinfection control practice is the responsibilityof all health care personnel.

• Those working in health care will inevitablyhave to care for people with known orsuspected infection and infectious diseases.

DEFINITION• Cohort nursing refers to the

grouping of patients with a sameinfection with in isolated area andit is a sort of strict isolation.

• For example, patients withtuberculosis are admitted in onebay or one ward and the designatedstaff nurses take care of thepatients.

• Cohorting of patients as well ascohorting of nurses is recommendedto maintain strict isolation.

• ‘Cohorting’-grouping of infectiouspatients and nursing them within anarea of a hospital ward is widelyrecommended as a strategy forcontrolling transmission of healthcare acquired infection.

• It is often recommended as an overflow strategy when single room isolation is not available.

• Cohort nursing patients with the same organism(or displaying similar signsand symptoms of infections) is an alternative form of nursing where single room capacity is exceeded.

• If there is a dedicated isolated ward available, place all patients infected with the same organism in this ward. Cohort patient should be cared for by designated staff.

• If there is no dedicated ward consider cohorting patients in to bays with in wards.

• If there is a dedicated isolated wardavailable, place all patients infectedwith the same organism in thisward.

• Cohort patient should be cared forby designated staff. If there is nodedicated ward consider cohortingpatients in to bays with in wards.

• For effective isolation ,bays shouldhave doors that can be closed toprovide physical separation fromother patients.

• In areas such as critical care ,it maybe necessary to cohort patients in tospecific areas of the unit, ensuringthat these areas can be physicallyseparated from the rest of theward.

PATIENT GUIDELINES FOR COHORTS

• Staff should

• Routinely provide affected patients andvisitors with an explanation of theirinfection,isolation procedures andtreatment.

• Ensure that rooms ,bays and areas usedfor isolated patients have dedicatedhand hygiene and toileting facilities;

• Ensure that there is clear signage on the door or wall to alert staff and visitors to infection control precautions;and

• Ensure that doors are kept closed at all times.

MANAGEMENT OF THE PATIENT ONCE ISOLATED

• Hand hygiene and personal protectiveequipment

• 1.High standards of handdecontamination minimize risk ofcross-infection.

• It is vital to perform hand hygienebefore and after each direct patientcontact,regardless of glove use and useof other protective measures.

• 2.There must be adequate hand-washing facilities and hand rub/gel available for use before and after contact with the patient.

• 3.Disposable apron should be worn by all staff and visitors assisting in the care of the patient or having contact with their immediate environment.

• 4.Disposable gloves should be worn where there is contact with bodily fluids and handling of contaminated items.

• 5.Fans should not be used to control the patient’s temperature.

• 6.Notes and charts should be kept outside the bay/ward.

CLEANING AND DECONTAMINATION

• 1.Local policies for environmentalcleaning, equipment decontamination,waste and linen management shouldreflect required national specificationsand be applied rigorously. Compliancewith these policies should be subject toregular monitoring and audits

• 2.Where possible ,equipment should be single patient use.

• 3.Multiple patient use equipment must be decontaminated in accordance with local policy and and the manufacture’s instructions.

• 4.Linen should be treated as infected in line with hospital policy.

5.All waste should be categorized ashazardous waste and disposed of inline with hospital policy.

6.Cleaning procedures should berigorously applied. There should beprocedures for enhanced andterminal cleaning in place.

• 7.It should be made clear to all staff exactly which teams and individuals are responsible for undertaking regular cleaning and those items that require cleaning.

MOVEMENT

• 1.Transfer and movement of patientsshould be kept to a minimum to reducethe risk of infection spreading andshould only be undertaken for clinicalreasons.

• 2.If a transfer is necessary ,thereceiving area must be informed sothat effective infection controlmeasures can be put in to place.

• 3.Hand hygiene and personalprotective equipment proceduresshould be closely followed whentransferring an infected patient.

• 4.The equipment used to transferthe patient ,e.g.trolley,should bedecontaminated after use inaccordance with local policy

CONCLUSION

• Reducing Health Care AquiredInfections requires every member ofstaff to make their contribution toeffective infection prevention andcontrol. As a matter of urgency ,allinstitutions should review theirisolation policy in order todetermine the best possibleisolation practices.