Instructions for 'Immuno-compromised patient's care'

1. Identify the patient who is immunocompromised.
2. Severely immuno-compromised patient should be kept in protective isolation. Explain the need for protective isolation to patient and relatives.
3. Patients placed in isolation should remain in their isolation rooms with the door closed.
4. Remove watch and all hand and wrist jewellery.
5. Take off any white coat or jacket/outside coat.
6. Disinfect hands with alcohol handrub.
7. If undertaking direct care e.g. changing a dressing, giving an injection, wash hands and forearms in dispenser liquid soap for at least 15 seconds.
8. Keep separate stethoscope, sphygmomanometer and other monitoring equipment for the patient.
9. No fresh flowers or plants are allowed.
10. Daily bath or shower; using antiseptic liquid soap.
11. Careful drying after a bath/shower.
12. Report to the doctors any sore areas or breaks in the skin.
13. The number of persons entering the isolation room should be minimal. If visitors are admitted to the isolation room, they should be given detailed instructions. If the visitor has been exposed to a communicable disease or has symptoms of illness, they should not be allowed to visit the patient. People who have been immunized (vaccinated) within the past two weeks should avoid contact with the patient.
14. Health care workers must be extremely vigilant for signs of infection. Because white blood cells counts are usually compromised, normal immune responses often do not occur in these patients. Four hourly temperature readings are vital. – inform the medical staff if the temperature rises above 38ºC or if 37⁵–38C and the patient is unwell and feverish for > 1 hour.
15. Gloves, gown or apron, and masks should be worn and discarded after attending patient.
16. If at all possible, the patient must not be assigned nurses who are looking after patients with obvious infections, particularly infected skin lesions, pneumonia or infective diarrhoea. Except in dire emergency, nursing and medical staff with obvious bacterial or viral infections should not enter the room.
17. Hot food must be served while it is hot, so ad to ensure these patients on the ward are served first.
18. Do not give the patient salads, shellfish or any food containing raw eggs.
19. Avoid unpasteurised dairy products.
20. Ensure fresh fruit is washed and peeled before consumption.
21. Supply with sufficient amount of alcohol hand disinfectant, paper towels and soap dispensers inside and outside the patient’s room.
22. If patients must be transported outside their isolation rooms for medically essential procedures that cannot be performed in the isolation rooms, they should wear surgical masks that cover their mouths and noses during transport. Procedures for these patients should be scheduled at times when they can be performed rapidly and when waiting areas are less crowded.