body substance isolation (BSI)

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Introduction

A system of infection-control procedures routinely used with all patients to prevent cross-contamination of pathogens. The system emphasizes the use of barrier precautions to isolate potentially infectious body substances. According to Lynch, Jackson, Cummings, et al. (1987), BSI has six components.

  • Wear gloves for anticipated contact with blood, secretions, mucous membranes, nonintact skin, & moist body substances for all patients. Change gloves before treating another patient. Hand-washing between patients is essential.
  • After other types of patient contact, wash the hands for 10 seconds with soap & friction to remove transient microbial flora, & then rinse with running water (Garner & Favero, 1986).
  • Wear additional barriers such as gowns, plastic aprons, masks, or goggles when moist body substances (secretions, blood, or body fluids) are likely to soil the clothing or the skin or splash in the face. The panel notes that protective eyewear, mask (or a faceshield that covers the eyes & face), gloves, & in some cases protective gowns should be used for pressure ulcer irrigation when there is a reasonable expectation that wound secretions might be aerosolized.
  • Place soiled reusable articles & linen, as well as trash, in containers that are securely sealed to prevent leaking. Double bagging is not necessary unless the outside of the bag is visibly soiled.
  • Place needles (without recapping them) & sharp instruments in puncture-resistant, rigid containers. If such containers are not available, recapping using the one-hand technique is acceptable.
  • Assign to private rooms those patients with diseases that could be transmitted by the airborne route (e.g., pulmonary tuberculosis) & other diseases listed under precautions for strict isolation in the category-specific isolation (CDC, 1970). The use of private rooms is also indicated for those patients likely to soil articles in their environment with body substances.

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