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[null,"Side-room Priority for St. George's University Hospitals NHS Foundation Trust"]
[null,"The use of side rooms should be reviewed daily by the ward manager"]
[null,"This chart is for guidance and where the use of a side room is ‘strongly advised or recommended’ the final decision should be taken by the Ward "]
[null,"Sister/Charge Nurse, Infection Prevention & Control (IP&C) and the site bed manager following a risk assessment. Out-of-hours, the final decision"]
[null,"on the use of a side room rests with the on bed/site manager who can contact the on call microbiologist and/or the on call senior manager for advice"]
[null,"if required. For some outbreaks of infection it will be necessary to cohort patients in bays or areas and again this is a decision that must be taken"]
[null,"following a risk assessment and a discussion with the ward manager, infection prevention & control and the bed management bed/site manager."]
[null,"Action ","Suspected/Confirmed        Condition","Notes","Deep Clean Team & Curtain Change Required after Discharge/Transfer or De-isolation"]
[null,"Side-room ESSENTIAL","Avian influenza/SARS (Severe Acute Respiratory Syndrome)/MERS-CoV (Middle East Respiratory Syndrome Coronavirus)","Isolate in negative pressure ventilation (if available) until free of symptoms","Yes"]
[null,null,"Possible Viral Haemorrhagic Fever (VHF)","Isolate until VHF is excluded.","Yes"]
[null,null,"Pulmonary Tuberculosis","Confirmed or suspected open pulmonary TB* – negative pressure preferable (essential if MDR TB risk). Isolation may cease 2 weeks after start of chemotherapy with agreement of chest/CIU physicians.","Yes"]
[null,null,"Measles","Isolate until 7 days after the appearance of the rash.","Terminal clean only ₸"]
[null,null,"Mumps","Isolate until 7 days after onset of swelling.","Terminal clean only ₸"]
[null,null,"Chickenpox or Shingles (on exposed skin e.g face/neck)","Isolate until lesions are dry (and no new lesions).","Terminal clean only ₸"]
[null,null,"Fever & Rash (Unknown Cause)","Isolate until rash has been diagnosed as non-infectious.","Terminal clean only ₸"]
[null,null,"Prolonged Neutropenia after bone marrow transplantation or intensive chemotherapy","To remain in sideroom and protective isolation until neutrophil count recovers.","Terminal clean only ₸"]
[null,null,"Meningococcal Meningitis (and other unkown bacterial Meningitis until diagnosis)","Isolate until 24 hours after start of appropriate antibiotic therapy.","Terminal clean only ₸"]
[null,null,"Candida auris†","Isolate until discharge.","Yes"]
[null,null,"Carbapenemase-Producing Organisms  ","Isolate until discharge.","Yes"]
[null,null,"Diarrhoea due to suspected or confirmed Norovirus and C. Difficile†","Isolate until free of symptoms for 48 hours.","Yes"]
[null,null,"Patients with Anorexia nervosa","Should remain in side rooms during the first 4 weeks of treatment.","Terminal clean only ₸"]
[]
[null,"Side-room STRONGLY ADVISED","Diarrhoeas (e.g. Salmonella, Campylobacter and undiagnosed)","Risk assess e.g.  explosive diarrhoea, is the patient vomiting, any staff with symptoms?","Yes"]
[null,null,"Hepatitis A & E","Isolation not necessary once the patient is jaundiced.","Yes"]
[null,null,"Influenza A & B, including H1N1 ","Isolate for a minimum of 7 days after onset of symptoms. If remains symptomatic isolate until free of symptoms. Retest after 5 days of isolation. If immunocompromised, 3 negative specimens are required on 3 separate days before discontinuing isolation. If cohorting necessary, only cohort the same type & strain. ","Yes"]
[null,null,"Group A Streptococcus","Isolation to cease once patient has had 24 hours of appropriate antibiotics. For wound infections, until repeat wound swab is negative.","Terminal clean only ₸"]
[null,null,"Palliative care patients","Palliative care patients with severe, uncontrolled pain or other symptoms. patients that are imminently dying ( approx 48 hrs ) and these patients should not be moved out of a side-room, if possible.","Terminal clean only ₸"]
[null,null,"Adenovirus                                        Parainfluenza                                    Respiratory Syncytial Virus Metapneumovirus","Isolate for a minimum of 5 days after onset of symptoms.  If symptomatic isolate until free of symptoms. Retest after 3 days of isolation. If immunocompromised, 3 negative specimens are required on 3 separate days before discontinuing isolation.If cohorting necessary, only cohort the same type & strain of the organism.","Yes"]
[null,null,"Pseudomonas - Highly resistant ","Isolate until discharge.","Yes"]
[null,null,"Penicillin resistant Pneumococcus","Isolate if patient is productive of sputum and until they have had 48 hours of appropriate antibiotics.","Yes"]
[]
[null,"Side-room RECOMMENDED","MRSA †","Risk assess e.g. isolate if MRSA in sputum and very productive or has eczema, weeping wounds etc.","Yes"]
[null,null,"Resistant Coliforms including Acinetobacter, Klebsiella, E. Coli, Enterobacter, ESBLs (Non Carbapenemase-producing) †","Risk assess e.g. isolate if coliform in sputum and very productive, or if highly resistant e.g. sensitive to Colistin only.","Yes"]
[null,null,"Neutropenia - other causes","Risk asses the need for protective isolation - desirable if siderooms available.","Terminal clean only ₸"]
[null,null,"Disruptive patients/prisoners","Patients who are distuptive or patients with very distressed relatives/large family groups may require a side room for the benefit of others.","Terminal clean only ₸"]
[null,null,"Viruses "]
[null,null,"Bocavirus, Coronavirus, Mycoplasma pneumoniae, Rhinovirus                                                ","Isolate until free of symptoms. In patients who are significantly immunocompromised, 1 negative sample is required before discontinuing isolation. If side room not available cohort patients with these viruses together or distance patient from others by leaving adjacent bed space empty.","Yes"]
[null,null,"Enterovirus ‡                                              Parechovirus ‡","Isolate until free of symptoms for 24 hours.","Yes"]
[null,null,"Shingles on covered area of body e.g. chest/abdomen","Isolate until lesions are dry (and no new lesions).","Terminal clean only ₸"]
[null,null,"Vancomycin Resistant Enterococcus (VRE)","Risk assess e.g. isolate if VRE in sputum and very productive.","Yes"]
[]
[null,"Side-room UNNECESSARY","Hepatitis B & C, HIV","Isolation only necessary if patient is bleeding profusely.","Only if blood contamination"]
[null,null,"Lice and scabies","Isolation not necessary unless patient has crusted/Norwegian scabies until treatment is completed.","Terminal clean only ₸"]
[null,null,"Legionnaire's Disease","Isolation unnecessary.","Terminal clean only ₸"]
[null,"† During outbreaks of these infections it may be necessary to cohort patients with these infections"]
[null,"* Please refer to the TB care plan and guidelines",null,"‡ Longer isolation may be required in NNU. Please contact the IPC team"]
[null,"₸ Terminal Clean denotes clean with Chlor-Clean by ward-based nursing/domestic staff. Curtain change not necessary."]
[null,"For further information on other organisms please see the Isolation of Patients protocol on the trust intranet."]
[null,"The IP&C team must be involved in risk assessment of a patient’s need for a side-room 08.30 – 16.30 Monday to Friday."]
[null,"Out of hours for urgent IP&C advice please bleep the on-call medical microbiologist via switchboard."]