What does ‘Barrier nursing’ mean”
Barrier nursing was used to describe infection prevention and control precautions aimed at reducing the risk of transmission of infectious diseases. It focused primarily on the patient being in isolation (that is, in a single room) and the healthcare provider using PPE.
Isolation in the veterinary context will be a little different depending on your context – but it will mean that the patient with the suspected or confirmed infectious risk is kept away from all other patients.
Reverse barrier nursing was the term used to protect immunocompromised patients from any staff who may transmit an infection to them. Immunocompromised patients were admitted to a single room, which may have HEPA or other filtration systems and staff wore PPE to reduce the risk of transmission of any pathogens.
The same principles are used for barrier and reverse-barrier nursing – the terms Standard precautions and Transmission based precautions (TBP) are more appropriate and consider ALL of the standard precautions such as hand hygiene, sharps management and waste management.
As an example, for an animal with diarrhoea – you will conduct a risk assessment – what pathogens are you concerned about? Are these zoonotic? Is regular PPE adequate or do you need P2/N95 masks? etc. Requirements can change – implement strategies for the worst case scenario to protect yourself, other staff, the patient and other patients and other members of the community.
Initiating Standard and Contact precautions may be adequate, as well as placing them in isolation and restricting visitors. See this Standard and Contact precautions poster
Post-script
Finding a definition for ‘barrier nursing’ was challenging – not a single IPC text I had included it their glossary or index. This 2024 NHS Patient Information sheet had a broad definition:
- To reduce the risk of spreading infections or antibiotic resistant germs to others.
- To protect patients from infection if they have a weak immune system due to illness or a medicine.
References
Anderson, M. E. (2015) ‘Contact precautions and hand hygiene in veterinary clinics’, Vet Clin North Am Small Anim Pract, 45(2), pp. 343-60, vi.
Gronthal, T., Moodley, A., Nykasenoja, S., Junnila, J., Guardabassi, L., Thomson, K. and Rantala, M. (2014) ‘Large outbreak caused by methicillin resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital–from outbreak control to outbreak prevention’, PLoS One, 9(10), pp. e110084.
Mostl, K., Egberink, H., Addie, D., Frymus, T., Boucraut-Baralon, C., Truyen, U., Hartmann, K., Lutz, H., Gruffydd-Jones, T., Radford, A. D., Lloret, A., Pennisi, M. G., Hosie, M. J., Marsilio, F., Thiry, E., Belak, S. and Horzinek, M. C. (2013) ‘Prevention of infectious diseases in cat shelters: ABCD guidelines’, J Feline Med Surg, 15(7), pp. 546-54.