Ambulatory Isolation Competency

2026 FY Adult ambulatory Isolation Competency

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Objectives

• Define Adult Ambulatory Isolation guidelines.
• Explain the proper steps to take when a patient presents with isolation criteria.
• Discuss environmental cleaning for the isolation patient.
• Describe resources and toolkits available for isolation guidelines.

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Isolation Overview

• Inpatient vs outpatient is treated differently
• Isolation guidelines are not well defined in the outpatient setting when compared to the inpatient setting

• Isolation precautions were piloted in select ambulatory clinc locations over the fall of 2024
• Available resources for the outpatient setting:
• PPE
• High Level Disinfection (HLD) & Sterile Processing
• Diagnostics

• CDC Summary Guide to Infection Prevention for Outpatient Setting

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Always use Standard Precautions

Hand Hygiene

Safe Injection Practices

Masks / Cough Etiquette

PPE for Potential Exposure

Cleaning / Disinfect Equipment and Environment

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Importance of Isolation Identification

• Ambulatory sites often are the first to see patients when potentially contagious conditions begin.
• Isolation can help minimize the spread of infection to other patients and staff members.

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What's New?

Isolation Flag in EPIC

Whiteboard notification

Signage

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Click on each note page to move forward.

(Click screen/arrow to watch video)

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Additional Information Click on EACH

C. Diff

Varicells/ Shingles

Airborne Isolation

COVID-19

TB

Cleaning Patient Equipment

Measles

RSV

C. Diff

Tips:

• Soap and water to kill spores
• Use dedicated patient care equipment (e.g., stethoscopes, blood pressure cuffs)

Disinfection:

• Clean high-touch surfaces & patient care equipment
• Refer to chart to right

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Respiratory Virus Infection

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Click on each RED items

Measles

• Isolate Immediately

• N95 Mask
• Keep Door Closed

• Call IP to place flag
• IP will contact Tennessee Department of Health

• Patient given facemask

• All lab work is collected per Tennessee Department of Health

Enviromental: Room closure for 1 hour to allow air exchanges

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Rashes and Wounds

Herpes Simplex Virus

Varicella Zoster Virus

Allergic Reaction

Scabies

Take Picture of rash and place in chart

Lice

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TB

Arrival / Waiting Room

Exam Room

Orders / Discharge or Admission

Environmental Considerations

• Close down room for 1 hour after to allow air exchanges​

• Patient dons surgical mask

• Isolate Patient:

• Wait in car
• Room patient immediately

• Wear N95 Mask

• Keep door closed; limit traffic in/out​

• Contact IP for flag placement​

If TB is suspected:

• Home isolation
• Orders clinical workup

When admitting notify:

• Accepting facility

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Airborne Isolation

• The room required closure for a minimum of 1 hour after the patients exits with confirmed or suspected:

• Tuberculosis
• Shingles
• Measles
• Varicella

• This allows proper air exchanges to occur to clean the air.
• Wearing an N95 is required if entering the room before the hour is up.

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Isolation Resource Book

High Touch Areas and Cleaning

Specimen Transport

Department of Infection Prevention

Isolation Toolkit

(Click EACH colored flag to move forward)

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Tool Kit

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clean High Touch areas

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References

CDC- Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care- https://www.cdc.gov/healthcare-associated-infections/hcp/prevention-healthcare/outpatient-settings-minimum-expectations-for-safe-care.html Vanderbilt Department of Infection Prevention: https://www.vumc.org/infection-prevention/vumc-department-infection-prevention Vanderbilt Medical Center Policy Titles:

• Cleaning Isolation Room (SOP)
• Isolation - Infection Control Precautions to Prevent Transmission of Contagious Infections
• Isolation Precautions for Aerosol-Generating Procedures in a Known or Suspected COVID or Influenza Patient (SOP)
• Isolation Precautions in Special Populations (SOP)
• Standing Order - Droplet Isolation Precautions

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Thank You! You may close out the module.

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Patient interventions:

• ​Schedule a Telehealth appointment
• If possible, schedule appointment:

• 5 days from start of symptoms / positive test
• 10 days from start of symptoms / positive test for immunocompromised patients
• Once symptoms are improving if asymptomatic

Before TRANSPORT:

• Place all blood specimens, blood products and or other potentially infections body fluids into secondary sealable and leak-proof containers.

• Secondary Container=
• Biohazard Bag

OR

• STAT zip lock bag

OR

• Secondary container if specimen is too large

Wall / White Board Notification

• "Outpatient Guidance" is circled to the left describing the type of isolation required

• Note: COVID will have a flag that provides additional guidance

Surgical Mask

Isolation Flag in Epic Example