Protecting Immunocompromised Patients: 10 Nursing Actions to Reduce Pathogen Exposure

Evidence-Based Protective Interventions

1. Standard Precautions Rigor: Hand hygiene (WHO 5 moments), respiratory hygiene, PPE per exposure risk.
2. Protective Environment: Private room (positive pressure for neutropenia); HEPA filtration if available.
3. Restricted Visitation: Limit to essential; screen for illness; PPE for visitors.
4. Environmental Hygiene: Daily disinfection of high-touch surfaces; terminal clean on discharge; dedicated equipment.
5. Safe Fluid/Waste Handling: Closed systems; PPE for blood/body fluids; proper sharps disposal.
6. Patient/Caregiver Education: Hand hygiene, mask use, food safety (no raw/undercooked), avoid crowds/sick contacts.
7. Vaccination: Inactivated vaccines per schedule (flu, pneumococcal, COVID, Hep B); avoid live vaccines if severely immunocompromised.
8. Surveillance & Early Intervention: Daily ANC, temp q4h, cultures at first fever; pre-emptive antibiotics per protocol.
9. Sterile Technique for Invasive Procedures: Central lines, ports, biopsies; minimize hub accesses.
10. Post-Exposure Prophylaxis (PEP): Immediate protocol for needlestick/splash (HIV, HBV, HCV).

Goal

Multilayered defense—engineering, administrative, PPE, behavioral—to compensate for host immune deficit.