Body Substance Isolation: Definition, Equipment & Procedures

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

Infection control in the healthcare system has continuously evolved throughout the years. In this lesson, we will learn about body substance isolation practices.

History of Infection Control in Healthcare

Working in present day healthcare settings, it is hard to imagine a time when infection control standards weren't available. Surgeons performed surgery without gloves, and nurses changed bloody dressings with their bare hands or cared for a patient with tuberculosis without any protection.

As early as 1877, there was some level of isolation practices documented. At this time, it was recognized that infectious patients should be housed in different facilities. By 1910, hospitals had cubicles that separated groups of patients. Nurses would wear their own gowns when caring for patients. They performed handwashing and would disinfect equipment. By the 1960s, hospitals were caring for infectious patients in private rooms.

The Center for Disease Control (CDC) is a national organization aimed at protecting our communities against health threats. In 1970, it first published isolation practices for hospitals, which were revised in 1983. Universal precautions were developed in 1985 in response to the HIV epidemic, but there were still more areas that needed to be addressed to protect patients and healthcare workers from exposure to infectious diseases.

Body Substance Isolation

Body substance isolation (BSI) was proposed in 1987. BSI characterized all moist body substances as potentially infectious and identified precautions that should be used regardless of a known infectious diagnosis or not.

Moist body substances include substances of any sort, such as urine, feces, blood, and saliva. The focus of BSI was primarily to establish the use of gloves for any contact with moist body substances in order to help prevent transmission of infection. Gowns and masks are also among the personal protective equipment to be used.

The rationale behind these precautions is that, at any time, you may have openings in the skin of your hands. Even if these are not visible, touching body substances with your bare hands allows entry into your body and can potentially infect you. All body substances should be considered potentially infectious - whether they come from your friend, family member, or a patient that looks generally healthy.

Body substance isolation practices include additional protections designed to address airborne or droplet transmitted diseases. Examples of these diseases include measles, mumps, and varicella. A healthcare personnel is not allowed to care for a patient with these diseases unless s/he is immune or has been vaccinated against them.

Let's look at some examples of body substance isolation in practice.

Examples of Body Substance Isolation

Nurse Suzie is caring for a patient with a draining wound to her leg. Suzie plans to don gloves and a gown before changing the dressing because the drainage is moist and potentially infectious.

Joe is a certified nurse assistant and is going to empty the urinary catheter bag of his patient. He dons gloves, as he knows that urine is a body substance that can be potentially infectious.

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