A 6-month-old infant is admitted to the pediatric unit with RSV bronchiolitis. The infant is receiving supplemental oxygen via nasal cannula at 2 L/min and has been placed in contact isolation. Which nursing action is the MOST important to prevent transmission of RSV to other patients and healthcare workers?

Core Principle: RSV is an enveloped virus that is easily inactivated by soap, water, and alcohol-based hand rubs. It can survive for hours on nonporous surfaces. The primary transmission route is via contaminated hands, making strict hand hygiene the most critical intervention.

• Hand Hygiene: Perform meticulous hand hygiene using an alcohol-based hand rub or soap and water before and after every patient contact, after touching potentially contaminated surfaces, and after glove removal.
• Contact Precautions: Wear gloves and a gown upon entering the room. Remove and discard PPE before exiting, followed immediately by hand hygiene.
• Patient Placement: Place the infant in a single room or cohort with other RSV-positive patients. A negative pressure room is not indicated for routine care.
• Environmental Cleaning: Ensure frequent cleaning and disinfection of high-touch surfaces (bed rails, doorknobs, medical equipment) with an EPA-registered hospital disinfectant.
• Respiratory Etiquette: Educate visitors and staff on covering coughs and sneezes. A surgical mask is not required for standard contact isolation but may be worn for source control if the patient has a productive cough.

Note on Palivizumab: This is a prophylactic agent for specific high-risk populations (e.g., premature infants with chronic lung disease). It is not a post-exposure treatment and plays no role in acute outbreak control.