Protecting Yourself and Your Patient - Infection Precautions

Infection precautions are used when your patient develops an infection that is considered a risk to others. Properly used, infection precautions prevent the transmission of microorganisms from health care worker to the patient, from patient to health care worker, and from one patient to another. The Centers for Disease Control has issued guidelines for two levels of infection precautions: Level 1—standard precautions, and Level 2—transmission-based precautions.

Standard precautions are used in the care of all patients in hospitals, and health care facilities. Regardless of diagnosis or infection potential, blood and all body fluids that might contain blood, broken skin, and mucous membranes are treated as sources of potential infection. The use of gloves, gowns, and facial protection such as goggles and masks, as well as chin-length facial shields, reduce exposure to blood-borne pathogens. While gowns and facial protection are not always needed, they should be worn when there is a risk of splashes, sprays, or spatters of blood or other potentially infectious materials near the eyes, nose, or mouth.

Transmission-based precautions are used for patients with suspected or diagnosed infections that can be transmitted by airborne or droplet contamination, or by contact with dry skin or contaminated surfaces. Transmission-based precautions are generally divided into airborne precautions, droplet precautions, and contact precautions. These precautions may be combined in instances where the patient has a disease that is spread by multiple routes of transmission.

• Airborne precautions are used for patients with infections caused by organisms that can remain suspended in the air for prolonged periods of time. Patients cared for using airborne precautions include those with tuberculosis, rubeola, varicella, and shingles. The patient should be placed in a private room with negative airflow. Persons entering the room should wear a respirator mask.
• Droplet precautions are used for patients with infections caused by organisms suspended in droplets that may travel three feet but are not suspended in the air for a long period of time. Patients cared for using droplet precautions include those with influenza, mumps, pertussis, rubella, diphtheria, pneumonia, scarlet fever, streptococcal pharyngitis, and meningitis caused by N. meningitis or H. influenza B. The patient may be placed in a private room or may cohort with a patient with the same illness. Client beds should remain three feet apart. The door to the room may remain open. When providing direct care, the nurse should wear a mask.
• Contact precautions are used for patients with infections caused by organisms spread by direct contact with dry skin or contaminated surfaces. Patients cared for by contact precautions include those with respiratory synctial virus, scabies, and C.deficile, as well as patients colonized with MRSA and VRE. The patient should be placed in a private room or may cohort with a patient with the same illness. The nurse should glove when entering the room, and gowns should be worn to prevent contact with the patient and contaminated surfaces. Equipment used by the patient, such as monitoring devices, should remain in the patient’s room and should be disinfected before being used by others.