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Isolation precautions

Isolation precautions create barriers between people and germs. These types of precautions help prevent the spread of germs in the hospital.

Anybody who visits a hospital patient who has an isolation sign outside their door should stop at the nurses' station before entering the patient's room. The number of visitors and staff who enter the patient's room may be limited.

Different types of isolation precautions protect against different types of germs.

Standard Precautions

Follow standard precautions with all patients.

When you are close to or handling blood, bodily fluid, bodily tissues, mucous membranes, or areas of open skin, you must use personal protective equipment (PPE). Depending on the anticipated exposure, types of PPE required include:

  • Gloves
  • Masks and goggles
  • Aprons, gowns, and shoe covers

It is also important to properly clean up afterward.

Transmission-based Precautions

Transmission-based precautions are extra steps to follow for illnesses that are caused by certain germs. Transmission-based precautions are followed in addition to standard precautions. Some infections require more than 1 type of transmission-based precaution.

Follow transmission-based precautions when an illness is first suspected. Stop following these precautions only when that illness has been treated or ruled out and the room has been cleaned.

Patients should stay in their rooms as much as possible while these precautions are in place. They may need to wear a mask when they leave their rooms.

Airborne precautions may be needed for germs that are so small they can float in the air and travel long distances.

  • Airborne precautions help keep staff, visitors, and other people from breathing in these germs and getting sick.
  • Germs that warrant airborne precautions include chickenpox, measles, and tuberculosis (TB) bacteria.
  • People who have these germs should be in special rooms where the air is gently sucked out and not allowed to flow into the hallway. This is called a negative pressure room.
  • Anyone who goes into the room should put on a well-fitted respirator mask before they enter.

Contact precautions may be needed for germs that are spread by touching.

  • Contact precautions help keep staff and visitors from spreading the germs after touching a person or an object the person has touched.
  • Some of the germs that contact precautions protect from are C. difficile and norovirus. These germs can cause serious infection in the intestines.
  • Anyone entering the room who may touch the person or objects in the room should wear a gown and gloves.

Droplet precautions are used to prevent contact with mucus and other secretions from the nose and sinuses, throat, airways, and lungs.

  • When a person talks, sneezes, or coughs, droplets that contain germs can travel about 3 feet.
  • Illnesses that require droplet precautions include influenza (flu), pertussis (whooping cough), and mumps.
  • Anyone who goes into the room should wear a surgical mask.

References

Calfee DP. Prevention and control of health care-associated infections. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 282.

Huskins WC, Sammons JS, Coffin SE. Health care-associated infections. In: Cherry JD, Harrison GJ, Kaplan SL, et al., eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 243.

Maki, DG, Tsigrelis C. Nosocomial infection in the intensive care unit. In: Parillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 4th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 50.

Siegel JD, Rhinehart E, Jackson M, et al. eds. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Available at: www.cdc.gov/hicpac/pdf/isolation/isolation2007.pdf. Accessed October 27, 2015.

Update Date 10/29/2015

Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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