Transmission-based precautions are important infection control practices used in healthcare environments. These measures are designed to prevent the spread of infectious diseases from person to person. Their purpose is to protect both patients and healthcare personnel from pathogens. These precautions complement standard practices to enhance safety.
Foundational Safeguards: Standard Precautions
Standard Precautions form the fundamental layer of infection control, applied universally to all patients in all healthcare settings, irrespective of their known or suspected infection status. These practices assume all blood, body fluids, non-intact skin, and mucous membranes may contain transmissible infectious agents. Hand hygiene is a primary component, including washing hands with soap and water for at least 20 seconds or using an alcohol-based hand rub (at least 60% alcohol). This significantly reduces microorganisms on hands.
Personal protective equipment (PPE) use is another cornerstone. This involves wearing gloves, gowns, masks, and eye protection based on anticipated exposure to infectious materials. For instance, gloves are donned before contact with mucous membranes or non-intact skin, and removed promptly. Respiratory hygiene and cough etiquette, encouraging individuals to cover coughs and sneezes and practice hand hygiene, are also included.
Safe injection practices prevent bloodborne pathogen transmission, ensuring needles and syringes are used for only one patient and one procedure. Safe handling of contaminated patient care equipment and environmental surfaces is also crucial. Proper cleaning and disinfection protocols are established for reusable equipment and frequently touched surfaces. These measures collectively establish a baseline of safety for everyone.
Targeted Measures: Contact Precautions
Contact Precautions are for patients infected or colonized with microorganisms spread by direct or indirect contact. Direct contact involves skin-to-skin contact, while indirect contact occurs through contaminated surfaces or patient care items. Common conditions include MRSA, Clostridioides difficile (C. diff), VRE, and scabies. These pathogens persist on surfaces and spread easily.
Measures limit transmission. Patients are often placed in a private room to prevent contact and reduce contamination. If unavailable, patients with the same pathogen may be cohorted. Healthcare personnel entering the room must wear a gown and gloves as a barrier against direct contact or contaminated surfaces.
Gowns and gloves are removed before leaving the room, followed by hand hygiene. Dedicated equipment, like stethoscopes or blood pressure cuffs, may be assigned to the patient to prevent cross-contamination. Shared equipment must be thoroughly cleaned and disinfected before use on another patient. These interventions help contain contact-transmissible organisms.
Targeted Measures: Droplet Precautions
Droplet Precautions are for patients with infections spread through large respiratory droplets. These droplets are generated when an infected individual coughs, sneezes, or talks. They typically travel short distances (3 to 6 feet) before settling out of the air and do not remain suspended for extended periods. Pathogens include influenza, pertussis (whooping cough), mumps, and some bacterial meningitis (e.g., meningococcal disease).
A private room is recommended to limit droplet dispersal. If unavailable, maintain at least 3 feet (1 meter) separation from other patients. Healthcare personnel entering the room or coming within this distance must wear a surgical mask. This mask prevents inhalation of larger infectious droplets.
The difference between droplet and airborne transmission is particle size and travel distance. Droplets are large and fall quickly, requiring close contact for transmission. Smaller airborne particles remain suspended and travel further. Adherence to these precautions helps contain respiratory infections.
Targeted Measures: Airborne Precautions
Airborne Precautions are for highly infectious agents that remain suspended in the air for prolonged periods and travel long distances on air currents. These smaller particles, called droplet nuclei, can be inhaled by susceptible individuals not in close proximity to the infected person. Diseases include tuberculosis, measles, and varicella (chickenpox). Their highly transmissible nature necessitates specialized environmental controls.
Patients are placed in an Airborne Infection Isolation Room (AIIR), also known as a negative pressure room. This specialized room maintains lower air pressure than the adjacent hallway, ensuring air flows into the room and not out. Air from an AIIR is exhausted directly outside or passed through a HEPA filter before recirculation, preventing infectious particle escape. Air changes within these rooms are typically frequent, 6 to 12 per hour.
Healthcare personnel entering an AIIR must wear a fit-tested N95 or higher-level respirator. These respirators filter at least 95% of airborne particles (0.3 microns), offering superior protection compared to surgical masks. Fit-testing ensures a tight seal, preventing unfiltered air leakage. This attention to environmental engineering and personal protective equipment is essential to prevent widespread transmission of these highly contagious airborne pathogens.