Infection control in healthcare settings relies on two tiers of measures: Standard Precautions and Transmission-Based Precautions. Standard Precautions are the fundamental practices applied to the care of all patients for basic safety. When a patient is known or suspected to be infected, healthcare professionals implement Transmission-Based Precautions. Droplet precautions represent one category of these measures, specifically designed to prevent the spread of infectious agents transmitted via close-range respiratory spray.
Understanding Droplet Transmission
Droplet transmission is the mechanism by which pathogens travel on relatively large, moist particles of respiratory secretions expelled from an infected person. These particles are generated during activities such as coughing, sneezing, or talking. Unlike tiny particles that remain suspended in the air for long periods, these droplets are heavy and tend to fall rapidly out of the air.
These particles usually travel only a short distance, typically less than three to six feet from the source, before landing on surfaces or the mucous membranes of another person. Infection occurs when these infectious droplets are deposited directly onto the eyes, nose, or mouth of a susceptible individual. This process emphasizes that transmission primarily requires close contact.
Common Illnesses Requiring Droplet Precautions
Many common respiratory illnesses necessitate droplet precautions because of their specific mode of spread. These protective measures are implemented for patients with symptoms or a confirmed diagnosis of a droplet-spread disease, aiming to intercept the expelled respiratory particles.
Seasonal Influenza, or the flu, is a common example of an illness requiring these precautions. The influenza virus is readily transmitted through the coughs and sneezes of an infected person, which aerosolize virus-laden droplets. Similarly, Pertussis (whooping cough) is a highly contagious bacterial infection of the respiratory tract that spreads when an infected person coughs or sneezes.
Certain types of Bacterial Meningitis also require droplet precautions, most notably that caused by Neisseria meningitidis (Meningococcal disease). This bacterium spreads through respiratory and throat secretions, such as when an infected person coughs or kisses. The protocols are usually maintained until the patient has been on effective antibiotic therapy for at least 24 hours.
Practical Steps for Implementing Droplet Precautions
Implementing droplet precautions centers on controlling the environment around the patient and ensuring appropriate personal protective equipment (PPE) is used. Patient placement is a primary concern, with a single-patient room preferred to maintain separation. If a private room is not available, patients with the same infection may be grouped together (cohorting), maintaining a separation of at least three feet between beds.
Healthcare personnel and visitors must wear a surgical mask upon entering the patient’s room, as this mask is effective at blocking large respiratory droplets. Unlike for airborne diseases, a specialized respirator like an N95 is not required for routine care. Limiting the patient’s movement outside the room is important, and if transport is necessary, the patient should wear a surgical mask if tolerated.