Download Infection Control - Tacoma-Pierce County Health Department

Infection Control
Jan. 2016
Communicable Disease Division
3629 South D Street, Tacoma, WA 98418
(253) 798-6410 (phone) • (253) 798-7666 (fax)
Standard, Contact, Airborne, and Droplet Precautions
Type of Precaution: Standard
Type of Precaution: Contact
When to Use Standard Precautions
When to Use Contact Precautions
During all patient encounters—prevents the spread of
bloodborne pathogens such as HIV, Hepatitis B and Hepatitis C.
Reason to Use Standard Precautions
Protects the healthcare worker from patient’s potentially
contaminated body fluids and prevents the spread of disease to
others.
Components of Standard Precautions
•
•
•
•
•
•
•
•
•
Wash hands before and after contact with all patients.
Wear gloves when exposure to body fluids is likely.
Change gloves, wash hands and put on new gloves when
gloves become contaminated.
Wear masks and eye protection or face shields when
splashing or splatter is likely.
Wear gowns or protective aprons when personal clothing
may become soiled.
Clean (or dispose) patient care equipment with EPAregistered disinfectant between patients.
Handle contaminated linen with gloves and avoid
touching personal clothing.
Bag soiled linen as close to the point of use as possible.
Dispose of sharps according to facility policy, OSHA
Bloodborne Pathogen Standard, and state and local
regulations.
For patients infected with an antibiotic resistant microorganism
(ARM) such as methicillin-resistant Staphylococcus aureus
(MRSA) or vancomycin-resistant enterococci (VRE), patients
with C. difficile, vesicular rashes, or major wounds with
significant drainage.
Reason to Use Contact Precautions
Reduces the risk of transmitting the disease to the healthcare
worker or having the healthcare worker serve as a vector for
transmission to other patients.
Components of Contact Precautions Include Standard
Precautions Plus
•
•
•
•
•
•
•
•
•
•
•
•
•
CD 1084-11-013 Reviewed 1/16
Place patient in a private room or room with a patient
with the same infection. If not possible, the roommate
should NOT have open wounds, no invasive devices (such
as tracheostomy, NG tube, IV line, Foley catheter) and
should not be immunocompromised.
Wear gloves at all times while in the room.
Wear gloves whenever touching the patient or anything
he or she has touched, such as bed rails.
Do not touch clean environmental surfaces with
contaminated gloves.
Wash hands immediately after removing gloves and
before leaving room.
Do not touch potentially contaminated environmental
surfaces or items with bare hands.
Wear a gown when entering the room if your clothing
may come in contact with the patient, environmental
surfaces or items in the room, or if the patient is
incontinent, has an ileostomy or colostomy, diarrhea, or
wound drainage not contained by a dressing.
Remove gown without touching the outside and place it
in the proper container before leaving the room.
Wear a mask if the patient has MRSA in the sputum or
lungs and is coughing.
Limit patient transport within the facility.
Dedicate the use of non-critical equipment (such as
stethoscope, blood pressure cuff and thermometer) to a
single patient or group of patients with the same ARM.
Clean and disinfect all equipment prior to use on another
patient.
Tacoma-Pierce County Health Department • www.tpchd.org
page 1 of 2
Type of Precaution: Airborne
Type of Precaution: Droplet
When to Use Airborne Precautions
When to Use Droplet Precautions
Use when the infectious agent is a small particle or aerosol that
is capable of remaining suspended in the air for long periods of
time. Examples include tuberculosis (TB), measles and varicella
(including disseminated herpes zoster). Centers for Disease
Control and Prevention believe that Sudden Acute Respiratory
Syndrome (SARS) could be transmitted via the airborne route
(in addition to the droplet route).
Reason to Use Airborne Precautions
•
Reduces the risk of transmitting the disease to the
healthcare worker or having the healthcare worker
serve as a reservoir for transmission to others.
Components of Airborne Precautions Include Standard
Precautions Plus
•
•
•
•
•
Provide infected or colonized patients with private room
(if private room unavailable, put patients with the same
disease together).
Use negative are-pressure ventilation (6-12 air exchanges
per hour), with air externally exhausted or highly-efficient
particulate air (HEPA) filtered, if re-circulated.
Wear OSHA approved and fit tested respiratory
protective devices (such as N95 respirator) for suspected
or proven infectious pulmonary TB or SARS.
Wear respirator and goggles or PAPR for SARS.
Persons NOT immune to measles or varicella should not
enter the room. Masks are not effective against measles
or varicella.
When the infectious agent is known to be a large particle
droplet generated by sneezing, coughing, talking, or during the
performance of certain cough-inducing procedures such as
suctioning, sputum induction or bronchoscopy. Examples
include influenza, respiratory MRSA (which also requires
contact precautions), rubella, meningococcal meningitis,
mumps, respiratory syncytial virus (RSV—which also requires
contact precautions) and pertussis. The World Health
Organization recognizes the droplet route for Sudden Acute
Respiratory Syndrome (SARS).
Reason to Use Droplet Precautions
Reduces the risk of transmitting the disease to the healthcare
worker or having the healthcare worker serve as a reservoir for
transmission to others.
Components of Droplet Precautions Include Standard
Precautions Plus
•
•
Provide infected or colonized patients with private room
(if private room unavailable, put patients with the same
disease together).
Wear a mask if within three feet of the patient.
References
• American Academy of Pediatrics. (Chapter 2). In: Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases.
26th ed. Elk Grove Village, IL.
• Tacoma-Pierce County Antibiotic Resistance Task Force, Controlling Antibiotic Resistance: A Practical Guide for Health Care Providers,
Schools, Residential & Correctional Facilities, Dentists & Veterinarians, January 2002.
CD 1084-11-013 Reviewed 1/16
Tacoma-Pierce County Health Department • www.tpchd.org
page 2 of 2