Policies on Contact and Isolation Precautions

Some disease processes and pathogens that are found in hospital patients and residents of long-term care facilities require special consideration to prevent spreading diseases or pathogens to health care workers and other patients. Contact and isolation precaution policies are a part of every health care facility's infection control processes and are based on guidelines provided by the Centers for Disease Control and Prevention. These guidelines provide information regarding universal precautions, contact procedures, droplet precautions and airborne contaminants.

Universal Precautions

• Universal precautions are recommended for dealing with any patient. These precautions are used any time there is a potential for contact with blood, body fluids, secretions, excretions or other contaminated items. Universal, or standard, precautions include practicing proper hand-washing, putting on gloves before coming into contact with patients or contaminated materials, wearing a mask, eye protection and a gown during procedures or when there is a potential for spraying or splattering of bodily fluids. Universal precautions also include handling needles, scalpels or other sharp instruments in the clinical setting.

Contact Precautions

• In addition to universal precautions, contact precautions are initiated when a patient is known or suspected to have an infection that could spread to others through direct or indirect contact with the patient's skin or body. These precautions include placing the patient in a private room or with other patients that have the same condition. A notice should be posted outside the room and on equipment specifically for the patient's use, with instructions provided to any individuals entering the area. Visitors and health care workers, before entering the room, should don personal protective clothing, including a gown and gloves, and remove it upon exiting. Proper hand hygiene and washing techniques should be used after leaving the patient's room as well.

Droplet Precautions

• Droplet precautions should be initiated when a patient is suspected or known to have a respiratory infection or condition, such as influenza or bacterial meningitis, that could be spread to others through inhalation of the microorganism or infectious agent from tiny particles of liquid exhaled by the patient. The patient should be placed in a private room or be kept with other patients suffering from the same condition at least 3 feet from each other. Visitors should be forewarned of these precautions and instructed to wear a mask when visiting with the patient or within 3 feet of the patient.

Airborne Precautions

• A patient that is known or suspected to have a infection, such as tuberculosis, rubella or varicella, can transmit the disease to others through airborne contact. Just as with contact or droplet precautions, airborne precautions require that patients be isolated in a private room; moreover, the room must be equipped with negative air pressure monitors, an air exchanger and HEPA filtration on the air ducts and system. The door to these rooms must be kept closed, and special masks must be worn to prevent the inhalation of infectious air while in the room. These rooms should not be entered except for authorized personnel, and patients should not be taken out of the room unless absolutely necessary.