• Designed to reduce the risk of airborne transmission of infectious agents through dissemination of small droplet nuclei >5 microns in size or small-particle residue of evaporated droplets that may remain suspended in the air for long periods or dust particles containing the infectious agent.
• Microorganisms carried in this manner can be dispersed widely by air currents and may become inhaled by or deposited on a susceptible host within the same room or over a longer distance from the source patient • Therefore, special air handling, filtration, and ventilation are required
• Examples: • measles, varicella (including disseminated zoster), TB• Wear respiratory protection when entering the room of a patient with known or suspected PTB or any of the other known or suspected airborne-transmitted diseases • at least an N-95 respirator or PAPR
• Place the patient in a private room that has: • Monitored negative air pressure in relation to the surrounding areas. • At least 6 but preferably 12 air changes per hour. • Appropriate discharge of air outdoors or monitored high- efficiency filtration of room air before recirculation. • Door that is closed at all times with the patient in the room.
• Health care workers who are susceptible should not enter the rooms of patients known or suspected to have: • measles (rubeola) or chickenpox (varicella)• If susceptible individuals must enter the room, they should wear a N-95 or PAPR mask• Persons immune to rubeola or varicella need not wear a mask
• Limit the transport of the patient from the room to essential purposes only. • Minimize patient dispersal of droplet nuclei by placing a surgical mask on the patient. • Notify the destination department about the patient and the patients status so they can provide protection to their staff and other patients. • Minimize the time the patient is in the visiting department.
• Designed for care of patients known or suspected to be infected with microorganisms transmitted by droplets (large particles) that can be generated by the patient when coughing, sneezing, talking, or during the performance of procedures.• Wear a mask when working within 3 feet (0.9 m) of the patients mouth.
• Examples: • Invasive Haemophilus influenzae type b disease, including meningitis, pneumonia, epiglottitis, sepsis • Invasive N. meningitidis disease, including meningitis, pneumonia, sepsis • Diphtheria, mycoplasma pneumonia, pertussis, pneumonic plague, streptococcal pharyngitis, pneumonia, or scarlet fever in infants and young children • Adenovirus, influenza, mumps, parvovirus B19, rubella
• Place the patient in a private room. • When a private room is not available, place patients with the same microorganism together (cohorting). • If neither of these is possible, maintain spatial separation of at least 3 feet between the infected patient and other patients
• Special air handling and ventilation are not necessary, the door may remain open• Limit the transport of the patient from the room to essential purposes only. • If transport is necessary, minimize dispersal of droplets by masking the patient.
• Used for patients known or suspected to be infected or colonized with epidemiologically important microorganisms that can be transmitted by direct or indirect contact
• direct contact with the patient • skin-to-skin or patients skin to staffs clothing as contact occurs when performing patient care activities that require touching the patients skin• indirect contact • touching with environmental surfaces or patient care items in the patients environment.
• Examples : • Methicillin (oxacillin)-resistant Staphylococcus aureus (MRSA [ORSA]) • Vancomycin-resistant Enterococcus. • Vancomycin-intermediate-resistant S. aureus, also known as glycopeptide- resistant S. aureus. • Clostridium difficile (when patient has diarrhea). • For diapered or incontinent patients, Escherichia coli 0157:H7, shigella, hepatitis A, rotavirus.
• Respiratory syncytial virus, parainfluenza virus, or enteroviral infections in young children; diphtheria; herpes simplex virus (primary cases).• Impetigo, major (noncontained) abscesses, cellulitis, or decubiti.• Pediculosis, scabies, staphylococcal furunculosis in infants and young children.• Herpes zoster.
• Place the patient in a private room or in a room with a patient who has the same microorganism (cohorting)• When possible, dedicate the use of noncritical patient care equipment to a single patient • Consider disposable equipment where possible.• Thoroughly clean and disinfect reusable equipment before use for another patient.
• In addition to wearing gloves as outlined under Standard Precautions, everyone (including visitors) must wear gloves when entering the room. • Change gloves after contact with infective material, such as feces and wound drainage.
• Remove gloves before leaving the patients environment and perform appropriate hand hygiene immediately with an antimicrobial soap or alcohol-based waterless antiseptic agent.• After glove removal and hand hygiene, make sure that hands do not touch potentially contaminated environmental surfaces or items in the patients room.