The document discusses isolation precautions used in healthcare settings, including standard precautions used for all patients and transmission-based precautions used for patients known or suspected to be infected by highly transmissible pathogens. It describes airborne, droplet, contact, and protective isolation precautions and the personal protective equipment used for each. The goal is to stop the spread of infections in the hospital by reducing risks of transmission through air, droplets, direct/indirect contact, or vulnerable patients.

1. Isolation and Standard
Precautions

2. Standard Precautions
o Associates follow Standard Precautions for the care of ALL
patients.
o Applies to blood, all body fluids, secretions, excretions (except
sweat), mucous membranes, and non-intact skin.
o All associates wear the appropriate personal protective
equipment (PPE) to prevent contact of their
clothes, skin, eyes, or mucous membranes to any substance
listed above.

3. Transmission Based
Precautions
o These precautions are designed for patients known or suspected to be
infected by highly transmissible or epidemiologically important
pathogens that require “Standard Precautions plus” to stop their
spread in the hospital.
o Drug resistant organisms are those with resistant susceptibility to
antimicrobials such as, but not limited to:
• MRSA – Methicillin Resistant Staph Aureus
• VRE – Vancomycin Resistant Enterococcus
• ESBL – Extended Spectrum Beta-Lactamase
o Patients that have positive cultures for drug resistant organisms are
placed in the appropriate isolation precautions.
o Patients with draining wounds/abscesses or foot ulcers are placed in
isolation until culture results are obtained.

4. Transmission Based
Precautions
• Transmission Based Precautions are broken down into four
types. The isolation codes below print to the patient’s
armband and display on CPSI screens to alert you to the
isolation type:
• Airborne Isolation
• Droplet Isolation
• Contact Isolation
• Protective Isolation

5. Airborne Precautions
o Airborne Precautions are designed to reduce the risk of
infection that can be spread through the air.
o Transmission occurs when tiny droplets or dust
containing the infected agent are suspended in the air for
long periods.
o The agent can float in the air currents of the facility and
can be inhaled by or deposited on a susceptible person.

6. Airborne Precautions
o To stop airborne transmission of an infection, the patient
should be placed in a specially ventilated room kept under
negative pressure.
o The air in this room is “changed out” a specific number of
times an hour and is exhausted outside. It is not re-circulated
in to the hospital. An ultraviolet light remains on in this room.
The “isolation” rooms on 3S, 4S, 3N, 4N, ER, CCU, PACU
and Pre-Op are designed for airborne isolation.

7. Airborne Precautions
o A special mask - N95 particulate respirator is needed to filter out
these particles that are expelled by the patient when they
cough, sneeze or talk.
o Fit testing for the N95 mask is done in the Associate Health
Department annually in the same month as the TB Skin Test.
o CDC and OSHA recommends the use of an N95 mask when
caring for patients in Airborne Precautions as well as when
performing aerosol generating procedures.

8. Airborne Isolation Precautions
o Keep both doors of the anti-room o Limit visitors
closed at all times except when
entering or exiting the room
o Visitors can be fit tested
o Keep UV light on at all times
o Document precautions at least every
o Wear your appropriately fit tested shift
N95 particulate respirator upon
entering after you fit check it o Ventilation check daily to assure
negative pressure
o Patient must be placed in negative
pressure isolation room
o If negative pressure electronic monitor
o Patient must wear a surgical mask is out of range report it immediately to
if out of his room and only out of the Engineering
room is absolutely necessary

9. Droplet Precautions
o Droplet Precautions are designed to reduce the risk of infection
that can be spread when the infected droplet contacts the
eyes, nose or mouth of a susceptible person.
o These are rather large droplets and only travel a short distance
before falling to the ground, usually about three feet.
o A regular surgical mask is needed to filter out these particles
that are expelled by the patient when they sneeze, cough, or
talk.
o The mask used for droplet precautions is for one time use and
to be disposed of in the patient room. Do not reuse.

10. Droplet Isolation Precautions
o Keep door shut
o Wear regular surgical mask if
within 3 feet of patient
o Place in regular room
o Patient must wear a surgical mask
when out of his room
o Patient is out of room only when
necessary
o Limit visitors
o Document precautions at least
every shift

11. Contact Precautions
o Contact Precautions are designed to reduce the transmission
risk of epidemiologically important micro-organisms by direct or
indirect contact.
o Contact involves dry or moist substances and physical transfer
of microorganisms to a susceptible person or transfer of the
organism from an inanimate object to a susceptible person.
o When patient is in contact precautions:
• Keep door closed
• Upon entering room don gloves and gown if you might have
contact with patient or environment
• Place in regular room

12. Contact Isolation Precautions
o Patient out of room only when o Wash hands immediately after
necessary removing gown and gloves (while
still in room) and don’t touch any
o Trash and linen hamper must thing before leaving. Organisms that
be in the patient’s room require contact precautions can live
for long periods of time outside of
o Use disposable the body and can be transferred to
stethoscope, thermometer, and any surface
other non-critical items
o Wash hands with antiseptic o Disinfect items that are removed
soap i.e.: Calgon Vestal as from patient room to be used
plain soap may not wash these elsewhere.
organisms off your hands.
o Document precautions at least each
shift

13. Protective Isolation
o Protective Isolation is designed to reduce the risk of
infection in an immuno-compromised patient.
o Patients requiring protective isolation can be placed in
any room with general hospital ventilation and the door
should be kept closed.