The primary types of infection control precautions are Standard Precautions and Transmission-Based Precautions, with Transmission-Based Precautions further categorized into Contact, Droplet, and Airborne Precautions.
Standard Precautions
These precautions are the foundation of infection control and should be used with all patients, regardless of suspected or confirmed infection status. They are designed to prevent the transmission of infections from recognized and unrecognized sources. Standard Precautions include:
- Hand hygiene: Performing hand hygiene with soap and water or an alcohol-based hand rub.
- Use of personal protective equipment (PPE): Wearing gloves, gowns, masks, and eye protection when exposure to blood or body fluids is anticipated.
- Respiratory hygiene/cough etiquette: Covering coughs and sneezes with a tissue, and proper disposal of the tissue, followed by hand hygiene.
- Safe injection practices: Using aseptic technique when administering injections and handling injection equipment.
- Safe handling of potentially contaminated equipment or surfaces: Cleaning and disinfecting environmental surfaces and reusable patient care equipment.
- Proper handling of laundry: Containing and transporting soiled linen in a leak-proof bag.
Transmission-Based Precautions
These precautions are used in addition to Standard Precautions when Standard Precautions alone may not be sufficient to prevent transmission of infection. They are based on the route of transmission of the infectious agent.
Contact Precautions
These precautions are used for infections spread by direct or indirect contact with the patient or their environment.
- Examples: Clostridium difficile (C. diff), Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE).
- Specific Measures:
- Wear gloves and gowns upon entry into the patient's room.
- Remove gloves and gowns before leaving the room.
- Perform hand hygiene immediately after removing PPE.
- Use dedicated patient-care equipment (e.g., stethoscope, blood pressure cuff). If equipment is shared, clean and disinfect between patients.
- Clean and disinfect frequently touched surfaces in the patient's environment daily.
Droplet Precautions
These precautions are used for infections spread through large respiratory droplets produced by coughing, sneezing, or talking. These droplets can travel short distances.
- Examples: Influenza, pertussis, respiratory syncytial virus (RSV).
- Specific Measures:
- Wear a surgical mask upon entry into the patient's room.
- If close contact with the patient is required, wear eye protection (e.g., goggles or a face shield).
- Patients should be placed in a single room or cohorted with patients with the same infection.
Airborne Precautions
These precautions are used for infections spread through small airborne particles that can remain suspended in the air for longer periods of time.
- Examples: Tuberculosis (TB), measles, chickenpox (varicella).
- Specific Measures:
- Place the patient in an airborne infection isolation room (AIIR), which is a single-patient room with negative pressure relative to surrounding areas and appropriate air handling.
- Healthcare personnel must wear a NIOSH-approved N95 respirator or higher-level respirator when entering the room.
- Susceptible persons should not enter the room. If entry is necessary, they must wear a respirator.
- Post signs instructing visitors to check with the nurses' station before entering the room.
In summary, infection control relies on a tiered approach, starting with Standard Precautions for all patients and supplementing with Transmission-Based Precautions (Contact, Droplet, or Airborne) when specific infections are suspected or confirmed. Adherence to these precautions is critical for preventing the spread of infections in healthcare settings.
