2 Infection Prevention and Isolation
Learn how to apply Standard Precautions, choose additional isolation measures by likely transmission route, and update precautions as clinical information changes.
Applying precautions to every patient
Infection prevention reduces the spread of microorganisms among patients, healthcare personnel, and the care environment. Apply for every patient, then add when a known or suspected infection may spread by a particular route. Begin appropriate measures promptly based on symptoms and likely causes, and adjust them as more information becomes available.
apply in every healthcare setting, whether or not infection is suspected. They assume that blood, body fluids other than sweat, nonintact skin, and mucous membranes may carry infectious agents. Choose protective measures by assessing the task and likely exposure.
Core practices include:
at appropriate moments.
Risk-based . Use gloves when with blood or body fluids is possible; add a gown, mask, and eye protection when splashing or contamination is anticipated. Gloves do not replace .
Respiratory hygiene: encourage people to cover coughs and sneezes, provide tissues and masks when appropriate, and clean hands after with respiratory secretions.
Safe handling of sharps, injections, equipment, laundry, and contaminated surfaces. Clean and disinfect reusable equipment before using it for another patient.
For example, wear gloves for a blood draw. For a procedure likely to splash blood or body fluids, add a gown and face or eye protection as indicated by the risk assessment.
during care
Clean hands before touching a patient and before an aseptic task; when moving from a contaminated body site to a clean site on the same patient; after touching a patient, the patient's surroundings, blood or body fluids, or contaminated items; and immediately after removing gloves.
For most routine care, use alcohol-based hand rub when hands are not visibly soiled. Rub all hand surfaces, including fingertips, thumbs, and between fingers, until dry. Wash with soap and water when hands are visibly soiled. Follow facility guidance for situations such as suspected or confirmed C. difficile or norovirus infection during outbreaks.
Choosing a transmission-based category
supplement . The three categories are , , and . Some infections require more than one category; follow current disease-specific guidance and facility policy.
precautions
Consider precautions when organisms may spread through direct with a patient or indirect through the patient's environment. Use a single room when available, wear a gown and gloves for interactions that may involve the patient or their environment, and use dedicated equipment when possible. C. difficile is an example.
precautions
Consider precautions when infection may spread through respiratory droplets, such as those produced by coughing or sneezing. Place the patient in a single room if possible, and wear a mask on room entry. Mask the patient during medically necessary transport if tolerated. Influenza and pertussis are examples.
precautions
Consider precautions when infection may spread through particles that can remain infectious in the air over distance. Use an when available. Personnel wear a fit-tested NIOSH-approved N95 or higher-level respirator. Mask the patient during necessary transport if possible. Tuberculosis, measles, and chickenpox are examples.
Selecting and updating isolation measures
Assess signs, symptoms, and exposure risks. Clues may include diarrhea, draining wounds, or a respiratory infection.
Begin precautions promptly when the likely infection presents a transmission risk; do not wait for test results if precautions are warranted.
Match precautions to the likely route. Use , , , or a combination, in addition to .
Use the required PPE and room placement. Check posted instructions, disease-specific guidance, and facility procedures; ask infection-prevention staff when uncertain.
Limit transport to what is medically necessary. Apply source-control measures, such as a patient mask when indicated, and protect others during movement.
Reassess and update precautions as test results and clinical information become available.
Isolation should not interrupt essential care. Explain the reason for precautions, maintain communication and appropriate patient , and use dedicated equipment or clean shared equipment between patients.