2 Isolation Precautions and Transmission-Based Care
Learn how Standard Precautions and transmission-based measures work together, how to select room placement and PPE, and how to maintain precautions during care and transport.
Two layers of protection
form the baseline for care: use them with every patient, in every care setting, regardless of known infection status. Perform hand hygiene, follow respiratory hygiene and safe injection practices, and handle equipment, laundry, and the environment safely.
Select PPE according to anticipated exposure. Wear gloves when blood or body fluids may the hands; add a gown and eye protection when splashes are likely. A mask and eye protection are also selected according to anticipated exposure.
Choosing
Add when a patient is known or suspected to have an infection that can spread by , droplets, or particles. Start appropriate precautions promptly when indicated, even while diagnostic results are pending. Use more than one category when indicated, and consult current disease-specific guidance and facility policy for required PPE and duration.
precautions address spread through direct with the patient or indirect with contaminated surfaces or equipment. A single-patient room is preferred. Wear a gown and gloves for interactions likely to involve the patient or their environment, following posted instructions and facility policy. Dedicate equipment when possible; clean and disinfect shared equipment between patients.
precautions address spread through close respiratory or mucous-membrane exposure to infectious respiratory secretions. A single-patient room is preferred. Wear a medical mask when entering the patient’s room or care space, and use additional PPE if exposure risk requires it. Special air handling is generally not required.
precautions address spread by infectious particles that can remain suspended and travel through the air. Place the patient in an , a single-patient room with monitored negative pressure, and keep the door closed. Personnel wear a fit-tested N95 respirator or higher-level protection as indicated, putting it on before entering.
These categories are general patterns, not substitutes for disease-specific instructions. Some infections require combined precautions or different PPE.
Room placement, signs, and transport
Prioritize a single room for isolation; a single room is also preferred for and precautions. If no single room is available, consult infection prevention staff about safe alternatives such as cohorting. Do not assume that patients with similar symptoms have the same infection.
Post a clear precaution sign at the room entrance showing the required precautions and PPE. Staff and visitors should read the sign before entering and follow facility instructions for putting on and removing PPE. Signs support, but do not replace, staff communication and hand hygiene.
When a patient must leave the room, notify the receiving department in advance so staff can prepare and maintain precautions. For precautions, limit movement to necessary purposes, contain drainage or affected areas, and remove contaminated PPE and perform hand hygiene before transport. Wear clean PPE for patient care at the destination as needed. For precautions, limit movement to necessary purposes, have the patient wear a mask if tolerated, and follow cough etiquette. For precautions, limit movement to necessary purposes, have the patient wear a medical mask if tolerated, notify the receiving area, and follow facility procedures.
A practical sequence and duration
Identify risk: Assess symptoms, likely routes of transmission, and anticipated exposure. Use empiric precautions when indicated while tests are pending.
Prepare: Place the patient appropriately, post the required sign, gather supplies, and explain the precautions to the patient and visitors.
Enter and provide care: Perform hand hygiene and put on the indicated PPE. Avoid unnecessary movement of supplies and equipment between rooms.
Exit safely: Remove PPE in the designated manner to avoid contaminating skin, clothing, or nearby surfaces, then perform hand hygiene.
If transport is needed: Confirm that it is necessary, apply route-appropriate source-control measures, notify the receiving area, and use clean PPE for care there as indicated.
continue only as long as the infection-specific risk warrants. Discontinuation depends on the organism, clinical course, and applicable guidance or facility policy.