6 Healthcare-Associated Infection Prevention

Begin with precautions for every patient

Standard Precautions apply to every patient, including patients whose infection status is unknown. Choose protective measures according to the anticipated exposure to blood, body fluids, or other potentially infectious material rather than relying only on whether an infection has been confirmed.

When a patient’s symptoms suggest a particular transmission route, promptly add appropriate Transmission-Based Precautions to Standard Precautions. Separate the patient while arranging evaluation, and adjust the precautions as more information becomes available. Use isolation signage and follow facility procedures.

Clean hands and select protective equipment

Perform Hand hygiene at recommended moments, including immediately after removing gloves, before patient contact and aseptic tasks, and after contact with a patient or the patient’s surroundings. Gloves do not replace hand hygiene. Alcohol-based hand rub is appropriate in most clinical situations; use soap and water when hands are visibly soiled.

Choose Personal protective equipment according to the anticipated exposure. For a procedure that may splash blood toward the face and contaminate clothing, use gloves and a gown, along with a mask and eye protection or a face shield to protect facial mucous membranes. A respirator is not required for every dressing change; select equipment for the expected exposure.

Add precautions for suspected transmission routes

Use Contact Precautions for a hospitalized patient with new, unexplained diarrhea when C. difficile infection is suspected and being evaluated; do not wait for a positive test. Use a gown and gloves, and dedicate patient-care equipment when possible. Soap-and-water handwashing is preferred after care of a patient with C. difficile, and the facility’s current protocol should be followed.

For suspected or confirmed seasonal influenza, use Droplet Precautions in addition to Standard Precautions. If transport is necessary, have the patient wear a facemask if possible, observe respiratory hygiene, and communicate the patient’s status to receiving personnel.

For suspected infectious pulmonary tuberculosis, promptly initiate Airborne Precautions. The preferred placement is an airborne infection isolation room (AIIR), and healthcare personnel entering should wear at least a fit-tested N95 respirator under the facility’s respiratory-protection program. During transport, mask the patient for source control if tolerated.

Manage shared equipment

Dedicate patient-care equipment when possible. If equipment must be shared, clean and disinfect it before using it for another patient; hand hygiene does not replace equipment reprocessing. For example, a blood pressure cuff used for a patient on Contact Precautions should be dedicated to that patient or cleaned and disinfected before use on someone else.

Remove protective equipment and communicate precautions

Remove and discard contaminated personal protective equipment as directed by room instructions and facility procedure before leaving a room. Follow removal with hand hygiene. Do not wear contaminated gloves into the hallway or use the same gloves for another patient, even if no body fluids are visible.

During transfers, communicate the patient’s precautions to receiving personnel. For respiratory illness, use patient masking during necessary transport when specified and tolerated.

Reduce risks from invasive devices

Reassess invasive devices regularly and remove them as soon as they are no longer clinically necessary. For example, remove a urinary catheter that was inserted for close monitoring during surgery once the patient is stable and there is no longer a clinical indication, following the care team’s protocol. Avoid unnecessary disconnections or manipulation of devices, which can introduce pathogens.