Contact Precautions

In addition to Standard Precautions, use Contact Precautions, or the equivalent, for specified patients known or suspected to be infected or colonized with epidemiologically important microorganisms that can be transmitted by direct contact with the patient (hand or skin-to-skin contact that occurs when performing patient-care activities that require touching the patient’s dry skin) or indirect contact with environmental surfaces or patient-care items in the patient’s environment.

A. Patient Placement
Place the patient in a private room. When a private room is not available, place the patient in a room with a patient who has an active infection with the same microorganisms but with no other infection. When a private room is not available and cohorting is not achievable, consider the epidemiology of the microorganisms and the patient population when determining patient placement. Consultation with infection control professionals is advised before patient placement.

B. Gloves and Hand Washing
In addition to wearing gloves as outlined under Standard Precautions, wear gloves (clean, non-sterile gloves are adequate) when entering the room. While providing care for a patient, change gloves after having contact with infective material that may contain high concentrations of microorganisms (fecal material and wound drainage). Remove gloves before leaving the patient’s room and wash hands immediately with an antimicrobial agent or a waterless antiseptic agent. After glove removal and hand washing, ensure that hands do not touch potentially contaminated surfaces or items in the patient’s room to avoid the transfer of microorganisms to other patients or environments.

C. Gown
In addition to wearing a gown as outlined under Standard Precautions, wear a gown (a clean, non-sterile gown is adequate) when entering the room if you anticipate that your clothing will have substantial contact with the patient, environmental surfaces, or if the patient is incontinent or has diarrhea, an ileostomy, a colostomy, or wound drainage not contained by a dressing. Remove the gown before leaving the patient’s environment. After gown removal, ensure that clothing does not contact potentially contaminated environmental surfaces to avoid the transfer of microorganisms to other patients or environments.

D. Patient Transport
Limit the movement and transport of the patient from the room to essential purposes only. If the patient is transported out of the room, ensure that precautions are maintained to minimize the risk of transmission of microorganisms to other patients and contamination of environmental surfaces or equipment.

E. Patient-Care Equipment
When possible, dedicate the use of non-critical patient-care equipment to a single patient (or cohort of patients infected or colonized with the pathogen requiring precautions) to avoid sharing between patients. If the use of common equipment or items is unavoidable, then adequately clean and disinfect them before use for another patient.

F. Additional Precautions for Preventing the Spread of Vancomycin Resistance
Consult the HICPAC report on preventing the spread of Vancomycin resistance for additional prevention strategies.

Garner JS. Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996; 17:53-80, and Am J Infect Control 1996; 24:24-52.