Transmission-based precautions

Transmission-based precautions are additional infection control measures used in healthcare settings, alongside standard precautions, to prevent the spread of certain infections. These precautions are tailored to the mode of transmission of specific diseases and are implemented when the suspected or confirmed presence of infectious agents represent a heightened risk of transmission. Transmission-based precautions are categorized into three main types: Contact Precautions, Droplet Precautions, and Airborne Precautions. Each category targets specific routes of transmission to effectively control the spread of infectious agents.

Contact Precautions

Contact precautions are designed to prevent the transmission of infectious agents, including multidrug-resistant organisms, that are spread by direct or indirect contact with the patient or the patient's environment. Examples of pathogens that require contact precautions include Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), and Clostridioides difficile. Healthcare workers are advised to wear gloves and gowns when entering the room of a patient under contact precautions and to ensure that all equipment is properly disinfected after use.

Droplet Precautions

Droplet precautions are implemented to prevent the spread of pathogens that are transmitted through large respiratory droplets produced when a patient coughs, sneezes, or talks. Diseases that may require droplet precautions include Influenza, Pertussis (whooping cough), and certain types of meningitis. Under droplet precautions, healthcare workers should wear surgical masks when within 3 feet of the patient. Patient placement in a private room is recommended if possible.

Airborne Precautions

Airborne precautions are used for diseases that are transmitted by smaller droplets, which can remain suspended in the air for long periods and can be inhaled by individuals who are not in direct contact with the patient. Diseases that necessitate airborne precautions include Tuberculosis (TB), Measles (rubeola), and Varicella (chickenpox). Healthcare workers must use respiratory protection, such as N95 respirators, when caring for patients under airborne precautions. Patients should be placed in an airborne infection isolation room (AIIR) with negative pressure to prevent the spread of infectious agents to other areas.

Implementation

The decision to implement transmission-based precautions is typically based on the clinical judgment of healthcare providers, in conjunction with local, state, and federal health guidelines. It is crucial for healthcare facilities to have policies and procedures in place for the timely identification and isolation of patients who may require transmission-based precautions. Education and training of healthcare personnel on the proper use and disposal of personal protective equipment (PPE) and adherence to infection control protocols are essential components of preventing the transmission of infectious diseases.

Conclusion

Transmission-based precautions are critical in the control and prevention of infectious diseases within healthcare settings. By understanding and properly implementing contact, droplet, and airborne precautions, healthcare workers can protect themselves, their patients, and the community from the spread of infectious agents.