BACKGROUND AND HISTORY
The concept of isolating patients with infectious diseases in separate facilities,
which became known as infectious disease hospitals, was introduced in a
published hospital handbook as early as 1877. Although infected and noninfected
patients were separated, nosocomial transmission continued, largely
because of the lack of minimal aseptic procedures, coupled with the fact that
infected patients were not separated from each other by disease. By 1890 to
1900, nursing textbooks discussed recommendations for practicing aseptic
procedures and designating separate floors or wards for patients with similar
diseases, thereby beginning to solve the problems of nosocomial transmission
(Lynch, 1949).
Shortly thereafter, the cubicle system of isolation changed U.S. hospital
isolation procedures as patients were placed in multiple-bed wards. “Barrier
nursing” practices, consisting of the use of aseptic solutions, hand washing
between patient contacts, disinfecting patient-contaminated objects, and
separate gown use, were developed to decrease pathogenic organism transmission
to other patients and personnel. These practices were used in U.S.
infectious disease hospitals. By the 1960s, the designation of specifically
designed single- or multiple-patient isolation rooms in general hospitals and
outpatient treatment for tuberculosis caused these specialized hospitals
(which since the 1950s had housed tuberculosis patients almost exclusively)
to close (Garner, 1996).
The lack of consistent infectious patient isolation policies and procedures
noted by the Centers for Disease Control (CDC) investigators in the 1960s led
to the CDC publication in 1970 of a detailed isolation precautions manual
entitled Isolation Techniques for Use in Hospitals, designed to assist large
metropolitan medical centers as well as small hospitals with limited budgets.
After revision in 1983, the manual was renamed the CDC Guidelines for
Isolation Precautions in Hospitals. These new guidelines encouraged hospital
infection control decision making with respect to developing isolation systems
specific to the hospital environment and circumstances or choosing to select
between category-specific or disease-specific isolation precautions. Decisions
regarding individual patient precautions were to be based on factors such as
patient age, mental status, or possible need to prevent sharing of contaminated
articles and were to be determined by the individual who placed the patient
on isolation status. Decisions regarding the need for decreasing exposure to
infected material by wearing masks, gloves, or gown were to be left to the
patient caregiver (Garner, 1984; Haley, 1985).
Issues of overisolation of some patients surfaced using the 1983 categories
of isolation, which included strict isolation, contact isolation, respiratory
isolation, tuberculosis (acid-fast bacilli) isolation, enteric precautions,
drainage-secretion precautions, and blood and body fluid precautions. In
using the disease-specific isolation precautions, the issue of mistakes in
applying the precautions arose if the patient carried a disease not often seen
or treated in the hospital (Garner, 1984; Haley, 1985), if the diagnosis was
delayed, or if a misdiagnosis occurred. This happened even if additional training of personnel was encouraged. These factors, coupled with increased
knowledge of epidemiologic patterns of disease, led to subsequent updates
of portions of the CDC reports:
■ Recommendations for the management of patients with suspected
hemorrhagic fever published in 1988 (CDC, 1988)
■ Recommendations for respiratory isolation for human parvovirus B19
infection specific to patients who were immunodeficient and had chronic
human parvovirus B19 infection or were in transient aplastic crisis (CDC,
1989)
■ Recommendations for the management of tuberculosis, which stemmed
from increasing concern for multidrug-resistant tuberculosis, especially
in human immunodeficiency virus (HIV)–infected patients in care
facilities (CDC, 1990)
■ Recommendations for hantavirus infection risk reduction (CDC, 1994)
■ Expansion of recommendations for the prevention and control of
hepatitis C virus (HCV) infection and hepatitis C virus–related chronic
disease (CDC, 1998)
■ Occupational exposure recommendations and postexposure management
for hepatitis B virus (HBV), HCV, and HIV (CDC, 2001)
■ Recommendations for infection control of avian influenza and management
of exposure to severe acute respiratory syndrome–associated coronavirus
(SARS-CoV) in the healthcare setting (CDC, 2004; CDC, 2005)
hemorrhagic fever published in 1988 (CDC, 1988)
■ Recommendations for respiratory isolation for human parvovirus B19
infection specific to patients who were immunodeficient and had chronic
human parvovirus B19 infection or were in transient aplastic crisis (CDC,
1989)
■ Recommendations for the management of tuberculosis, which stemmed
from increasing concern for multidrug-resistant tuberculosis, especially
in human immunodeficiency virus (HIV)–infected patients in care
facilities (CDC, 1990)
■ Recommendations for hantavirus infection risk reduction (CDC, 1994)
■ Expansion of recommendations for the prevention and control of
hepatitis C virus (HCV) infection and hepatitis C virus–related chronic
disease (CDC, 1998)
■ Occupational exposure recommendations and postexposure management
for hepatitis B virus (HBV), HCV, and HIV (CDC, 2001)
■ Recommendations for infection control of avian influenza and management
of exposure to severe acute respiratory syndrome–associated coronavirus
(SARS-CoV) in the healthcare setting (CDC, 2004; CDC, 2005)
BODY SUBSTANCE ISOLATION
An entirely different approach to isolation, called body substance isolation
(BSI), was developed in 1984 by Lynch and colleagues (1987, 1990) and
required personnel, regardless of patient infection status, to apply clean
gloves immediately before all patient contact with mucous membranes or
nonintact skin, and to wear gloves if a likelihood existed of contact with any
moist body substances. An apron or other barrier was also to be worn to
keep the provider’s own clothing and skin clean. It was recommended also
that personnel be immunized if proof of immunity could not be documented
when barriers, such as masks, could not prevent transmission by airborne
routes (e.g., rubella, chickenpox). Additionally, when immunity was not
possible, as with pulmonary tuberculosis, masks were to be worn during all
patient contact. Goggles or glasses, hair covers, and shoe covers were also
used as barriers. Careful handling of all used sharps, recapping of needles
without using the hands, and the disposal of used items in rigid punctureresistant
containers were stressed. Trash and soiled linen from all patients
were bagged and handled in the same manner. This approach sought to
protect the patient from contracting nosocomial infections and the provider
from bacterial or viral pathogens that might originate with the patient.
An entirely different approach to isolation, called body substance isolation
(BSI), was developed in 1984 by Lynch and colleagues (1987, 1990) and
required personnel, regardless of patient infection status, to apply clean
gloves immediately before all patient contact with mucous membranes or
nonintact skin, and to wear gloves if a likelihood existed of contact with any
moist body substances. An apron or other barrier was also to be worn to
keep the provider’s own clothing and skin clean. It was recommended also
that personnel be immunized if proof of immunity could not be documented
when barriers, such as masks, could not prevent transmission by airborne
routes (e.g., rubella, chickenpox). Additionally, when immunity was not
possible, as with pulmonary tuberculosis, masks were to be worn during all
patient contact. Goggles or glasses, hair covers, and shoe covers were also
used as barriers. Careful handling of all used sharps, recapping of needles
without using the hands, and the disposal of used items in rigid punctureresistant
containers were stressed. Trash and soiled linen from all patients
were bagged and handled in the same manner. This approach sought to
protect the patient from contracting nosocomial infections and the provider
from bacterial or viral pathogens that might originate with the patient.
UNIVERSAL PRECAUTIONS
In response to increasing concerns by health care workers and others about
occupational exposure and the risk of transmission of human immunodeficiency
virus, HBV, and other blood-borne pathogens during provision of
health care and first aid, the CDC, in 1987, defined a set of precautions that
considered blood and certain body fluids from all patients to be potential
sources of infection for human immunodeficiency virus, HBV, and other
blood-borne pathogens. These recommendations became known as
universal precautions (UP) and have subsequently been integrated into the
Recommendations for Isolation Precautions in Hospitals, 1996, which includes
the current standard precautions (SP) (Table 2-1).
In response to increasing concerns by health care workers and others about
occupational exposure and the risk of transmission of human immunodeficiency
virus, HBV, and other blood-borne pathogens during provision of
health care and first aid, the CDC, in 1987, defined a set of precautions that
considered blood and certain body fluids from all patients to be potential
sources of infection for human immunodeficiency virus, HBV, and other
blood-borne pathogens. These recommendations became known as
universal precautions (UP) and have subsequently been integrated into the
Recommendations for Isolation Precautions in Hospitals, 1996, which includes
the current standard precautions (SP) (Table 2-1).
Table 2.1 Recommendations for Isolation Precautions in
Hospitals, Hospital Infection Control Practices Advisory
Committee, 1996
Hospitals, Hospital Infection Control Practices Advisory
Committee, 1996
STANDARD PRECAUTIONS
Use Standard Precautions, or the equivalent, for the care of all patients.
Use Standard Precautions, or the equivalent, for the care of all patients.
HAND WASHING
Wash hands after touching blood, body fluids, secretions, excretions, and contaminated items,
whether or not gloves are worn. Wash hands immediately after gloves are removed, between
patient contacts, and when otherwise indicated to avoid transfer of microorganisms to other
patients or environments. It may be necessary to wash hands between tasks and procedures
on the same patient to prevent cross-contamination of different body sites.
Use a plain (nonantimicrobial) soap for routine hand washing.
Use an antimicrobial agent or a waterless antiseptic agent for specific circumstances (e.g.,
control of outbreaks or hyperendemic infections), as defined by the infection control program.
(See “Contact Precautions” for additional recommendations on using antimicrobial and
antiseptic agents.)
Wash hands after touching blood, body fluids, secretions, excretions, and contaminated items,
whether or not gloves are worn. Wash hands immediately after gloves are removed, between
patient contacts, and when otherwise indicated to avoid transfer of microorganisms to other
patients or environments. It may be necessary to wash hands between tasks and procedures
on the same patient to prevent cross-contamination of different body sites.
Use a plain (nonantimicrobial) soap for routine hand washing.
Use an antimicrobial agent or a waterless antiseptic agent for specific circumstances (e.g.,
control of outbreaks or hyperendemic infections), as defined by the infection control program.
(See “Contact Precautions” for additional recommendations on using antimicrobial and
antiseptic agents.)
GLOVES
Wear gloves (clean, nonsterile gloves are adequate) when touching blood, body fluids,
secretions, excretions, and contaminated items. Put on clean gloves just before touching
mucous membranes and nonintact skin. Change gloves between tasks and procedures on the
same patient after contact with material that may contain a high concentration of
microorganisms. Remove gloves promptly after use, before touching noncontaminated items
and environmental surfaces, and before going to another patient, and wash hands immediately
to avoid transfer of microorganisms to other patients or environments.
Wear gloves (clean, nonsterile gloves are adequate) when touching blood, body fluids,
secretions, excretions, and contaminated items. Put on clean gloves just before touching
mucous membranes and nonintact skin. Change gloves between tasks and procedures on the
same patient after contact with material that may contain a high concentration of
microorganisms. Remove gloves promptly after use, before touching noncontaminated items
and environmental surfaces, and before going to another patient, and wash hands immediately
to avoid transfer of microorganisms to other patients or environments.
MASK, EYE PROTECTION, FACE SHIELD
Wear a mask and eye protection or a face shield to protect mucous membranes of the eyes,
nose, and mouth during procedures and patient care activities that are likely to generate
splashes or sprays of blood, body fluids, secretions, and excretions.
Wear a mask and eye protection or a face shield to protect mucous membranes of the eyes,
nose, and mouth during procedures and patient care activities that are likely to generate
splashes or sprays of blood, body fluids, secretions, and excretions.
GOWN
Wear a gown (a clean, nonsterile gown is adequate) to protect skin and to prevent soiling of
clothing during procedures and patient care activities that are likely to generate splashes or
sprays of blood, body fluids, secretions, or excretions. Select a gown that is appropriate for
the activity and amount of fluid likely to be encountered. Remove a soiled gown as promptly
as possible, and wash hands to avoid transfer of microorganisms to other patients or
environments.
Wear a gown (a clean, nonsterile gown is adequate) to protect skin and to prevent soiling of
clothing during procedures and patient care activities that are likely to generate splashes or
sprays of blood, body fluids, secretions, or excretions. Select a gown that is appropriate for
the activity and amount of fluid likely to be encountered. Remove a soiled gown as promptly
as possible, and wash hands to avoid transfer of microorganisms to other patients or
environments.
PATIENT CARE EQUIPMENT
Handle used patient care equipment soiled with blood, body fluids, secretions, and excretions
in a manner that prevents skin and mucous membrane exposures, contamination of clothing,
Handle used patient care equipment soiled with blood, body fluids, secretions, and excretions
in a manner that prevents skin and mucous membrane exposures, contamination of clothing,
Table 2.1 Recommendations for Isolation Precautions in
Hospitals, Hospital Infection Control Practices Advisory
Committee, 1996—cont’d
Hospitals, Hospital Infection Control Practices Advisory
Committee, 1996—cont’d
and transfer of microorganisms to other patients and environments. Ensure that reusable
equipment is not used for the care of another patient until it has been cleaned and
reprocessed appropriately. Ensure that single-use items are discarded properly.
equipment is not used for the care of another patient until it has been cleaned and
reprocessed appropriately. Ensure that single-use items are discarded properly.
ENVIRONMENTAL CONTROL
Ensure that the hospital has adequate procedures for the routine care, cleaning, and
disinfection of environmental surfaces, beds, bed rails, bedside equipment, and other
frequently touched surfaces, and ensure that these procedures are being followed.
Ensure that the hospital has adequate procedures for the routine care, cleaning, and
disinfection of environmental surfaces, beds, bed rails, bedside equipment, and other
frequently touched surfaces, and ensure that these procedures are being followed.
LINEN
Handle, transport, and process used linen soiled with blood, body fluids, secretions, and
excretions in a manner that prevents skin and mucous membrane exposures and contamination
of clothing, and that avoids transfer of microorganisms to other patients and environments.
Handle, transport, and process used linen soiled with blood, body fluids, secretions, and
excretions in a manner that prevents skin and mucous membrane exposures and contamination
of clothing, and that avoids transfer of microorganisms to other patients and environments.
OCCUPATIONAL HEALTH AND BLOOD-BORNE PATHOGENS
Take care to prevent injuries when using needles, scalpels, and other sharp instruments or
devices; when handling sharp instruments after procedures; when cleaning used instruments;
and when disposing of used needles. Never recap used needles, or otherwise manipulate them
using both hands, or use any other technique that involves directing the point of a needle
toward any part of the body; rather, use either a one-handed “scoop” technique or a
mechanical device designed for holding the needle sheath. Do not remove used needles from
disposable syringes by hand, and do not bend, break, or otherwise manipulate used needles
by hand. Place used disposable syringes and needles, scalpel blades, and other sharp items in
appropriate puncture-resistant containers, which are located as close as is practical to the
area in which the items were used, and place reusable syringes and needles in a punctureresistant
container for transport to the reprocessing area.
Use mouthpieces, resuscitation bags, or other ventilation devices as an alternative to
mouth-to-mouth resuscitation methods in areas where the need for resuscitation is predictable.
Take care to prevent injuries when using needles, scalpels, and other sharp instruments or
devices; when handling sharp instruments after procedures; when cleaning used instruments;
and when disposing of used needles. Never recap used needles, or otherwise manipulate them
using both hands, or use any other technique that involves directing the point of a needle
toward any part of the body; rather, use either a one-handed “scoop” technique or a
mechanical device designed for holding the needle sheath. Do not remove used needles from
disposable syringes by hand, and do not bend, break, or otherwise manipulate used needles
by hand. Place used disposable syringes and needles, scalpel blades, and other sharp items in
appropriate puncture-resistant containers, which are located as close as is practical to the
area in which the items were used, and place reusable syringes and needles in a punctureresistant
container for transport to the reprocessing area.
Use mouthpieces, resuscitation bags, or other ventilation devices as an alternative to
mouth-to-mouth resuscitation methods in areas where the need for resuscitation is predictable.
PATIENT PLACEMENT
Place a patient who contaminates the environment or who does not (or cannot be expected
to) assist in maintaining appropriate hygiene or environmental control in a private room. If a
private room is not available, consult with infection control professionals regarding patient
placement or other alternatives.
Place a patient who contaminates the environment or who does not (or cannot be expected
to) assist in maintaining appropriate hygiene or environmental control in a private room. If a
private room is not available, consult with infection control professionals regarding patient
placement or other alternatives.
AIRBORNE PRECAUTIONS
In addition to standard precautions, use airborne precautions, or the equivalent, for patients
known or suspected to be infected with microorganisms transmitted by airborne droplet
nuclei (small-particle residue [5 μm or smaller in size] of evaporated droplets containing
microorganisms that remain suspended in the air and that can be dispersed widely by air
currents within a room or over a long distance).
In addition to standard precautions, use airborne precautions, or the equivalent, for patients
known or suspected to be infected with microorganisms transmitted by airborne droplet
nuclei (small-particle residue [5 μm or smaller in size] of evaporated droplets containing
microorganisms that remain suspended in the air and that can be dispersed widely by air
currents within a room or over a long distance).
PATIENT PLACEMENT
Place the patient in a private room that has (1) monitored negative air pressure in relation to
the surrounding area, (2) six to twelve air changes per hour, and (3) appropriate discharge of
air outdoors or monitored high-efficiency filtration of room air before the air is circulated to
other areas in the hospital. Keep the room door closed and the patient in the room. When a
private room is not available, place the patient in a room with a patient who has active
infection with the same microorganism, unless otherwise recommended, but with no other
infection. When a private room is not available and cohorting is not desirable, consultation
with infection control professionals is advised before patient placement.
Place the patient in a private room that has (1) monitored negative air pressure in relation to
the surrounding area, (2) six to twelve air changes per hour, and (3) appropriate discharge of
air outdoors or monitored high-efficiency filtration of room air before the air is circulated to
other areas in the hospital. Keep the room door closed and the patient in the room. When a
private room is not available, place the patient in a room with a patient who has active
infection with the same microorganism, unless otherwise recommended, but with no other
infection. When a private room is not available and cohorting is not desirable, consultation
with infection control professionals is advised before patient placement.
RESPIRATORY PROTECTION
Wear respiratory protection when entering the room of a patient with known or suspected
infectious pulmonary tuberculosis. Susceptible persons should not enter the room of patients
known or suspected to have measles (rubeola) or varicella (chickenpox) if other, immune
caregivers are available. If susceptible persons must enter the room of a patient known or
Wear respiratory protection when entering the room of a patient with known or suspected
infectious pulmonary tuberculosis. Susceptible persons should not enter the room of patients
known or suspected to have measles (rubeola) or varicella (chickenpox) if other, immune
caregivers are available. If susceptible persons must enter the room of a patient known or
Table 2.1 Recommendations for Isolation Precautions in
Hospitals, Hospital Infection Control Practices Advisory
Committee, 1996—cont’d
Hospitals, Hospital Infection Control Practices Advisory
Committee, 1996—cont’d
suspected to have measles (rubeola) or varicella, they should wear respiratory protection.
Persons immune to measles (rubeola) or varicella need not wear respiratory protection.
PATIENT TRANSPORT
Limit the movement and transport of the patient from the room to essential purposes only. If
transport or movement is necessary, minimize patient dispersal of droplet nuclei by placing a
surgical mask on the patient, if possible.
Limit the movement and transport of the patient from the room to essential purposes only. If
transport or movement is necessary, minimize patient dispersal of droplet nuclei by placing a
surgical mask on the patient, if possible.
ADDITIONAL PRECAUTIONS FOR PREVENTING TRANSMISSION OF TUBERCULOSIS
Consult CDC Guidelines for Preventing the Transmission of Tuberculosis in Health Care Facilities
for additional prevention strategies.
Consult CDC Guidelines for Preventing the Transmission of Tuberculosis in Health Care Facilities
for additional prevention strategies.
DROPLET PRECAUTIONS
In addition to standard precautions, use droplet precautions, or the equivalent, for a patient
known or suspected to be infected with microorganisms transmitted by droplets (large-particle
droplets [larger than 5 μm in size] that can be generated by the patient during coughing,
sneezing, talking, or the performance of procedures).
In addition to standard precautions, use droplet precautions, or the equivalent, for a patient
known or suspected to be infected with microorganisms transmitted by droplets (large-particle
droplets [larger than 5 μm in size] that can be generated by the patient during coughing,
sneezing, talking, or the performance of procedures).
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(s) who has active infection with the same microorganism but with no
other infection (cohorting). When a private room is not available and cohorting is not
achievable, maintain spatial separation of at least 3 feet between the infected patient and
other patients and visitors. Special air handling and ventilation are not necessary, and the
door may remain open.
Place the patient in a private room. When a private room is not available, place the patient in a
room with a patient(s) who has active infection with the same microorganism but with no
other infection (cohorting). When a private room is not available and cohorting is not
achievable, maintain spatial separation of at least 3 feet between the infected patient and
other patients and visitors. Special air handling and ventilation are not necessary, and the
door may remain open.
MASK
In addition to standard precautions, wear a mask when working within 3 feet of the patient.
(Logistically, some hospitals may want to implement the wearing of a mask to enter the room.)
In addition to standard precautions, wear a mask when working within 3 feet of the patient.
(Logistically, some hospitals may want to implement the wearing of a mask to enter the room.)
PATIENT TRANSPORT
Limit the movement and transport of the patient from the room to essential purposes only. If
transport or movement is necessary, minimize patient dispersal of droplets by masking the
patient, if possible.
Limit the movement and transport of the patient from the room to essential purposes only. If
transport or movement is necessary, minimize patient dispersal of droplets by masking the
patient, if possible.
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-toskin
contact that occurs when performing patient care activities that require touching the
patient’s dry skin) or indirect contact (touching) with environmental surfaces or patient care
items in the patient’s environment.
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-toskin
contact that occurs when performing patient care activities that require touching the
patient’s dry skin) or indirect contact (touching) with environmental surfaces or patient care
items in the patient’s environment.
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(s) who has active infection with the same microorganism but with no
other infection (cohorting). When a private room is not available and cohorting is not
achievable, consider the epidemiology of the microorganism and the patient population when
determining patient placement. Consultation with infection control professionals is advised
before 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(s) who has active infection with the same microorganism but with no
other infection (cohorting). When a private room is not available and cohorting is not
achievable, consider the epidemiology of the microorganism and the patient population when
determining patient placement. Consultation with infection control professionals is advised
before patient placement.
GLOVES AND HAND WASHING
In addition to wearing gloves as outlined under “Standard Precautions,” wear gloves (clean,
nonsterile gloves are adequate) when entering the room. During the course of 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 environment and wash hands immediately with an antimicrobial agent or
In addition to wearing gloves as outlined under “Standard Precautions,” wear gloves (clean,
nonsterile gloves are adequate) when entering the room. During the course of 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 environment and wash hands immediately with an antimicrobial agent or
Table 2.1 Recommendations for Isolation Precautions in
Hospitals, Hospital Infection Control Practices Advisory
Committee, 1996—cont’d
Hospitals, Hospital Infection Control Practices Advisory
Committee, 1996—cont’d
a waterless antiseptic agent. After glove removal and hand washing, ensure that hands do not
touch potentially contaminated environmental surfaces or items in the patient’s room to avoid
transfer of microorganisms to other patients or environments.
touch potentially contaminated environmental surfaces or items in the patient’s room to avoid
transfer of microorganisms to other patients or environments.
GOWN
In addition to wearing a gown as outlined under “Standard Precautions,” wear a gown (a clean,
nonsterile gown is adequate) when entering the room if you anticipate that your clothing will
have substantial contact with the patient, environmental surfaces, or items in the patient’s
room, 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 transfer of microorganisms to other patients or environments.
In addition to wearing a gown as outlined under “Standard Precautions,” wear a gown (a clean,
nonsterile gown is adequate) when entering the room if you anticipate that your clothing will
have substantial contact with the patient, environmental surfaces, or items in the patient’s
room, 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 transfer of microorganisms to other patients or environments.
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.
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.
PATIENT CARE EQUIPMENT
When possible, dedicate the use of noncritical 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 use of common equipment or items is unavoidable, adequately
clean and disinfect them before use for another patient.
When possible, dedicate the use of noncritical 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 use of common equipment or items is unavoidable, adequately
clean and disinfect them before use for another patient.
ADDITIONAL PRECAUTIONS FOR PREVENTING THE SPREAD OF
VANCOMYCIN RESISTANCE
Consult the HICPAC report on preventing the spread of vancomycin resistance for additional
prevention strategies.
VANCOMYCIN RESISTANCE
Consult the HICPAC report on preventing the spread of vancomycin resistance for additional
prevention strategies.
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HICPAC, Hospital Infection Control Practices Advisory Committee.
From Centers for Disease Control and Prevention: Recommendations for Isolation Precautions in
Hospitals, 1996. Available at: http://www.cdc.gov/ncidod/hip/isolat/isopart1.htm and
www.cdc.gov./ncidod/hip/isolat/isopart2.htm
From Centers for Disease Control and Prevention: Recommendations for Isolation Precautions in
Hospitals, 1996. Available at: http://www.cdc.gov/ncidod/hip/isolat/isopart1.htm and
www.cdc.gov./ncidod/hip/isolat/isopart2.htm
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