What are the three 3 types of additional precautions?

Routine Practices and Additional Precautions In All Health Care Settings, 3rd edition

This document outlines the practice of Routine Practices and Additional Precautions (RP/AP) in health care settings across the continuum of care including, but not limited to, pre-hospital care, acute care, complex continuing care, rehabilitation facilities, long-term care, chronic care, ambulatory care and home health care.

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  4. Infection Control and Prevention
  5. Infection Control and Prevention - Transmission-based precautions

Transmission-based precautions are used in addition to standard precautions when use of standard precautions alone does not fully prevent communicable disease transmission. There are three types of transmission-based precautions--contact, droplet, and airborne - the type used depends on the mode of transmission of a specific disease. Some diseases require more than one type of transmission-based precaution (e.g. SARS, which requires airborne and contact precautions as well as eye protection with all client contact).

Additional resources

Isolation Precautions CDC Guidelines

Contacts

Healthcare-Associated Infection (HAI) Prevention Program
Division of Public Health
Bureau of Communicable Diseases
Phone 608-267-7711
Fax 608-261-4976

  • Contact Precautions
    • Use the following measure in addition to standard precautions when in contact with individuals known or suspected of having diseases spread by direct or indirect contact (examples include norovirus, rotavirus, draining abscesses, head lice).
    • Wear gloves and gown when in contact with the individual, surfaces, or objects within his/her environment.
    • All re-usable items taken into an exam room or home should be cleaned and disinfected before removed. Disposable items should be discarded at point of use.
  • Droplet Precautions

    In addition to standard precautions, wear a surgical mask when within 3 feet (6 feet for smallpox) of persons known or suspected of having diseases spread by droplets (examples include influenza, pertussis, meningococcal disease).

  • Airborne Precautions
    • Use the following measures in addition to standard precautions when in contact with individuals known or suspected to have diseases spread by fine particles dispersed by air currents (examples include tuberculosis, measles, and SARS).
    • Put on a NIOSH-certified fit-tested N-95 respirator just before entry to an area of shared air space and wear at all times while in the area of shared air space. Remove and discard respirator just after exiting area. The respirator may be discarded into the regular trash unless contact precautions must also be followed. In this case, place the respirator in a plastic zip-lock bag, seal and then discard into the trash. A powered air-purifying respirator (PAPR) may also be used (see PPE section).
    • If available, portable high efficiency particulate air (HEPA) filtration units may be operated in the area where the infected individual is located to filter out infectious particles. (Use of such a unit does NOT eliminate the need for employees to wear respiratory protection).
  • Eye Protection

    If eye protection is indicated, wear goggles or a face shield during ALL contact with the individual, not just when splashes or sprays are anticipated, as with standard precautions.

Last Revised: June 23, 2020

Transmission-Based Precautions are the second tier of basic infection control and are to be used in addition to Standard Precautions for patients who may be infected or colonized with certain infectious agents for which additional precautions are needed to prevent infection transmission.
Source: Guideline for Isolation Precautions

Use Contact Precautions for patients with known or suspected infections that represent an increased risk for contact transmission.

  • See Guidelines for Isolation Precautions for complete details.

  • Ensure appropriate patient placement in a single patient space or room if available in acute care hospitals. In long-term and other residential settings, make room placement decisions balancing risks to other patients. In ambulatory settings, place patients requiring contact precautions in an exam room or cubicle as soon as possible.
  • Use personal protective equipment (PPE) appropriately, including gloves and gown. Wear a gown and gloves for all interactions that may involve contact with the patient or the patient’s environment. Donning PPE upon room entry and properly discarding before exiting the patient room is done to contain pathogens.
  • Limit transport and movement of patients outside of the room to medically-necessary purposes.  When transport or movement is necessary, cover or contain the infected or colonized areas of the patient’s body. Remove and dispose of contaminated PPE and perform hand hygiene prior to transporting patients on Contact Precautions. Don clean PPE to handle the patient at the transport location.
  • Use disposable or dedicated patient-care equipment (e.g., blood pressure cuffs). If common use of equipment for multiple patients is unavoidable, clean and disinfect such equipment before use on another patient.
  • Prioritize cleaning and disinfection of the rooms of patients on contact precautions ensuring rooms are frequently cleaned and disinfected (e.g., at least daily or prior to use by another patient if outpatient setting) focusing on frequently-touched surfaces and equipment in the immediate vicinity of the patient.

Use Droplet Precautions for patients known or suspected to be infected with pathogens transmitted by respiratory droplets that are generated by a patient who is coughing, sneezing, or talking.

  • See Guidelines for Isolation Precautions for complete details.

  • Source control: put a mask on the patient.
  • Ensure appropriate patient placement in a single room if possible. In acute care hospitals, if single rooms are not available, utilize the recommendations for alternative patient placement considerations in the Guideline for Isolation Precautions. In long-term care and other residential settings, make decisions regarding patient placement on a case-by-case basis considering infection risks to other patients in the room and available alternatives. In ambulatory settings, place patients who require Droplet Precautions in an exam room or cubicle as soon as possible and instruct patients to follow Respiratory Hygiene/Cough Etiquette recommendations.
  • Use personal protective equipment (PPE) appropriately. Don mask upon entry into the patient room or patient space.
  • Limit transport and movement of patients outside of the room to medically-necessary purposes. If transport or movement outside of the room is necessary, instruct patient to wear a mask and follow Respiratory Hygiene/Cough Etiquette.

Use Airborne Precautions for patients known or suspected to be infected with pathogens transmitted by the airborne route (e.g., tuberculosis, measles, chickenpox, disseminated herpes zoster).

  • See Guidelines for Isolation Precautions for complete details.

  • Source control: put a mask on the patient.
  • Ensure appropriate patient placement in an airborne infection isolation room (AIIR) constructed according to the Guideline for Isolation Precautions. In settings where Airborne Precautions cannot be implemented due to limited engineering resources, masking the patient and placing the patient in a private room with the door closed will reduce the likelihood of airborne transmission until the patient is either transferred to a facility with an AIIR or returned home.
  • Restrict susceptible healthcare personnel from entering the room of patients known or suspected to have measles, chickenpox, disseminated zoster, or smallpox if other immune healthcare personnel are available.
  • Use personal protective equipment (PPE) appropriately, including a fit-tested NIOSH-approved  N95 or higher level respirator for healthcare personnel.
  • Limit transport and movement of patients outside of the room to medically-necessary purposes. If transport or movement outside an AIIR is necessary, instruct patients to wear a surgical mask, if possible, and observe Respiratory Hygiene/Cough Etiquette.  Healthcare personnel transporting patients who are on Airborne Precautions do not need to wear a mask or respirator during transport if the patient is wearing a mask and infectious skin lesions are covered.
  • Immunize susceptible persons as soon as possible following unprotected contact with vaccine-preventable infections (e.g., measles, varicella or smallpox).

What are 3 Standard Precautions?

Hand hygiene. Use of personal protective equipment (e.g., gloves, masks, eyewear). Respiratory hygiene / cough etiquette.

What are additional precautions and when should they be used?

Additional precautions are measures used in addition to Standard Precautions when extra practices are required to prevent transmission of specific infectious diseases.

What does additional precaution include?

Additional Precautions are infection prevention and control precautions and practices required in addition to Routine Practices. They are based on the mode (means) of transmission of the infectious agent: airborne, droplet, and contact.

What are the 4 types of precautions?

Each kind of transmission-based precaution is dependent on the type of infection or pathogen the patient or source has, as outlined as follows:.
Contact precautions: ... .
Bloodborne precautions: ... .
Droplet precautions: ... .
Airborne precautions:.