Guidelines on Infection Prevention and Control for Cork ...

Guidelines on Infection Prevention and Control 06: Transmission Based Precautions Revision 01

Cork Kerry Community Healthcare of 21

This is a controlled document, the most recent version is on www.hse.ie/infectioncontrol 2017

Guidelines on Infection Prevention

and Control for Cork Kerry

Community Healthcare

06: Transmission Based Precautions

This guidance document has been adopted as the policy document by:

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Date adopted:.........................................................

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Infection Prevention and Control, Cork Kerry Community Healthcare,




SECTION 6

TRANSMISSION BASED PRECAUTIONS

1. Introduction 2. Contact Precautions 3. Droplet Precautions 4. Airborne Precautions

Appendices

Appendix 6.1 Transmission Based Precautions Signs

• Contact Precautions • Droplet Precautions • Airborne Precautions

Appendix 6.2 Application of Standard and Transmission

Based Precautions

Appendix 6.3 Donning and Removal of Personal Protective Equipment

Developed by Niamh Mc Donnell, Patricia Coughlan, Liz Forde, Helena Sheahan

Infection Prevention & Control Nurses

In conjunction with ---------------------------------

Date Approved September 2017

Approved by Cork Kerry Community Healthcare

Healthcare Associated Infections (HCAI) / Antimicrobial Resistance (AMR)

Committee

Reference number IPCG 6.0/ 2017 Revision number 01

Revision cycle September 2020 or sooner if new evidence becomes available

Responsibility for

review

Infection Prevention and Control Nurses




1. Introduction

Transmission Based Precautions are additional precautions that are recommended when Standard Precautions alone may not be sufficient to prevent the transmission

of certain infectious agents such as Clostridium difficile, influenza or tuberculosis etc.

Transmission Based Precautions address the specific mode of transmission of the infecting micro-organism which can be by

� contact - direct or indirect, and/or � droplet, and/or � airborne.

The key elements of Transmission Based Precautions are;

• Resident Placement • Hand hygiene • Personal protective equipment • Transport • Care equipment • Environmental cleaning • Management of laundry • Occupational health and • Duration of precautions.

Before implementing Transmission Based Precautions, it is important to first consider;

• the individual resident • the setting • the infectious agent

• the presence of other vulnerable resident and • the type of procedures/activities being undertaken.

Please discuss individual cases with Infection Prevention and Control for further advice.

Standard Precautions must always be used in addition to Transmission Based Precautions.




2. Contact Precautions

Contact Precautions are recommended in addition to Standard Precautions when a resident is known or suspected to be infected or colonised with specific infectious

agents that are spread by direct or indirect contact. Examples of infections spread by contact include, Clostridium difficile Infection (CDI), Norovirus or some multi-

drug resistant organisms (MDRO’s).



Key Elements of Contact Precautions

Resident Placement

Appropriate resident placement is assessed in conjunction with infection prevention and control or, where relevant the Department of Public Health. A risk assessment

will include the suspected/confirmed infection and the infection risk to other resident in the vicinity to determine resident placement.

• A single room with staff hand washing facilities and en-suite toilet facilities is the preferred option.

However, if a single room is not available, the following options may be advised;

1. Single room with staff hand washing facilities but with no en-suite facilities. A dedicated commode must be used.

2. A single room without any hand washing or toilet facilities. A dedicated commode must be used.

A notice should be placed on the room door/area advising visitors and other HCW’s

to report to staff-in-charge before entering. Signage indicating only the precautions that are required and not information regarding the residents condition to maintain

their privacy. Refer to appendix 6.1 for Contact Precautions signs.

Resident should be • educated regarding the reason/indication for Contact Precautions, • educated to wash their hands with soap and water after using the

bathroom and before eating. Resident who are unable to perform hand hygiene should be given assistance and

• requested not to leave the room unless absolutely necessary.

Hand Hygiene

Hand hygiene is the single most important measure in preventing and reducing the spread of infection. In accordance with The WHO Moments for Hand Hygiene, clean

hands

1. Before touching a resident. 2. Before aseptic or clean procedures. 3. After blood or body fluid exposure risk. 4. After touching a resident. 5. After touching resident surroundings/environment.




• Hands should be decontaminated with an alcohol hand rub or an antimicrobial

soap except in the following situations- C. difficile: Hands should be washed with soap (antimicrobial or non-

antimicrobial) and water. Alcohol hand rubs are not effective against C. difficile spores. Research indicates that removal of C. difficile

occurs as a result of the physical action of hand washing and rinsing (Dept of Health, 2014).

Norovirus: There is conflicting evidence and guidance regarding the efficacy of

hand hygiene products on Norovirus (WHO, 2009, Public Health England, 2012). Therefore from a practical application hand washing

with soap and water is advised when caring for all patients with diarrhoea.

Personal Protective Equipment (PPE)

In addition to the PPE advised for Standard Precautions the following measures apply to resident being cared for using Contact Precautions:

• Disposable gloves and plastic aprons should be worn for all care activities that involve direct contact with the resident skin, equipment used for client care or surfaces in close proximity to the resident.

• Aprons and gloves should be put on before entering the resident room. • PPE should be removed and hand hygiene performed before leaving the

resident room. PPE should be disposed of in the resident room. • During care gloves should be changed and hand hygiene carried out in line

with the 5 moments for hand hygiene.

Resident Transport

The movement and transport of resident should be limited to essential purposes only.

If movement or transport of a resident is required;

• Inform transport personnel and the receiving department/healthcare facility of the need for Contact Precautions.

• Remove and dispose of contaminated aprons and gloves and perform hand hygiene prior to transporting the resident being cared for using Contact Precautions.

• Don appropriate PPE (apron/gown and gloves) prior to touching the resident at the transport destination.

• Transport equipment (stretcher, bed, wheelchair) used for the transfer must be cleaned and decontaminated before use on another resident.

Care Equipment

In addition to Standard Precautions the following applies to resident being cared for

using Contact Precautions.

• Only take essential equipment and supplies into the room. Do not overstock

the room as unused stock will have to be discarded on cessation of Contact Precautions.

• Residents’ charts/records should not be taken into the room.

• Medical devices (e.g. thermometers, stethoscopes) and care equipment (e.g. commode) should be dedicated for individual resident use for the duration of

Contact Precautions. Where possible use single use items.




• If communal equipment is used, such equipment must be cleaned and

disinfected in accordance with the manufacturers instructions, immediately after use. For majority of items use

o a general purpose neutral detergent in a solution of warm water followed by a disinfection solution of 1,000 parts per million (ppm)

available chlorine or o a combined detergent/disinfectant solution at a dilution of 1,000 ppm

available chlorine.

Environmental Cleaning

In addition to Standard Precautions the following applies were a resident is being cared for using Contact Precautions.

• The residents’ environment should be thoroughly cleaned using a neutral detergent and water daily. Particular attention should be given to frequently touched surfaces (e.g. bed rails, over bed table, door handles) and equipment in

the immediate vicinity of the resident. • In addition to cleaning, the requirement for disinfection should be based on a

risk assessment, considering the following: • National guidance on specific infectious agents e.g Norovirus • Resident ability to maintain their hygiene

• Degree of environmental contamination • Local guidance from Infection Prevention and Control Nurse.

• Where required clean and disinfect the environment using either o a general purpose neutral detergent in a solution of warm water followed by

a disinfection solution of 1,000 parts per million (ppm) available chlorine or o a combined detergent/disinfectant solution at a dilution of 1,000 ppm

available chlorine. • Disposable gloves should be worn for environmental cleaning/disinfection when

implementing Contact Precautions.

Deep cleaning of the environment following transfer/discharge/death of resident who was on Contact Precautions

Prior to initiating environmental cleaning and disinfection:

• All privacy and window curtains must be removed and sent for laundering. • All disposable items including paper towels and toilet paper must be discarded.

• All sterile and non-sterile supplies in the resident environment which cannot be reprocessed must be discarded.

• Clean and disinfect the environment and all resident care equipment using either o a general purpose neutral detergent in a solution of warm water followed by

a disinfection solution of 1,000 parts per million (ppm) available chlorine or o a combined detergent/disinfectant solution at a dilution of 1,000 ppm

available chlorine.

Management of Laundry

All linen from a resident being cared for using Contact Precautions should be placed

in an alginate/water soluble bag for laundering and then placed in the appropriate laundry stream as per local laundry policy.

Occupational Health




In addition to Standard Precautions, staff should be aware of their immune status

for infectious pathogens (e.g. Varicella).

Non- immune staff should avoid direct contact with infected resident. If a staff

member is unsure of his/her immune status for a particular pathogen, it is advisable to clarify with the Occupational Health Department.

Visitors

• Where visiting is essential advice visitors of the precautions needed before and

after visiting including, not to visit other residents in the facility. • Visitors should be encouraged to carry out hand hygiene before entering and on

leaving the room, and before and after resident contact where they provide direct care.

• Visitors are not required to wear PPE unless they are carrying out direct care for

a resident.

Duration of Contact Precautions

Infection Prevention and Control advice should be sought. Contact Precautions should be continued

• while the resident remains symptomatic

• and/or considered infectious or

• until the completion of effective treatment.




3. Droplet Precautions

Droplet Precautions are recommended in addition to Standard Precautions for resident with infectious agents transmitted by large droplets. Droplet transmission

occurs when large droplets from the respiratory tract of an infected individual are transferred directly on to a mucosal surface or conjunctivae (e.g. eyes, nose,

mouth) of another individual. Respiratory droplets are expelled when a person is coughing, sneezing or talking, they may also be expelled during certain healthcare aerosol generating procedures such as intubation. Transmission from large particle

droplets requires relatively close contact (approximately 3 feet) between the infected individual and another person.

Examples of infections spread by droplets are influenza, meningococcal disease (for the first 24 hours of antimicrobial treatment), group A streptococcal (for the first 24

hours of antimicrobial treatment) and mumps.



Key Elements of Droplet Precautions

Resident Placement

Appropriate resident placement is assessed in conjunction with infection prevention and control or, where relevant the Department of Public Health. A risk assessment will include the suspected/confirmed infection and the infection risk to other

resident in the vicinity to determine resident placement.

• A single room with staff hand hygiene and en-suite toilet facilities is the

preferred option. The door of the room should remain closed.

A notice should be placed on the room door/area advising visitors and other HCW’s

to report to staff-in-charge before entering. Signage indicating only the precautions that are required and not information regarding the residents condition to maintain their privacy. Refer to appendix 6.1 for Droplet Precautions signs.

Resident should be educated

• regarding the reason/indication for Droplet Precautions, • on respiratory hygiene and cough etiquette, • on how and when to perform hand hygiene. Resident who are unable to

perform hand hygiene should be given assistance and Residents should be requested not to leave the room unless absolutely necessary.

Hand Hygiene

Hand hygiene is the single most important measure in preventing and reducing the

spread of infection. In accordance with The WHO Moments for Hand Hygiene, clean hands

1. Before touching a resident. 2. Before aseptic or clean procedures. 3. After blood or body fluid exposure risk.




4. After touching a resident. 5. After touching resident surroundings/environment.


In addition to the PPE advised for Standard Precautions the following measures apply to resident being cared for using Droplet Precautions:

PPE is • applied before entering the resident’s room. • put on and removed as outlined in Appendix 6.3 “Donning and Removal of

PPE” Clean hands before leaving the resident room.

Surgical face masks

• A fluid repellent surgical face mask should be worn by all HCW’s when

undertaking care activities and within 3 feet/1 metre of a resident. • Masks should be changed when heavily contaminated e.g. wet with breath

moisture or if torn or damaged. • Masks are a single use items. • Respirator mask (FFP2/3) mask may be required for specific suspected or

confirmed infections during aerosol generating procedures such as

intubation/manual ventilation of a resident with influenza.

Gloves and Plastic Apron Gloves and a disposable plastic apron should be worn for all activities that involve

direct contact with the residents’ skin or surfaces and equipment in close proximity to the client.

During care gloves should be changed and hand hygiene carried out in accordance with the WHO 5 Moments for Hand Hygiene

Resident Transport

The movement and transport of resident should be limited to essential purposes

only.

If movement/transport of a resident is necessary

• Inform transport personnel and the receiving department/healthcare facility of the need for Droplet Precautions.

• If tolerated, the resident should be instructed to wear a surgical facemask,

and instructed on respiratory hygiene and cough etiquette when moving outside their room.

• Healthcare workers should wear a surgical face mask where a resident is unwilling or unable to wear a surgical face mask.

• Remove and dispose of contaminated aprons and gloves and perform hand

hygiene prior to transporting resident on Droplet Precautions. • Don PPE prior to contact with the resident at the transport destination.

• Transport equipment (stretcher, bed, wheelchair) used for the transfer must be cleaned and disinfected after use.

Care Equipment

In addition to the Standard Precautions the following measures apply to resident on

Droplet Precautions:




• Only take essential equipment and supplies into the room. Do not overstock

the room as unused stock will have to be discarded on cessation of Droplet Precautions.

• Resident charts/records should not be taken into the room. • Medical devices (e.g. thermometers, stethoscopes) and resident care

equipment (e.g. commode) should be dedicated for individual resident use for the duration of Droplet Precautions. Where possible use single use items.

• If communal equipment is used, such equipment must be cleaned and

disinfected in accordance with the manufacturers instructions, immediately after use. For majority of items use

o a general purpose neutral detergent in a solution of warm water followed by a disinfection solution of 1,000 parts per million (ppm) available chlorine or

o a combined detergent/disinfectant solution at a dilution of 1,000 ppm available chlorine.


In addition to Standard Precautions the following applies to residents/client being cared for using Droplet Precautions.

• Clean and disinfect the environment using either o a neutral detergent and disinfect a general purpose neutral detergent in a

solution of warm water followed by a disinfection solution of 1,000 parts

per million (ppm) available chlorine or o a combined detergent/disinfectant solution at a dilution of 1,000 ppm

available chlorine. • The frequency of cleaning and disinfection may need to be increased if

resident are producing copious amounts of respiratory secretions.

• Items or surfaces likely to be contaminated with blood or body fluids/excretions/secretions should be cleaned and disinfected immediately.

• Personal protective equipment as recommended above should be worn for environmental cleaning/disinfection due to Droplet Precautions.

Deep cleaning of the environment following transfer/discharge/death of resident who was on Droplet Precautions


o All privacy and window curtains must be removed and sent for laundering.

o All disposable items including paper towels and toilet paper must be

discarded. o All sterile and non-sterile supplies in the resident environment which cannot

be reprocessed must be discarded on transfer/discharge. o Clean and disinfect the environment using either

o a neutral detergent and disinfect a general purpose neutral detergent in a

solution of warm water followed by a disinfection solution of 1,000 parts per million (ppm) available chlorine or






All linen from a resident being cared for with Droplet Precautions should be placed in an alginate/water soluble bag for laundering and then placed in the appropriate

laundry stream as per local policy.

Occupational Health

In addition to Standard Precautions, staff should be aware of their immune status for infectious pathogens known to be transmissible via droplet route (e.g. mumps).

Non-immune staff should avoid direct contact with infected resident. If a staff member is unsure of his/her immune status for a particular pathogen, it is

advisable to clarify with Occupational Health Dept.

Visitors

• Visitors should be limited and visitors who are non-immune to the infection should avoid contact until the resident is deemed to be no longer infectious to

others. • Where visiting is essential and visitors are non-immune, visitors should be

educated on the precautions needed before and after visiting including

1. how to put on a surgical mask prior to entering the resident room 2. how to remove a surgical mask, dispose of it safely and clean their hands

and 3. requested not to visit other resident in the facility.

Duration of Droplet Precautions

Infection Prevention and Control advice should be sought. Droplet Precautions

should be continued

• while the resident remain symptomatic

• and/or considered infectious or

• until the completion of effective treatment.




4. Airborne Precautions

Airborne Precautions are recommended in addition to Standard Precautions to prevent the transmission of infections spread by very small respiratory particles

which are expelled from an infected individual during activities like coughing, sneezing or talking. They are also generated during particular healthcare aerosol

generating procedures such as intubation.

Examples of infection spread by airborne route are infectious pulmonary or laryngeal tuberculosis, rubella, measles and chicken pox.



Key Elements of Airborne Precautions

Resident Placement

Where applicable contact Infection Prevention and Control/the Department of Public Health to assess appropriate resident placement. A risk assessment will include the

suspected/confirmed infection and the infection risk to other residents in the vicinity to determine resident placement.

Depending on what infection is suspected,

• An airborne isolation room may be required. An airborne isolation room is a negative pressure isolation room with an anteroom or a room with neutral

pressure design. The door must remain closed. However if an airborne isolation room is not available, the following may be

advised; 1. transfer to another unit/hospital with suitable facilities, 2. a single room with staff hand washing and ensuite facilities and the door

must remain closed.

A notice should be placed on the room door/area advising visitors and other HCW’s to report to staff-in-charge before entering. Signage indicating only the precautions that are required and not information regarding the residents condition to maintain

their privacy. Refer to appendix 6.1 for Airborne Precautions signs.

Resident should be educated • regarding the reason/indication for Airborne Precautions • on respiratory hygiene and cough etiquette

• on how and when to perform hand hygiene. Resident who are unable to perform hand hygiene should be given assistance

Residents should be • instructed not to leave the room unless absolutely necessary and • to wear a surgical facemask if movement outside the room is required

and is tolerated.

Hand Hygiene

Hand hygiene is the single most important measure in preventing and reducing the spread of infection. In accordance with The WHO Moments for Hand Hygiene,

decontaminate hands




1. Before touching a resident. 2. Before aseptic or clean procedures. 3. After blood or body fluid exposure risk. 4. After touching a resident. 5. After touching resident surroundings/environment.


In addition to the PPE advised for Standard Precautions the following measures apply to residents being cared for using Airborne Precautions:

PPE is

• applied before entering the resident’s/client’s room.

• put on and removed as outlined in Appendix 6.3 “Donning and Removal of PPE”

Clean hands before leaving the resident room. Respiratory Masks and other face protection

• FFP3 masks are recommended for aerosol generating procedures (e.g.

suctioning) for all residents and for routine care of residents with Multi Drug

Resistant TB (MDR- TB) and Extensively Drug Resistant TB (XDR-TB).

• FFP2 masks are recommended for routine care of residents with known or

suspected pulmonary or laryngeal TB where MDR-TB or XDR-TB is not

suspected.

• HCWs visiting a resident in their own home should wear either an FFP2 or

FFP3 mask in accordance with the above recommendations for FFP2 and

FFP3 masks. Resident privacy must be maintained if mask is worn in the

home. Apply the mask on entry in to the home and remove mask on leaving

the home.

The supervising clinician should be consulted before the use of masks is

discontinued.

The FFP 2 and FFP 3 masks must; • Conform to EN1492001

• Be fit tested. In order to be effective the mask must fit tightly to the wearers face, fit testing should be undertaken by a trained professional.

• Be fit checked (i.e. the wearer must check that the mask fits properly on

their face every time they enter the resident area). • Be put on before entering the isolation room.

• Be changed when torn or damaged. • Be removed and disposed of as per local waste policy.

Gloves and a disposable plastic apron • Gloves and a disposable plastic apron should be worn for all activities that

involve direct contact with the resident/residents skin or surfaces and equipment in close proximity to the resident/resident (e.g. medical equipment, beside locker, bed rails etc).

• PPE must be changed and hand hygiene performed in accordance with WHO 5 Moments for hand hygiene during care.




Care Equipment

In addition to the Standard Precautions the following measures apply to resident on Airborne Precautions:

• Only take essential equipment and supplies into the room. Do not overstock the room as unused stock will have to be discarded on cessation of Airbourne

Precautions. • Resident charts/records should not be taken into the room. • Medical devices (e.g. thermometers, stethoscopes) and resident care

equipment (e.g. commode) should be dedicated for individual resident use for the duration of Airborne Precautions. Where possible use single use

items. • If communal equipment is used, such equipment must be cleaned and

disinfected in accordance with the manufacturers instructions, immediately

after use. For majority of items use o a general purpose neutral detergent in a solution of warm water

followed by a disinfection solution of 1,000 parts per million (ppm) available chlorine or

o a combined detergent/disinfectant solution at a dilution of 1,000 ppm

available chlorine.


In addition to Standard Precautions the following applies to residents being cared

for using Airborne Precautions.

• Clean and disinfect the environment using either o a neutral detergent and disinfect a general purpose neutral detergent in a

solution of warm water followed by a disinfection solution of 1,000 parts per million (ppm) available chlorine or


• The frequency of cleaning and disinfection may need to be increased if resident are producing copious amounts of respiratory secretions.

• Items or surfaces likely to be contaminated with blood or body

fluids/excretions/secretions should be cleaned and disinfected immediately. • Personal protective equipment as recommended above should be worn for

environmental cleaning/disinfection due to Airborne Precautions.

Deep cleaning of the environment following transfer/discharge/death of

resident who was on Airborne Precautions


• All privacy and window curtains must be removed and sent for laundering. • All disposable items including paper towels and toilet paper must be discarded. • All sterile and non-sterile supplies in the resident environment which cannot be

reprocessed must be discarded on transfer/discharge. • Clean and disinfect the environment using either

o a neutral detergent and disinfect a general purpose neutral detergent in a solution of warm water followed by a disinfection solution of 1,000 parts per million (ppm) available chlorine or





Resident Movement/Transport

Residents being cared for using Airborne Precautions should not be transferred unless their medical condition warrants it or for placement in an appropriate

isolation room.

If movement/transport of a resident is necessary;

• The resident should be encouraged to wear a surgical mask, and instructed on respiratory hygiene and cough etiquette.

• Surgical masks if worn should be changed when heavily contaminated, wet with breath moisture or damaged.

• It may be necessary for transport personnel to wear a surgical mask or respirator (depending on the individual disease suspected) if the resident cannot tolerate wearing a surgical mask.

• FFP2 or FFP3 masks are not recommended for use by resident on Airborne Precautions.

• Remove and dispose of contaminated aprons and gloves and perform hand hygiene prior to transporting residents on Airborne Precautions.

• Don appropriate PPE (apron/gown and gloves) prior to contact with the resident at the transport destination.


All linen from a resident being cared for using Airborne Precautions should be placed in an alginate/water soluble bag for laundering and then placed in the appropriate laundry stream as per local policy.

Occupational Health

In addition to Standard Precautions, staff should be aware of their immune status for infectious pathogens known to be transmitted via the airborne route (e.g., varicella zoster virus, measles virus). Non-immune staff should avoid direct contact

with infected residents. Specific guidance should be sought from the occupational health department.

Visitors

• Visitors should be limited and visitors who are non-immune to the infection

should avoid contact until the resident is deemed to be no longer infectious to others.

• Where visiting is essential and visitors are non-immune, visitors should be educated on the precautions needed before and after visiting including

1. how to put on the appropriate mask prior to entering the resident room 2. how to remove the mask, dispose of it safely and clean their hands and 3. requested not to visit other residents in the facility.

Duration of Airborne Precautions

Airborne precautions should continue until

• signs and symptoms of infection have resolved, or

• upon completion of the infectious period, or

• until effective treatment has been completed.

In the case of TB the duration of precautions will be on the advice of the supervising physician.




References and Bibliography Department of Health (2014) Surveillance, Diagnosis and Management of Clostridium difficile Infection in Ireland National Clinical Guideline No. 3 Available at http://www.hpsc.ie/A-Z/Gastroenteric/Clostridiumdifficile/Guidelines/File,13950,en.pdf Healthcare Infection Control Practices Advisory Committee (2007) Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007. http://www.documents.hps.scot.nhs.uk/hai/infection-control/transmission-based-precautions/mic-p-tbp-2009-04.pdf Health Protection Surveillance Centre (2010) Guidelines on the Prevention and Control of Tuberculosis in Ireland National TB Advisory Committee Dublin. Amended 2014. http://www.hpsc.ie/a-z/vaccinepreventable/tuberculosistb/guidance/File,4349,en.pdf Public Health England (2012) Norovirus: managing outbreaks in acute and community health and social care settingshttps://www.gov.uk/government/publications/norovirus-managing-outbreaks-in-acute-and-community-health-and-social-care-settings

Royal College of Physicians of Ireland/HSE (2015) Guidelines for Hand Hygiene in Irish Healthcare Settings (2015) update of the 2005 Guidelines, Dublin. http://www.hpsc.ie/A-

Z/Gastroenteric/Handwashing/Publications/File,15060,en.pdf World Health Organisation (2009) WHO Guidelines on Hand Hygiene in Healthcare. First Global Resident Safety Challenge. http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf

World Health Organisation (2012) Hand Hygiene in Out Patient and Home –based care and Long-term care facilities. Geneva.




Appendix 6.1 Transmission Based Precaution Signs –Contact Precautions

Posters available on www.hse.ie/infectioncontrol




Appendix 6.1 –Transmission Based Precautions Signs– Droplet Precautions





Appendix 6.1 Transmission Based Precaution Signs –Airborne Precautions





Appendix 6.2 Application of Standard and Transmission Based Precautions

Type of

precautions

Example of

infectious agent

Single room Gloves Apron/gown Mask Application and

Removal of PPE

Standard Standard precautions apply to the care of all residents regardless of their diagnosis or presumed infectious status

Contact C. difficile, enteric

infections, Norovirus,

infectious skin

conditions

�

�

�

Apply PPE before entering

single room

Remove and dispose of

PPE inside single room

Droplet Influenza,

meningococcal

disease, mumps

�

�

�

�


single room


PPE inside single room

Airborne Open

Pulmonary/Laryngeal

TB, chicken pox,

measles

�

�

�

�


single room


PPE outside single room




Appendix 6.3 Donning and Removal of Personal Protective Equipment

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