Transmission-based Precautions I: Contact, Enteric, and Droplets

Contact precautions are implemented for patients known or suspected to be infected or colonized with epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact. These precautions protect other patients by isolating the infected individual, restricting their movement, and requiring healthcare workers to wear appropriate personal protective equipment before entering the room.

Patient-care equipment such as thermometers and stethoscopes must not be shared among patients without proper disinfection. This prevents transmission of infectious agents from one patient to another. Equipment should be cleaned, sterilized, and disinfected according to established protocols before use with different patients to maintain infection control standards.

Enteric precautions target infections transmitted through contaminated food, water, or contact with fecal matter and vomitus. They require patient isolation, use of gloves and aprons, and mandatory handwashing with soap and water when direct contact occurs with feces or vomitus, as alcohol-based hand rubs alone are insufficient for enteric pathogen elimination.

Droplet precautions do not require special ventilation because respiratory droplets and those from projectile vomiting or severe diarrhea are relatively large and do not remain suspended in the air for extended periods. These droplets travel short distances before settling, making standard room isolation with closed doors sufficient to prevent transmission to other patients.

Droplet precautions require healthcare workers to wear gloves and an apron for any procedure involving patient contact. Additionally, a face mask should be placed on the infected patient to reduce droplet dispersal. The patient's movement outside the room should be restricted unless medically necessary to minimize exposure risk to other individuals.

Enteric precautions must be initiated at the first instance of diarrhea or vomiting and continued until a definitive diagnosis confirms the symptoms have a non-infectious cause. This precautionary approach prevents transmission of enteric pathogens that enter the body orally or through contact with contaminated materials from infected individuals.

Transmission-based precautions for contact, enteric, and droplet transmission are part of a comprehensive infection prevention framework. These precautions work alongside standard precautions and other measures to prevent healthcare-associated infections. Additional transmission-based precautions exist for airborne and protective environment scenarios requiring different control measures.