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Isolation precautions

Definition

Isolation precautions create barriers between people and germs. These types of precautions help prevent the spread of germs in the hospital.

Anybody who visits a hospital patient who has an isolation sign outside their door should stop at the nurses' station before entering the patient's room. The number of visitors and staff who enter the patient's room may be limited.

Different types of isolation precautions protect against different types of germs.

Standard Precautions

When you are close to patients or handling blood, bodily fluid, bodily tissues, mucous membranes, or areas of open skin, you must use personal protective equipment (PPE).

Follow standard precautions with all patients, based on the type of exposure expected.

Depending on the anticipated exposure, types of PPE that may be required include:

• Gloves

• Masks and goggles

• Aprons, gowns, and shoe covers

It is also important to properly clean up afterward.

Transmission-based Precautions

Transmission-based precautions are extra steps to follow for illnesses that are caused by certain germs. Transmission-based precautions are followed in addition to standard precautions. Some infections require more than one type of transmission-based precaution.

Follow transmission-based precautions when an illness is first suspected. Stop following these precautions only when that illness has been treated or ruled out and the room has been cleaned.

Patients should stay in their rooms as much as possible while these precautions are in place. They may need to wear a mask when they leave their rooms.

Airborne precautions may be needed for germs that are so small they can float in the air and travel long distances.

• Airborne precautions help keep staff, visitors, and other people from breathing in these germs and getting sick.

• Germs that warrant airborne precautions include chickenpox, measles, and tuberculosis (TB) bacteria infecting the lungs or larynx or voicebox (larynx).

• People who have these germs should be in special rooms where the air is gently sucked out and not allowed to flow into the hallway. This is called a negative pressure room.

• Anyone who goes into the room should put on a well-fitted respirator mask before they enter.

Contact precautions may be needed for germs that are spread by touching.

• Contact precautions help keep staff and visitors from spreading the germs after touching a person or an object the person has touched.

• Some of the germs that contact precautions protect from are C difficile, norovirus, and COVID-19. These germs can cause serious infection in the intestines or lungs.

• Anyone entering the room who may touch the person or objects in the room should wear a gown and gloves.

Droplet precautions are used to prevent contact with mucus and other secretions from the nose and sinuses, throat, airways, and lungs.

• When a person talks, sneezes, or coughs, droplets that contain germs can travel about 3 feet (90 centimeters).

• Illnesses that require droplet precautions include flu (influenza), whooping cough (pertussis), mumps, and respiratory illnesses, such as those caused by coronavirus infections including COVID-19.

• Anyone who goes into the room should wear a surgical mask.

References

Calfee DP. Prevention and control of health care-associated infections. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 261.

Centers for Disease Control and Prevention website. Isolation precautions guideline. www.cdc.gov/infection-control/hcp/isolation-precautions/?CDC_AAref_Val=https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html. Updated November 27, 2023. Accessed June 18, 2024.

Palmore TN. Infection prevention and control in the health care setting. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 298.

Review Date: 10/13/2023

Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.