Contact Precautions

In addition to Standard Precautions, use Contact Precautions in the care of patients known or suspected to have a serious illness easily transmitted by direct patient contact or by indirect contact with items in the patient’s environment.

Illnesses requiring contact precautions may include, but are not limited to: presence of stool incontinence (may include patients with norovirus, rotavirus, or Clostridium difficile), draining wounds, uncontrolled secretions, pressure ulcers, presence of generalized rash, or presence of ostomy tubes and/or bags draining body fluids.

Additional Personal Protective Equipment (PPE) for Contact Precautions

Contact precautions are in addition to Standard Precautions

PLUS

Gloves

• Wear gloves when touching the patient and the patient’s immediate environment or belongings
• Remove gloves promptly after use and discard before touching non-contaminated items or environmental surfaces, and before providing care to another patient
• Wash hands immediately after removing gloves

PLUS

Gowns

• Wear a fluid resistant, non-sterile gown if substantial contact with the patient or their environment is anticipated
• Do not wear the same gown for the care of more than one patient

Additional Procedures

Room

• Private room or cohort, (room) patients infected or colonized with the same organism
• Prioritize placement of patients in an exam room if they have stool incontinence, draining wounds and/or skin lesions that cannot be covered, or uncontrolled secretions

Patient

• Instruct patients with known or suspected infectious diarrhea to use a separate bathroom, if available; clean/disinfect the bathroom before it can be used again

How contact transmission occurs:

• Contact transmission can occur in two ways:
  • Direct Contact Transmission
  • Indirect Contact Transmission

Contact precautions are required to protect against either direct or indirect transmission.

Contact precautions are indicated for persons with gastrointestinal (diarrheal) illness, and incontinent persons including those who use incontinent products.

Direct Contact Transmission

• Involves body-surface to body-surface contact and physical transfer of microorganisms between a susceptible person (host) and an infected or colonized person.
  
  
• More often occurs between a health care worker and a patient than between patients.

Indirect Contact Transmission

• Involves contact of susceptible person (host) with a contaminated intermediate object such as needles, dressings, gloves or contaminated (unwashed) hands.
  
  
• Disease is more likely to develop following direct or indirect contact transmission when the pathogen is highly virulent or has a low infectious dose or the patient or health care worker is immunocompromised.
  
  
• Poor hand hygiene is most often cited as a cause of contact transmission.

see also>>Personal Protective Equipment (PPE) for Infection Control