Transmission-Based Precautions

Contact precautions

Contact precautions apply when the organism spreads by direct or indirect touch: Clostridioides difficile, multidrug-resistant organisms, scabies, draining wounds and norovirus.

Gown and gloves go on before entering the room and come off before leaving. Equipment is dedicated to the client where possible.

Droplet precautions

Droplets are large, travel only three to six feet and fall out of the air. Influenza, pertussis, Neisseria meningitidis, mumps and group A streptococcal pharyngitis all sit here.

A surgical mask worn by the nurse within the droplet range is sufficient. No special air handling is required, and the door may stay open.

Airborne precautions

Airborne organisms remain suspended in small droplet nuclei and travel on air currents. The classic trio is tuberculosis, measles (rubeola) and varicella; disseminated herpes zoster is included.

These clients need an airborne infection isolation room with negative pressure and at least six to twelve air exchanges per hour, with the door kept closed. Staff wear a fit-tested N95 respirator or higher.

• Tuberculosis — N95, negative pressure, door closed
• Measles and varicella — airborne plus contact; immune staff preferred
• Client leaves the room only when necessary, wearing a surgical mask

Transport logic

Transport reverses the barrier. Inside the room the nurse wears the protection. Leaving the room, the source is contained: the client wears a surgical mask for droplet and airborne precautions, and draining wounds are covered with a clean dressing for contact precautions.

Notify the receiving department before departure so they can prepare — but containment comes first.