Standard Precautions
Applied to all patients regardless of diagnosis. Includes: hand hygiene, PPE (gloves, gown, mask, eye protection based on anticipated exposure), safe needle handling, patient care equipment management, environmental cleaning. Key principle: treat ALL blood and body fluids as potentially infectious.
Transmission-Based Precautions
Contact: MRSA, VRE, C. diff, scabies — gloves + gown. Droplet: influenza, meningococcal, pertussis — surgical mask + private room. Airborne: TB, measles, varicella — N95 + negative pressure room. Some conditions require combined precautions.
Chain of Infection
Six links: Infectious agent → Reservoir → Portal of exit → Mode of transmission → Portal of entry → Susceptible host. Break any link to prevent transmission. Nursing actions: hand hygiene (entry), isolation (exit/transmission), vaccines (host susceptibility), antibiotics (agent).
Isolation Types
Airborne isolation: negative pressure room, door closed, N95 for all entering. Droplet isolation: private room or cohort, surgical mask within 3 feet. Contact isolation: gloves and gown upon room entry, dedicated equipment. Protective (reverse) isolation: for severely immunocompromised — positive pressure room, prevent infection transmission TO the patient.
Important Notes
- C. difficile: alcohol-based hand rub does NOT kill spores — soap and water ONLY.
- Airborne precautions require NIOSH-certified N95 respirator — surgical masks are insufficient.
Clinical Tips
- Remember ICAHO mnemonic for isolation signs: I = isolation type, C = call before entering, A = attire needed, H = hand hygiene, O = other instructions.
Summary
Infection control is the foundation of safe practice. Consistent application of standard and transmission-based precautions prevents HAIs and protects both patients and healthcare workers.
