Lippincott Nursing Pocket Card - April 2022

Isolation Precautions



Isolation precautions create barriers between microbes and patients, staff, and equipment to prevent the spread of infection in the health care setting.


Standard Precautions

Standard precautions are based on the principle that all blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes may contain transmissible infectious agents. Standard precautions are the minimal protection that should be used to care for all patients at all times to protect health care workers and to prevent spread from health care worker to patient. They apply to all patients, regardless of suspected or confirmed infection status in all health care settings.

Hand Hygiene

  • Either soap and water or alcohol-based hand disinfection (AHD) may be used.
  • Perform after touching blood, body fluids, secretions, excretions, and contaminated items.
  • Perform immediately after removing gloves and before and after patient contact.

Personal Protective Equipment (PPE)

  • Gloves: for touching blood, body fluids, secretions, excretions, contaminated items, mucous membranes, and non-intact skin
  • Gown: during procedures and patient care activities with anticipated exposure of skin/clothes to body fluids, secretions, excretions
  • ​Mask/eye protection: during procedures and patient care activities with anticipated splashes or sprays of blood, body fluids, or secretions

Safe Injection

  • Needles and syringes are single-use devices.
  • Limit use of multi-dose vials, and dedicate to a single patient, when possible.
  • Dispose of needles and sharp instruments in impervious containers.

Safe Handling

  • Safely handle potentially contaminated equipment or surfaces in the patient environment.
  • Ensure environmental cleaning and disinfection, per facility policy.

Respiratory Hygiene

  • Dispose of tissues in no-touch receptacles.
  • Perform hand hygiene after soiling hands with respiratory secretions.
  • Use mask or maintain spatial separation (greater than 6 feet) if possible.
  • Hospitals and outpatient settings are currently requiring all patients and staff to wear a surgical face mask at all times to prevent transmission of COVID-19.

Transmission-based Precautions

Transmission based precautions provide additional infection control measures based on disease specific recommendations and should always be used in addition to standard precautions.
Contact Precautions
Contact precautions prevent transmission of infectious organisms spread by direct or indirect contact with the patient or the patient’s environment. 
Contact precautions include:
  • Private room or cohort
  • Clean, nonsterile gloves when entering the room; remove before exiting
  • Clean, nonsterile gown when entering the room if substantial contact with the patient or potentially contaminated areas in the patient’s environment is anticipated; remove before exiting
  • Limit transport to essential purposes and ensure precautions are taken to minimize contamination of environmental surfaces and equipment.
  • When possible, dedicate the use of noncritical patient care equipment to a single patient and avoid sharing between patients.
  • Indications:
    • Colonization of any bodily site with multidrug-resistant bacteria such as Methicillin Resistant Staphylococcus Aureus (MRSA), Vancomycin Resistant Enterococcus (VRE), and drug-resistant gram-negative organisms
    • Enteric infections (Norovirus, C. difficileEscherichia coli)
    • Viral infections (Herpes Simplex Virus, Varicella-Zoster Virus, parainfluenza, enterovirus, certain coronaviruses)
    • Scabies
    • Impetigo
    • Noncontained abcesses or decubitus ulcers (especially for Staphylococcus aureus and group A Streptococcus)

Droplet Precautions

The goal of droplet precautions is to prevent transmission of infectious organisms spread by droplets (greater than 5 microns) through close respiratory or mucous membrane contact with respiratory secretions via coughing, sneezing, talking, or droplet-inducing procedures.

Droplet precautions include:
  • Private room or cohort
  • Special air flow is not needed, and door may remain open.
  • Wear mask (surgical or isolation) if working within 3 feet of the patient. (Note: some facilities require mask for all entries into the room.)
  • Droplet mask on patient when leaving room, if tolerated
  • Limit transport to essential purposes only.
  • Follow respiratory hygiene/cough etiquette.
  • Gown and gloves as per standard precautions and facility policy.
  • Indications include known or suspected infections of the following organisms:
    • Neisseria meningitidis
    • Haemophilus influenzae type B
    • Mycoplasma pneumoniae
    • Bordetella pertussis
    • Group A Streptococcus
    • Diphtheria
    • Pneumonic plague
    • Influenza
    • Rubella
    • Mumps
    • Adenovirus
    • Parvovirus B19
    • Rhinovirus (pediatric patients)
    • Certain coronaviruses

Airborne Precautions

Airborne precautions prevent transmission of infectious disease that are spread by airborne droplets (less than or equal to 5 microns) that remain infectious and suspended in air for long periods of time over long distances and can be widely dispersed by air currents.
Airborne precautions include:
  • Private room with monitored negative pressure ventilation of 6-12 air exchanges per hour; airborne infection isolation room (AIIR) preferred
  • Discharge of air to the outside or HEPA-filtered before recirculation
  • Door and windows must be kept closed at all times.
  • Respiratory protection (usually an N-95 mask) for susceptible persons must be worn prior to entering room and removed after leaving room.
  • Droplet mask on patient when leaving room if tolerated; follow respiratory hygiene/cough etiquette.
  • Limit transport to essential purposes only.
  • If possible, non-immune healthcare workers should not care for patients with vaccine- preventable airborne diseases.
  • Indications include known or suspected infections of the following organisms:
    • Tuberculosis
    • Varicella
    • Measles
    • Smallpox
    • Certain coronaviruses
    • Ebola

Anderson, D.J. (2020, December 17). Infection prevention: Precautions for preventing transmission of infection. UpToDate.  

Siegel, J.D., Rhinehart, E., Jackson, M., Chiarello, L., & the Healthcare Infection Control Practices Advisory Committee, (2007). Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007.