Transition-Based Precautions
AIRBORNE
■ Used for microorganisms that spread through air (droplet nuclei 5 m [e.g., TB, measles, chicken pox])
■ Private room; negative air pressure room; door closed; high-efficiency disposable mask (replace when moist) or particulate respirator (e.g., for TB); transport patient with mask, teach to dispose soiled tissues in fluid impervious bag at bedside
DROPLET
■ Used for microorganisms spread by large-particle droplets (droplet nuclei 5 m, (e.g., pneumonia [streptococcal, mycoplasmal, meningococcal], rubella, mumps, influenza, adenovirus)
■ Private room if available or cohort pts, mask when within 3ft of pt, door open, mask for pt when transporting, teach to dispose soiled tissues in fluid-impervious bag at bedside
CONTACT
■ Used for organisms spread by direct or indirect contact; methicillinresistant S. aureus (MRSA), vancomycin-resistant enterococcus (VRE), vancomycin intermediate-resistant S. aureus (VISA); enteric pathogens (e.g., E. coli, C. difficile), herpes simplex, pediculosis, hepatitis A and E, varicella zoster, respiratory syncytial virus
■ Private room or cohort pts; gowns, gloves over-gown cuffs; dedicate equipment
Neutropenic Precautions (Reverse Isolation)
■ For individuals with compromised immune system
■ Use standard precautions, especially hand hygiene
■ Caregivers and visitors should be free of communicable illnesses
■ Private room if possible; keep room meticulously clean
■ Teach to avoid sources of potential infection (crowds, confined spaces
such as airplanes, raw fruits/vegetables, flowers/plants)
