Contact Precautions

In addition to standard precautions, contact precautions should be utilized with patients known to have or suspected of having serious illnesses easily transmitted by direct patient contact or by contact with items in the patient's environment. Examples of such infectious diseases are seen in Table 14.8,-3..

TABLE 148-3 Contact Spread Infectious Diseases

As with standard precautions, utilization of previously described techniques for hand washing, glove, face mask and eye protection or face shield, gown, equipment and linen, environmental controls, and workplace controls applies. If the examination and care of a patient result in contact with infective materials and a high concentration of microorganisms (wound drainage or fecal material), changing of gloves is required. Hand washing with an antimicrobial agent or waterless antiseptic is required after removal of gloves. After glove removal and hand washing, workers should avoid contact with potentially contaminated environmental surfaces or items in the patient's room.

In addition to wearing a gown as described in the standard precautions, one should wear a clean, nonsterile gown upon entering a patient's room if one anticipates substantial contact with the patient or if the patient is incontinent or has diarrhea, a colostomy, an ileostomy, or wound drainage not contained by dressings. The gown should be removed prior to leaving the patient's room, and care should be taken to avoid contact with potentially contaminated environmental surfaces.

Transportation and movement should be limited to essential purposes only. If the patient must be moved to another treatment area, one should ensure that contamination spread is minimized by large, bulky dressings.

Medical equipment (e.g., blood pressure cuffs, stethoscopes, bedside commodes, etc.) should be dedicated to a single patient (or cohort of similarly infected patients) to avoid sharing between noninfected patients. Health care personnel who use personal medical equipment (e.g., stethoscopes) should thoroughly clean these items between using them on different patients if the possibility of contamination exists.

Specific workplace activities and medical devices may significantly mitigate the occupational exposures experienced by health care personnel. These task-related and device-related recommendations are found in Table 118.-4. and Table 1..18.-.5., respectively.

TABLE 148-4 Task-Specific Recommendations for Use of PPE

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