Contact Precautions: You should know them forwards and backwards

One thing you are going to want to have down pat, is your contact precautions! Not only the PPE you should have on for each type of disease, but also what order to PPE off, what the patient should have on when being transported to another unit, what those transporting the patient should have on, the order in which you remove each piece of equipment, how often to perform hand hygiene and which diseases require which type of precaution.

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Contact Precautions: You should know them forwards and backwards

Standard Precautions

These are the safety measures that should be taken with all patients.

  1. Wash Your Hands - Most important step in infection control. It prevents nosocomial infections.
  2. DON Gloves - Before coming in contact with anything wet. ie. broken skin, mucous membranes, blood, body fluids, soiled instruments, contaminated waste materials
  3. Wash hands again upon removal of gloves and between patients.

Contact Precautions

Before entering

  1. Wash hands
  2. DON gown then gloves

Upon entering

  1. Use disposable equipment when possible
  2. When not available clean and disinfect all equipment before removing from room

Transporting patient

  1. PT should perform hand hygiene and wear a clean gown
  2. For direct contact with pt, nurse or care provider should wear a gown and gloves.
  3. Notify receiving area

Before leaving the patient's room

  1. Remove gloves then gown
  2. Wash hands

Contact Precautions Microorganisms

  1. Antibiotic Resistant Organisms (Methicillin resistant Staphylococcus aureu (MRSA), Extended spectrum beta-lactamase (ESBL), Penicillin resistant Streptococcus pneumoniae (PRSP), Multi-drug resistant Pseudomonas aeruginosa (MDRP))
  2. Scabies
  3. Herpes Zoster (Shingles) localized
  4. Diarrhea, Clostrididum difficile

Airborne Contact Precautions

Before entering

  1. Wash hands
  2. Don N95 Respirator (Mask)
  3. Don gown then gloves
  4. Negative Pressure Isolation Room KEEP DOOR CLOSED

Transporting patient

  1. Patient must wear a surgical or procedure mask and a clean gown
  2. Patient must wash hands
  3. For direct contact with pt, nurse or care provider should wear a gown and gloves.
  4. Notify receiving area

Before leaving pt's room

  1. Remove gloves then gown NOT N95 mask
  2. Wash hands

After leaving pt's room

  1. Shut door
  2. Wash hands
  3. Remove N95 mask
  4. Wash hands

Airborne Contact Precautions Microorganisms

  1. Measles (Rubeola)
  2. Tuberculosis (TB)
  3. Chicken Pox (Varicella-Zoster virus)
  4. Herpes Zoster (Shingles) disseminated

Droplet Contact Precautions

Before Entering

  1. Wash Hands
  2. DON Mask and Eye Protection
  3. DON Gown then Gloves

Patient Transport

  1. Pt must perform hand hygiene
  2. Pt must wear a surgical or procedure mask and a clean gown
  3. For direct contact with pt, nurse or care provider should wear a gown and gloves.
  4. Notify receiving area

Before Leaving Pt's Room

  1. Remove gloves then gown
  2. Wash Hands
  3. Remove eye protection and mask
  4. Wash Hands

Droplet Contact Precautions Microorganisms

  1. Influenza (Flu)
  2. Viral Respiratory tract infections (adenovirus, parainfluenza, rhinovirus, RSV)
  3. Streptococcus group A pharyngitis, pneumonia, scarlet fever
  4. Neisseria meningitidis invasive infections
  5. H. Influenzae type b invasive infections
  6. Pertussis
  7. Rubella
  8. Mumps

Happy Studying

 

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david.cummiskey

About david.cummiskey

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thank you so much, I'm printing this out to put in my "big binder of handy stuff".

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Specializes in Med/Surg/Pedi/Tele.

Excellent resource. Thank you!

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"before leaving the patient's room:

1. remove gloves then gown

2. wash hands"

david, i'm a bit concern about this statement - if i remove my glove first then gown as you wrote, my hands will get in contact with the outer part of my gown and i would actually be contaminated... am i the only one seeing things this way???

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marcy74 said:
"before leaving the patient's room:

1. remove gloves then gown

2. wash hands"

david, I'm a bit concern about this statement - if I remove my glove first then gown as you wrote, my hands will get in contact with the outer part of my gown and I would actually be contaminated... am I the only one seeing things this way???

the reason for the gloves being removed first is because the ties of the gown are not contaminated...just the same as when you remove a mask from your face. you want to make sure you have removed your gloves prior to to that...remember you are touching the ties, not the actual gown itself.

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soon2bRN516 said:
The reason for the gloves being removed first is because the ties of the gown are not contaminated...just the same as when you remove a mask from your face. You want to make sure you have removed your gloves prior to to that...REMEMBER you are touching the ties, not the actual gown itself.

soon2bRN516 is right. When removing the gown you remove your gloves first like I mentioned and discard them in the trash can. Next, you would pull your hands back through the sleeve holes being careful not to touch the outer contaminated portion of the gown. You can now either grab the ties or any part of the interior of the gown and roll it over itself into a ball and discard of it in the appropriate trash can, depending on what it came into contact with. Good question though, thank you for asking. 

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Thanks, this is great david.cummiskey!!!

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lnmorr80 said:
Thanks, this is great david.cummiskey!

No prob :up:

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Dont forget that a patient with RSV virus in addition to droplet contact precaution will be put also on the contact precautions,otherwise this is great,thank you very much,I'm printing this out

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My rationale for removing the gloves first is that you want to remove the most soiled equipment which in my opinion is the gloves since it is the hands that touch many different contaminated subjects,then loosen up the ties on the back of your gown and then then remove the gown,wash your hands (remeber here you going close to oral route;so you want to have your hands clean before they come into close contact with your hands...

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I read in one of the Q banks of Kaplan that Rubella and RSV fall under Contact Precautions. Just wanted to clarify those coz I am confused on those two.

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Specializes in ICCU - cardiac.

Rubella (measles) is airborne precautions!!!

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