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.

Updated:  

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

 

Specializes in ICCU - cardiac.
bdg456 said:
I read in one of the Q banks of Kaplan that Rubella and RSV fall under Contact Precautions. Just wanted to clarify those because I am confused on those two.

RSV is droplet and contact. Rubella (measles) is airborne.

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amybethf said:
RSV is droplet and contact. Rubella (measles) is airborne.

I got my information from the flyers they post on the doors of the pts' rooms. For RSV, yes it is droplet and contact you can't have a droplet precaution that isn't contact because droplet requires more PPE in addition to that required by a regular contact precaution. Also, to clear up the confusion about Rubella. I have here that Rubella (measles) is Droplet Precautions for the first 4 days after onset of rash and then airborne from there on out. It can be spread by respiratory secretions and Urine (in congenital cases).

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Specializes in Med/Surg n ICU.
david.cummiskey said:
I got my information from the flyers they post on the doors of the pts' rooms. For RSV, yes it is droplet and contact you can't have a droplet precaution that isn't contact because droplet requires more PPE in addition to that required by a regular contact precaution. Also, to clear up the confusion about Rubella. I have here that Rubella (measles) is Droplet Precautions for the first 4 days after onset of rash and then airborne from there on out. It can be spread by respiratory secretions and Urine (in congenital cases).

NCLEX isn't the real world :nono: Rubella is airborne (Saunders, 2008) Rubeola is droplet (Saunders, 2008):smokin:

you can find this in the 4 edition pg568-569

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Thank you for that!! I printed the precautions out to help me with my studying! I had a ton of those questions along with priortizing!

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ktbeth104 said:
Thank you for that!! I printed the precautions out to help me with my studying! I had a ton of those questions along with priortizing!

Your welcome ?

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ujones00 said:
NCLEX isn't the real world Rubella is airborne (Saunders, 2008) Rubeola is droplet (Saunders, 2008)

you can find this in the 4 edition pg568-569 

Your Saunders is outdated 2008 Rebella is Droplet and Rubeola is Airborne (The RN Course Book Preparation for the NCLEX-RN Examination 12th Edition Kaplan, 2009, pp.82)

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Specializes in Med/Surg n ICU.
david.cummiskey said:
Your Saunders is outdated 2008 :nono: Rebella is Droplet and Rubeola is Airborne (The RN Course Book Preparation for the NCLEX-RN Examination 12th Edition Kaplan, 2009, pp.82):D

you right:yeah: I just checked.... sorry :bow:

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ujones00 said:
you right I just checked.... sorry 

Haha, no worries, just glad we got that figured out. Well, that's one question I know I'll get right now if they ask it 

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Specializes in Med/Surg n ICU.
david.cummiskey said:
Haha, no worries, just glad we got that figured out. Well, that's one question I know I'll get right now if they ask it 

I might use my Kaplan book instead of outdated Saunders

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Specializes in LTC.

Yeah remember droplet(like rain drops) and rubella(umbrella to protect from rain drops).:smokin:

Got that idea from someone on here.:D

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CrystalClear75 said:
Yeah remember droplet(like rain drops) and rubella(umbrella to protect from rain drops).

Got that idea from someone on here.

NICE! I like it! Thanks for sharing!

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anyway thank you David I just finished making flashcard with the info you posted,I think it will significantly increase my chance of passing the NCLEX that I'm scheduled for August 12.

One thing I dont understand why would we have to don the gown and gloves for a pt with airborne or droplet precautions...I thought we needed only masks,I mean can you catch chickenpox or mumps by taking someone radial pulse with your bare hands??

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