Contact precautions prevent the spread of infectious diseases transmitted by contact with body substances containing the infectious agent or items contaminated with the body substances containing the infectious agent. Contact precautions apply to patients who are infected or colonized (presence of microorganism without clinical signs and symptoms of infection) with epidemiologically important organisms that can be transmitted by direct or indirect contact. (See Diseases requiring contact precautions, page 128.)
P.127
Effective contact precautions require a single room and the use of gloves and gowns by anyone having contact with the patient, the patient's support equipment, or items soiled with body substances containing the infectious agent. Thorough hand washing and proper handling and disposal of articles contaminated by the body substance containing the infectious agent are also essential.
Equipment
Gloves • gowns or aprons • masks, if necessary • isolation door card • plastic bags.
Gather any additional supplies, such as a thermometer, stethoscope, and blood pressure cuff.
Preparation of equipment
Keep all contact precaution supplies outside the patient's room in a cart or anteroom.
Implementation
- Situate the patient in a single room with private toilet facilities and an anteroom if possible. If necessary, two patients with the same infection may share a room. Explain isolation procedures to the patient and his family.
- Place a contact precautions card on the door to notify anyone entering the room.
- Wash your hands before entering and after leaving the patient's room and after removing gloves.P.128
P.129
- Place any laboratory specimens in impervious, labeled containers, and send them to the laboratory at once. Attach requisition slips to the outside of the container.
- Instruct visitors to wear gloves and a gown while visiting the patient and to wash their hands after removing the gown and gloves.
- Place all items that have come in contact with the patient in a single impervious bag, and arrange for their disposal or disinfection and sterilization.
- Limit the patient's movement from the room. If the patient must be moved, cover any draining wounds with clean dressings. Notify the receiving department or area of the patient's isolation precautions so that the precautions will be maintained and the patient can be returned to the room promptly.
Special considerations
- Cleaning and disinfection of equipment between patients is essential.
- Try to dedicate certain reusable equipment (thermometer, stethoscope, blood pressure cuff) for the patient in contact precautions to reduce the risk of transmitting infection to other patients.
- Remember to change gloves during patient care as indicated by the procedure or task. Wash your hands after removing gloves and before putting on new gloves.
Documentation
Record the need for contact precautions on the nursing care plan and as otherwise indicated by your facility. Document initiation and maintenance of the precautions, the patient's tolerance of the procedure, and any patient or family teaching. Also document the date contact precautions were discontinued.