Transmission Precautions
Overview of Policy
J. Iverson Riddle Development
Center
Intern: Cynthia Attaway BSN, RN
The University of N.C. at Greensboro
Overview Significance of Policy

Infections are a significant source of
morbidity and mortality
 Infections result in an estimated 150,000200,000 hospital admissions per year
 Estimated cost of $673 million -$2 billion
annually
 Death rate for a resident can reach as high
as 40%
Objectives for Nursing Staff

Review Transmission Policy.

Specify Transmission protocols with
signs.

Identify Personal Protective
Equipment with correct precaution.
Outcomes for Nursing Staff

Nursing staff to educate “Team” of
Revised Transmission Policy

Nursing staff to monitor “Team” to
follow Transmission Precautions
Transmission-Based Precautions
(A.K.A. Isolation Precautions)

Refers to actions (precautions)
implemented in addition to standard
precautions.

Actions that are used for residents with
documented or suspected infections or
colonized with infectious agents.
Implementation of TransmissionBased Precautions

Important for staff to identify the type of
transmission precaution needed for the
resident
 Communication is essential of
transmission-precautions to all “Team”
members.
 Staff to know the appropriate Personal
Protective Equipment (PPE)
 PPE readily available
Contact Precautions
(Yellow Sign)

Measures that are intended to
prevent transmission of infectious
agents including epidemiological
important microorganisms which are
spread by direct or indirect contact
with the resident or environment.
MRSA
Contact (Special Enteric)
Methicillian- Resistant Staphyloccus (MRSA)
Vancomycin- Resistant Enterococci (VRE)
Clostridium Difficile ( C. Diff.)
C. Diff
VRE
MRSA
Contact ( Special Enteric)

The resident is colonized with MRSA
 VRE and C. Diff. colonized in the
gastrointestinal tract and continent
 MRSA or VRE in an intact skin lesion or
wound that is covered with simple
dressing
 MRSA or VRE in urine and continent or
wears briefs where urine is contained.
Must be placed outside the door
www.unc.edu/depts/Spice/resource.html
Droplet Precautions
(Green Sign)
Respiratory droplets transmit
infections directly from the
respiratory tract of an infected
individual to susceptible mucosal
surfaces of the recipient
 Facial protection is necessary
 Coughing, sneezing, talking,
suctioning, and CPR

Flu
Droplet-Borne Organisms
Examples
Large particle droplets greater than 5
microns in size
 Influenza
 Mumps
 Pertussis

Must be placed outside the door
www.unc.edu/depts/Spice/resource.html
Airborne Precautions
Prevents the transmission of
organisms that remain infectious
when suspended in the air
 Examples: Flu, Varicella Zoster
(shingles) and M. Tuberculosis

Management of Airborne Infections
( Blue Sign)
Resident may be transferred to an
acute care facility
 Single-resident airborne isolation
room
 Staff caring for the resident should
wear mask or respirator

Mycoplasma Tuberculosis
Must be placed outside the door
www.unc.edu/depts/Spice/resource.html
N-95 versus Regular Mask





N-95
Very close fitting
Efficient filtration
of airborne
particles
Blocks 95% very
small particles
Single use

Face Masks

Loose fitting,
disposable and
physical barrier

Not intended to be
used more than
once
The Faces of Microorganisms :
Influenza
Clostridium
Difficile
MRSA
Pseudomonas
aeruginosa
Mycoplasma
(TB)
VRE
Personal Protective Equipment

Sequence for Donning Personal
Protective Equipment
1.
2.
3.
4.
Gown
Mask
Goggles or Face Shield
Gloves
Personal Protective Equipment

Sequence for Removing Personal
Protective Equipment
1.
2.
3.
4.
Gloves
Goggles or Face Shield
Gown
Mask
Reasons for Non-Compliance

Family centered environment

Alcohol based hand rub is not safe to
be placed inside and outside of
doors

Residential living environment
Reasons for Non-Compliance
References

Center for Disease Control and Prevention
Guideline for Isolation Precautions
www.cdc.gov
 Google images
 J. Iverson Riddle Developmental Center
Policy 3.17
 North Carolina Statewide Program for
Infection Control and Epidemiology for
(N.C. Spice) Transmission-Based
www.unc.edu/depts/Spice/resource.html