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When do you need contact precautions?

September 15, 2016

DO YOU KNOW When you need Contact Precautions when someone has an infectious disease?

Did you know...that Contact Precautions are needed whenever there is an infectious disease going on with your client’s skin?  This includes: boils, infected wounds, rashes of unknown origin, scabies, bedbugs, impetigo, fungus, cellulitis, necrotizing cellulitis, warts, herpes zoster (shingles), etc. Below is a summary of Universal (Standard) Precautions with the addition of Contact Precautions.  As always, the individual situation of the client you are seeing will dictate which precautions are necessary in any particular situation.
Hand Hygiene Perform hand hygiene (soap and water or hand sanitizer) after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn.  Perform hand hygiene immediately after gloves are removed, between patient contacts, and when otherwise indicated to avoid transfer of microorganisms to other patients or environments.  When hands are visibly soiled with blood or other body fluids, wash hands with soap and water.  It may be necessary to perform hand hygiene between tasks and procedures on the same patient to prevent cross-contamination of different body sites.
Gloving  Wear gloves (clean nonsterile gloves are adequate) when it can be reasonably anticipated that contact with blood or other potentially infectious materials, mucous membranes, non-intact skin, or potentially contaminated intact skin (e.g., of a patient incontinent of stool or urine) could occur. Remove gloves after contact with a patient and/or the surrounding environment (including medical equipment) using proper technique to prevent hand contamination. Do not wear the same pair of gloves for the care of more than one patient. Do not wash gloves for the purpose of reuse since this practice has been associated with transmission of pathogens.
Mouth, Nose, and Eye protection Use personal protective equipment (PPE) to protect the mucous membranes of the eyes, nose, and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions and excretions.  Select masks, goggles, face shields, and combinations of each according to the need anticipated by the task performed.
Gowning and Bootie-ing Wear a gown, that is appropriate to the task, to protect skin and prevent soiling or contamination of clothing during procedures and patient-care activities when contact with blood, body fluids, secretions, or excretions is anticipated.  Wear booties when the floor can be assumed to contain pathogens, particulates, bugs or larvae that can be picked up and carried to another setting.
Appropriate Device Handling of Patient Care Equipment and Instruments/Devices Handle used patient-care equipment soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other patients and environments.  Ensure that reusable equipment is not used for the care of another patient until it has been appropriately cleaned and reprocessed and that single-use items are properly discarded.  Clean and disinfect surfaces that are likely to be contaminated with pathogens, including those that are in close proximity to the patient (e.g., bed rails, over bed tables) and frequently-touched surfaces in the patient care environment (e.g., door knobs, surfaces in and surrounding toilets in patients' rooms) on a more frequent schedule compared to that for other surfaces (e.g., horizontal surfaces in waiting rooms). A 1/10 Clorox spray is available in the office as well as Clorox health wipes.
Appropriate Handling of Laundry
Handle, transport, and process used linen to avoid contamination of air, surfaces and persons.
 
Information adapted from: http://www.cdc.gov/mrsa/healthcare/clinicians/precautions.html, accessed 9-12-16