Overview
This lecture reviews standard and transmission-based precautions (airborne, droplet, contact) for infection control, including PPE, key diseases, and important practices for the NCLEX exam.
Standard Precautions
- Standard precautions are used with every patient to prevent transmission of unidentified infections.
- Includes: hand hygiene, PPE as needed, safe equipment handling, environmental cleaning, respiratory hygiene, laundry, and patient placement.
- Hand hygiene: Perform before/after patient contact, after glove use, and after touching patient surfaces.
- Use soap and water when hands are visibly soiled, before eating, after bathroom use, or if patient has diarrhea illnesses (e.g., C. diff, norovirus, rotavirus).
- PPE (personal protective equipment) includes gloves (fluids), gowns (potential clothing contact), goggles/face mask/shield (risk of splashes).
Airborne Precautions
- Airborne diseases are spread by inhaling tiny particles that remain airborne after a person coughs or sneezes.
- Requires N95 mask at all times; patient placed in negative pressure (airborne infection isolation) room with the door closed.
- Diseases: Chickenpox (varicella), disseminated herpes zoster (shingles), measles, tuberculosis.
- Chickenpox and disseminated herpes zoster also require contact precautions.
- Limit patient transport; patient must wear a surgical mask if leaving the room.
- Mnemonic: "Airborne CHICKEN Number 95 DISSECTED HER TUBBY MEALworm" (Chickenpox, N95, Disseminated herpes, Tuberculosis, Measles).
Droplet Precautions
- Droplet diseases spread via large respiratory droplets (cough, sneeze), traveling up to 3 feet.
- Requires wearing a surgical mask at all times; add goggles/face shield, gloves, gown for close care.
- Diseases: Whooping cough (pertussis), adenovirus, strep pharyngitis, scarlet fever, pneumonia, influenza, parvovirus B19, mumps, meningococcal disease, diphtheria, German measles (rubella), epiglottitis, mycoplasma pneumonia, pneumonic plague, rhino virus.
- Influenza and adenovirus also require contact precautions.
- Room ventilation not required; keep patients/visitors 3 feet away; door can stay open.
- Mnemonic: "Whose adjustable droplet mask stops scary pneumatic fluid parasites plaguing distinguished German men? My epic mom's Rhonda."
Contact Precautions
- Contact diseases are spread by direct/indirect contact with patients or their environment.
- Requires gloves and gown at all times; use soap and water with C. diff, norovirus, or rotavirus.
- Diseases: MRSA, VRE, ESBL, Klebsiella, C. diff, norovirus, rotavirus, hepatitis A (incontinent patients), impetigo, lice, scabies, herpes simplex, chickenpox, skin diphtheria, shingles, wound infections, RSV, parainfluenza, conjunctivitis.
- Single room preferred; cohort with same infection if needed.
- Mnemonic: "DAWN medical glove/gown with every contact precaution session" (Diarrhea, Antibiotic-resistant, Wound, Eye, Skin, Contact, Pulmonary).
Key Terms & Definitions
- Standard Precautions — Basic infection control practices for all patients.
- Transmission-Based Precautions — Additional precautions for known or suspected infections (airborne, droplet, contact).
- PPE — Personal protective equipment including gloves, gown, mask, goggles/face shield.
- Negative Pressure Room — Special ventilation room used for airborne precautions.
- Hand Hygiene — Washing hands with soap/water or using sanitizer to prevent infection spread.
Action Items / Next Steps
- Take the quiz on precautions to test your knowledge.
- Review PPE use and hand hygiene protocols for each type of precaution.