Isolation precautions
Formal Definition
A hospital infection control system using category-based or transmission-based precautions to prevent spread of communicable diseases among patients, staff, and visitors; standard precautions (universal gloving/gowning for blood and body fluids, hand hygiene) apply to ALL patients; transmission-based precautions layered on top based on the organism and route: contact (MRSA, VRE, C. diff, scabies — gown + gloves + dedicated equipment), droplet (influenza, pertussis, meningococcus — surgical mask within 6 feet of patient), airborne (TB, measles, varicella, disseminated zoster — N95 respirator + negative pressure room); sometimes combined in the same patient (e.g., disseminated varicella requires airborne + contact).
How It's Used on the Ward
"Isolation" or "in isolation" — the patient is in a private room with a sign on the door specifying what PPE is required to enter (gown + gloves for contact, surgical mask for droplet, N95 for airborne); gown-and-glove contact precautions for MRSA, VRE, ESBL, C. diff are the most common isolation in hospitals today.
Example
""MRSA bacteremia patient placed in contact precautions — gown and gloves required for all room entry, dedicated stethoscope and BP cuff in the room, hand hygiene before and after patient contact. Visitors instructed to wear gown + gloves too. Patient will remain in contact precautions for entire hospitalization (some institutions allow discontinuation after documented clearance; others maintain isolation through entire stay). Cohorting MRSA-positive patients on a single ward is sometimes used to reduce PPE burden and promote consistent compliance.""
Clinical Context
CDC/HICPAC standard and transmission-based precaution categories: STANDARD (hand hygiene, PPE for blood/body fluid, safe injection practices, respiratory hygiene/cough etiquette — apply to ALL patients regardless of diagnosis). CONTACT (private room or cohort, gown + gloves for entry, dedicated equipment — for MRSA, VRE, ESBL, C. difficile, scabies, RSV in infants). DROPLET (private room, surgical mask within 6 feet — for influenza, pertussis, meningococcal disease, mumps, rubella). AIRBORNE (negative-pressure room, N95 respirator or PAPR for entry, door closed — for TB, measles, varicella, disseminated zoster). ENTERIC (subset of contact for enteric pathogens with high environmental stability — C. diff, norovirus — requires soap-and-water handwashing, alcohol gel not effective for spores). Patient transport: limit movement, place surgical mask on patient (droplet/airborne) or cover wounds/drainage (contact). Cohorting: same-organism patients can share rooms to reduce PPE burden. Discontinuation policies vary by institution.