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Transmission-based precautions

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Transmission-based precautions

Transmission-based precautions are infection-control precautions in health care, in addition to the so-called "standard precautions". They are the latest routine infection prevention and control practices applied for patients who are known or suspected to be infected or colonized with infectious agents, including certain epidemiologically important pathogens, which require additional control measures to effectively prevent transmission.

Universal precautions are also important to address as far as transmission-based precautions. Universal precautions is the practice of treating all bodily fluids as if it is infected with HIV, HBV, or other blood borne pathogens.

Transmission-based precautions build on the so-called "standard precautions" which institute common practices, such as hand hygiene, respiratory hygiene, personal protective equipment protocols, soiled equipment and injection handling, patient isolation controls and risk assessments to limit spread between patients.

The following table shows the history of guidelines for transmission-based precautions in U.S. hospitals as of 2007:

Communicable diseases occur as a result of the interaction between a source (or reservoir) of infectious agents, a mode of transmission for the agent, a susceptible host with a portal of entry receptive to the agent, the environment. The control of communicable diseases may involve changing one or more of these components, the first three of which are influenced by the environment. These diseases can have a wide range of effects, varying from silent infection – with no signs or symptoms – to severe illness and death. According to its nature, a certain infectious agent may demonstrate one or more following modes of transmission direct and indirect contact transmission, droplet transmission and airborne transmission.

Transmission-based precautions are used when the route(s) of transmission is (are) not completely interrupted using "standard precautions" alone.[citation needed]

Standard precautions include:

Research studies in the form of randomized controlled trials and simulation studies are needed to determine the most effective types of personal protective equipment for preventing the transmission of infectious diseases to healthcare workers. There is low-quality evidence that supports making improvements or modifications to personal protective equipment to help decrease contamination. Examples of modifications include adding tabs to masks or gloves to ease removal and designing protective gowns so that gloves are removed at the same time. In addition, there is weak evidence that the following PPE approaches or techniques may lead to reduced contamination and improved compliance with PPE protocols: Wearing double gloves, following specific doffing (removal) procedures such as those from the CDC, and providing people with spoken instructions while removing PPE.

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