Germs spread through the air, by hand, and from touching patient-care equipment and other objects. Germs that can cause severe disease via contact with skin wounds, via ingestion, through eyes/nose, or those that can survive on surfaces for long periods of time usually require contact precautions to prevent spread. Examples of types of infections that require the use of contact precautions include:

• Skin infections and rashes
• Respiratory infections that produce coughs, sneezes, or sputum
• Gastrointestinal infections that cause diarrhea and vomiting
• Infections caused by multidrug-resistant organisms, such as Methicillin-resistant Staphylococcus Aureus (MRSA)

BEST PRACTICES FOR WORKERS

• Wear cloth face coverings, at a minimum, at all times when around coworkers or the general public. If a respirator, such as an N95 respirator or better, is needed for conducting work activities, then that respirator should be used, and the worker should use their cloth face covering when they are not using the respirator (such as during breaks or while commuting).
• Frequently wash your hands with soap and water for at least 20 seconds. When soap and running water are not immediately available, use an alcohol-based hand sanitizer with at least 60% ethanol or 70% isopropanol as active ingredients and rub hands together until they are dry. Always wash hands that are visibly soiled.
• Avoid touching your eyes, nose, or mouth with unwashed hands.
• Practice good respiratory etiquette, including covering coughs and sneezes or coughing/sneezing into your elbow/upper sleeve.
• Avoid close contact (within 6 feet for a total of 15 minutes or more over a 24-hour period) with people who are visibly sick and practice physical distancing with coworkers and the public.
• Stay home if sick.

STANDARD PRECAUTIONS FOR ALL EMPLOYEES

All blood and body fluids/substances are potentially infectious. Standard precautions are the work practices required to achieve a basic level of infection prevention and control. The use of standard precautions aims to minimise, and where possible, eliminate the risk of transmission of infection, particularly those caused by blood borne viruses.

Standard precautions are the minimum infection prevention and control practices that must be used at all times for all patients in all situations. 

• blood (including dried blood)
• all other body fluids/substances (except sweat), regardless of whether they contain visible blood
• non-intact skin
• mucous membranes.
  

Standard precautions consist of the following practices:

• hand hygiene before and after all patient contact.
• the use of personal protective equipment, which may include gloves, impermeable gowns, plastic aprons, masks, face shields and eye protection.
• the safe use and disposal of sharps.
• the use of aseptic “non-touch” technique for all invasive procedures, including appropriate use of skin disinfectants.
• reprocessing of reusable instruments and equipment.
• routine environmental cleaning.
• waste management.
• respiratory hygiene and cough etiquette.
• appropriate handling of linen.

PROTECTION FOR WORKERS WHO PERFORM SCREENING DUTIES

Ensure workers performing screening activities, are appropriately protected:

• Implement engineering controls, such as physical barriers or dividers or rope and stanchion systems, to maintain at least 6 feet of distance between screeners and workers being screened.
• Ensure that screening is conducted in a safe area by, for example, directing parking lot or delivery traffic elsewhere.
• If screeners need to be within 6 feet of workers, provide them with appropriate PPE based on the repeated close contact the screeners have with other workers.
• Such PPE may include gloves, a gown, a face shield, and, at a minimum, a medical-grade face mask.
• Train employees on how to properly put on, take off, and dispose of all PPE.
• Filtering facepiece respirators, such as N95s, may be appropriate for workers performing screening duties. If respirators are needed, they must be used in the context of a comprehensive respiratory protection program that includes medical evaluation, fit testing, and training.

FINAL WORD

All contact precautions are important to keep people and patients secure and safe in a health setting or in the community at large. There is a simple message aligned with contact precautions. It is that intelligent and timely hand washing with just soap and water can go a long way to prevent the transmission of germs and disease.