16/09/2026
PNLE TAKERS!
🩶INFECTIOUS DISEASE NURSING BULLETS🩶
🩷Transmission-Based Precautions
1. Standard Precaution – The Foundation of Infection Control. Use with all patients regardless of diagnosis. Perform hand hygiene after any contact with blood or body fluids, wear gloves for any potential contact with bodily fluids, and use masks/eye protection if splashing is possible. All sharp instruments must be disposed of in puncture-resistant containers (never recap used needles).
2. Contact Precautions. Require gown and gloves upon room entry; dedicate or disinfect equipment between patients. A private room is preferred (or cohort with same infection). Indicated for infections spread by direct contact, such as MRSA, VRE, C. difficile, RSV, scabies. For C. diff, remember alcohol hand rubs won’t kill spores – wash hands with soap and water on exit.
3. Droplet Precautions. Require a surgical mask when within at least three (3) feet of the patient. Place patient in a private room (or cohort with same pathogen). Used for large-droplet infections like influenza, meningococcal meningitis, mumps, rubella, pertussis (whooping cough). Limit patient transport; if transport is necessary, put a surgical mask on the patient.
4. Airborne Precautions. Require an N95 respirator for staff and an airborne infection isolation room with negative pressure (6–12 air changes/hour). Used for tiny droplet nuclei that stay suspended, as in TB, measles, varicella (chickenpox) (also disseminated zoster or SARS). Keep the door closed and only immune staff should care for measles or varicella patients. If patients must leave the room, have them wear a surgical mask.
5. Neutropenic/Protective Precautions. Used for immunocompromised patients (low neutrophils). This is essentially reverse isolation: caregivers wear gloves/masks to protect the patient from germs. No fresh fruits, vegetables, flowers, or live plants are allowed in the room (they can carry microbes). Strict hand washing is required before entry to protect the patient.
6. PPE Donning Order. When putting on personal protective equipment, the recommended sequence is: gown first, then mask (or N95 respirator), then goggles/face shield, and gloves last. This protects you as you gear up.
7. PPE Doffing Order. When removing PPE, take gloves off first (they are most contaminated), then goggles/face shield, then gown, and mask off last. Remove PPE at the doorway or anteroom except the respirator (remove after leaving airborne isolation room) to avoid contaminating other areas.
8. Patient Transport & Isolation. Avoid transporting isolated patients unless essential. For droplet or airborne cases, have the patient wear a surgical mask during transport. Alert the receiving department of isolation needs in advance so they can prepare.
9. Additional Precaution Notes. Use dedicated or disposable equipment (stethoscopes, thermometers) for contact isolation patients to prevent cross-infection. For droplet precautions, visitors and staff should maintain distance ≈3 feet or wear a mask if closer. For airborne, keep the room door closed and monitor negative airflow regularly. Always combine transmission-based precautions in addition to standard precautions – standard precautions are the foundation.
Common Pathogens
10. Staphylococcus aureus (including MRSA). Gram+ cocci often on skin; can cause wound infections, pneumonia, sepsis. MRSA (Methicillin-Resistant S. aureus) requires contact precautions. Treat with vancomycin or other MRSA-active antibiotics. Hand hygiene and contact isolation are key to prevent spread.
11. Vancomycin-Resistant Enterococcus (VRE). Enterococcus faecium/faecalis resistant to vancomycin. Causes UTIs, bloodstream or wound infections, especially in ICUs. Use contact precautions (gloves/gown) and dedicated equipment. Options for treatment include linezolid or daptomycin.
12. Clostridioides difficile (C-diff). Spore-forming anaerobic bacillus causing severe antibiotic-associated colitis. Causes profuse watery diarrhea with a distinct foul odor and cramping. Contact precautions required; hand washing with soap (not just sanitizer) is mandatory, as alcohol gels don’t kill spores. Treat with metronidazole or oral vancomycin. Clean room with bleach (spores resist routine cleaners).
13. Mycobacterium tuberculosis (TB). Acid-fast bacillus spread by airborne droplets. Causes chronic cough (often with blood-tinged sputum), night sweats, weight loss, fever, and lung infiltrates. Requires airborne isolation (negative-pressure room, N95 mask). Diagnosis via sputum AFB culture; treated with months-long multi-drug therapy (RIPE: rifampin, isoniazid, pyrazinamide, ethambutol).
14. Human Immunodeficiency Virus (HIV). Blood-borne retrovirus that attacks CD4 T-cells. Leads to AIDS when CD4 count
