Transmission-Based Precautions (Isolation): Contact Precautions

Doctors, nurses and other health care workers must always use Standard Precautions (good hand washing prior to entering your child’s room and after leaving your child’s room) to limit the risk of spreading infections. Health care workers may use gloves, gowns, masks, eye protection or face shields when taking care of your child.

These precautions are required at all hospitals by Federal law to protect patients as well as health care workers.  

Transmission-Based Precautions (Isolation) are used along with Standard Precautions when the spread of infection might not be completely stopped when using only Standard Precautions.  

• The purpose of these precautions is to keep germs from spreading from your child to other patients, family members, visitors or healthcare workers. When these precautions are not followed, germs could spread to other people, making them very sick.
• Sometimes children will be placed in more than one level of precaution.  In this case, both precautions must be followed. For example, if your child is on Contact and Droplet Precautions, the precautions would include a gown, gloves, and a mask.

Contact Precautions

• Certain germs can be spread by contact. This means touching a person with the germs on skin or in body fluids, or touching surfaces in the person’s room may spread these germs.
• Your child may be placed on Contact Precautions as a safety measure if he or she has symptoms of these germs or if laboratory results show that your child has the germs.
• Your child may need to be on Contact Precautions even if he or she seems to be well. This is because some germs can still be spread to other people from your child.
• Your child will need to stay in his or her room unless taken out of the room by a staff member for testing or procedures.
• Contact Precautions can be frustrating for a child.  A Child Life specialist may help by providing play activities.

Ways you can help your child:

• Spend as much time as possible with your child or have a family member or friend stay.
• Activities such as reading, playing games, music, puppet play, drawing, painting pictures, puzzles and looking at family pictures.

What Contact Precautions Means

A red sign will be posted at the entrance to your child’s room when these precautions are needed so that everyone entering knows what to wear (Picture 1). 

Everyone (parents, family, guests, and healthcare workers) must wash their hands with soap and water or use waterless alcohol-based hand rub when entering and leaving the room.

• If parents are resting on the bedside furniture, they do not need to wear gowns or gloves.  Gown or gloves need to be worn only when the parent will be helping with the child’s care or coming in contact with body fluids.  Some examples are:

1. If parents are helping with dressing changes or are suctioning their child they should wear gloves and gown.
2. If a child has diarrhea or has been vomiting, parents should wear gowns while holding the child on their lap.

• While breastfeeding your child, you do not need to wear a gown and gloves, but hand hygiene must be done before and after.
• During Kangaroo Care (Skin-to-Skin Care) in the Neonatal Intensive Care Unit (NICU), you do not need to wear a gown and gloves, but hand hygiene must be done before and after.
• Family, guests, and healthcare workers must follow the precautions posted on the door to the child’s room.  Family, including siblings, must be able to follow the posted precautions.

Gloves

• Gloves must be worn on both hands.  Gloves will fit either hand.
• Make sure your hands are clean and dry before you put on the gloves.
• The outsides of the gloves have germs on them, so it is important to remove them properly.

How to remove gloves

Gowns

Gowns must be worn by parents when taking care of their child (Picture 2).

• Put on a clean gown each time you go in your child’s room.
• Take the gown off before you leave your child’s room and place it in the laundry hamper inside his room. 
• Always wash your hands with soap and water or alcohol-based hand rub right after removing the gown.
• If the gown gets wet, change into a clean gown so your clothes will not get germs on them.
• Don’t wear the gown outside your child’s room.  

The front and the sleeves of the gown have germs on them, so it is important to remove it promptly.

How to remove the gown

 

Hand Hygiene

Hand hygiene involves either washing hands with soap and water or killing germs on the hands with a waterless alcohol-based hand rub.  Proper hand hygiene is one of the best ways to stop the spread of germs and prevent infections. To prevent your child or you from getting unwanted germs, wash hands with soap and water or use a waterless alcohol-based hand rub every time you enter and leave the room.

Wash your hands with soap and water at these times:

• Before eating
• When hands have dirt on them
• After changing diapers
• After contact with body fluids like blood, urine or vomit
• After using the restroom

To use the waterless alcohol-based hand rub:

1. Apply the rub to the palms of your hands. 
2. Rub your hands together covering all surfaces. 
3. Rub until your hands are dry. 

All doctors, nurses, and other healthcare workers know they must perform proper hand hygiene before and after touching a patient, after contact with items near the patient, before putting on gloves for a sterile procedure and after removing gloves. It is all right for you to remind them to perform hand hygiene.

Before you leave your child’s room

1. Remove gown and gloves and leave them in the room.
2. Perform hand hygiene.

If you have any questions, be sure to ask a member of your child’s healthcare team.

TBP Contact Precautions (PDF)

HH-II-176 8/08, Revised 1/18 Copyright 2008, Nationwide Children’s Hospital