Many hospitals continue to use the system known as category-specific isolation to protect people from bacteria infecting a given patient. These types divides infectious diseases into a few broad categories that are determined by how the organisms are transmitted. The five categories of isolation generally used in this system are strict isolation, respiratory isolation, wound and skin precautions, enteric precautions, and blood/body fluid precautions. The rationale for this approach is that it is easier for nurses and health care providers to remember the procedures for these broad categories than to remember what to do for individual infectious diseases.

The concern about diseases transmitted by blood and body fluids, blood/body fluid precautions are now use for all individuals in all healthcare situations. In facilities in which body substance precautions are used, enteric precautions, which are limited to vomitus and feces are omitted because the precautions necessary for this category as well as those for the blood/body fluid category are included in the body substance precautions.

Additional categories of isolation are used in both systems to protect patients who have a suppressed immune system and re therefore highly susceptible to contracting an infection. One category is called compromised host precautions, and the other is termed protective isolation. Although it has been proved that the most effective measure for infection control is handwashing, additional precautions are added to provide these individuals with increased safety.

Strict Isolation

Strict isolation is used if the identified pathogens are transmitted both through the air and by contact. Strict isolation is also used when the organism is particularly virulent and resistant to the major antibiotics. Precautions to be taken include placing the patient in a private room with the door closed; wearing a gown, mask, and gloves when entering the room; washing hands on entering and leaving the room; and double-bagging limens and other articles used in the care of the patient.

Respiratory Isolation

If the pathogens involved are airborne, respiratory isolation is carried out. It is desirable to place the patient in a private with the door closed. Masks must be worn, but gowns and gloves are not necessary unless there is direct contact with linens or secretions.

Hands should be washed on entering and leaving the room. Any article contaminated wi9ith secretions from the patient must be disinfected or double-bagged for disposal or decontamination.

Wound and Skin Precautions

For the patient with a wound infected with microorganisms that can be spread by contact, wound and skin precautions are observed. Isolation of the patient is not required, but a private room is desirable. Gowns must be worn when in direct contact with the patient, the linen, or the dressings to protect your uniform from possible contamination. Gloves should be used when in direct contact with the infected area or when handling dressings or anything contaminated with drainage. Masks are necessary only during dressing changes. Hands are washed on entering and leaving the room. Instruments, dressings, and linens must be placed in moisture-impervious bags or double-bagged for decontamination or disposal.

Enteric Precautions

Enteric precautions are used when the pathogens involved are transmitted by direct contact with gastrointestinal secretions, vomitus, or feces. A private room is necessary for the pediatric patient because children cannot be trusted to remain only on their own beds. Gowns must be worn when in direct contact with the patient or contaminated linens. Gloves are worn when in direct contact with the patient’s perineal area, feces, vomitus, or contaminated materials. Masks are not necessary. Hands are washed on entering and leaving the room. Listen should be double-bagged or placed in moisture-impervious bags. Urine, feces, and vomitus should be discarded in an adjoining private bathroom, and any articles contaminated with them must be discarded or disinfected.