EHC uses Standard and Transmission-Based Precautions as outlined below to prevent spread of pathogens to patients, visitors and healthcare workers.
Standard Precautions are based on the principle that all blood, body fluids, secretions, excretions (except sweat), non—intact skin, and mucous membranes may contain transmissible infectious agents. Standard Precautions apply to ALL patients, in ALL settings, regardless of suspected or confirmed infection and include: hand hygiene as previously discussed; the use of gloves, gown, mask, eye protection, or face shield, depending on the anticipated exposure; and safe injection practices. For some interactions (e.g., performing venipuncture), only gloves may be needed; during other interactions (e.g., intubation), use of gloves, gown, and face shield or mask and goggles may be necessary.
Transmission-Based Precautions are used in addition to Standard Precautions when the route(s) of transmission of an infectious pathogen is(are) not completely interrupted using Standard Precautions alone and are denoted by signs outside patient rooms. There are five categories of Transmission-Based Precautions at EHC, as outlined in Table 1. For diseases that have multiple routes of transmission, more than one Transmission-Based Precautions category is required (e.g. contact precautions + airborne precautions for disseminated varicella).
Table 1. Categories of Transmission Based Precautions
| Transmission-Based Precaution | PPE Required | Examples |
|---|---|---|
| Contact Precautions | Gown + gloves | Carbapenem-resistant Enterobacterales, Candida auris |
| Enteric Contact Precautions | Gown + gloves + hand hygiene with soap and water | Norovirus, C. difficile |
| Droplet Precautions | Surgical/procedural mask | Influenza, meningococcal meningitis |
| Droplet Plus Precautions | N95 or equivalent respirator + eye protection | COVID-19, mpox |
| Airborne Precautions | N95 or equivalent respirator | Tuberculosis, measles |
Universal masking, put in place during the COVID-19 pandemic, is no longer required. However, masking (with a surgical/procedural mask) is required in the following scenarios:
- By healthcare workers, during direct patient care in select units that primarily care for immunocompromised patients
- By everyone (including healthcare workers, patients, and visitors) in the Emergency Department waiting rooms, inpatient dialysis units, infusion centers and/or with symptoms of an acute respiratory illness
For more details and a complete list of "mask-up" units, please see the EHC Policy "Use of Masks During Ongoing Community Transmission of Respiratory Pathogens" and the related document "List of Inpatient Units / Waiting Rooms where Masking for Patient Care is Mandatory" in Policy Manager.
Additional information about transmission-based precautions can be found in Policy Manager under "Standard and Isolation Precautions" and "Standard and Isolation- Appendix A" in Policy Manager.