One-Pager
Infection Control and Isolation
Standard and transmission-based precautions, PPE order, hand hygiene, neutropenic precautions, sharps and room assignment
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Standard precautions
For every client, every time, whether or not an infection is known.
- Hand hygiene (below)
- PPE by expected exposure: gloves for body fluids; gown, mask and eye protection for splashes
- Respiratory hygiene: mask coughing clients; seat them more than 3 ft apart
- New sterile needle and syringe for every injection
- Disinfect shared equipment and surfaces; don't shake used linen
Enhanced barrier precautions (nursing homes): gown and gloves for high-contact care of residents with MDROs, wounds or indwelling devices; no room restriction.
Transmission-based precautions
| Type | Examples | PPE and room |
|---|---|---|
| Contact | MRSA, VRE, RSV, scabies, head lice, impetigo | Gown and gloves on entry; dedicated equipment |
| Contact (enteric) | C. diff, norovirus | Contact PPE, soap-and-water hands, sporicidal (e.g., bleach) cleaning |
| Droplet | Influenza, pertussis, meningococcus, mumps, rubella, strep throat (children) | Surgical mask on entry |
| Airborne | Pulmonary or laryngeal TB, measles, varicella*, disseminated zoster* | Fit-tested N95; AIIR, door closed |
| Condition | Precautions end |
|---|---|
| Meningococcus, group A strep, scabies, head lice, impetigo | 24 h into effective treatment |
| Pertussis | 5 days into effective antibiotics |
| Mumps | 5 days after swelling begins |
| Rubella | 7 days after rash onset |
| Measles | 4 days after rash onset |
| Influenza | Longer of: 7 days from onset, or 24 h after symptoms resolve |
| Pulmonary TB | Improving on therapy, 3 negative smears on separate days |
| Varicella | All lesions dry and crusted |
| Norovirus | At least 48 h after symptoms resolve |
Localized zoster: standard (lesions covered) if healthy; airborne plus contact if immunocompromised until dissemination is ruled out.
PPE order
| Step | Donning | Doffing |
|---|---|---|
| 1 | Gown | Gloves |
| 2 | Mask or N95 (seal check) | Goggles or face shield |
| 3 | Goggles or face shield | Gown, rolled inside out |
| 4 | Gloves over gown cuffs | Mask or N95, by the ties |
| 5 | — | Hand hygiene |
Hand hygiene first. Remove PPE at the doorway, except a respirator: remove it outside, door closed.
Hand hygiene
- Alcohol rub (60% or more) preferred unless hands are visibly soiled; rub until dry, about 20 s
- Soap and water: visibly soiled, before eating, after the restroom, C. diff, norovirus
- Soap: lather at least 15 s (many texts say 20)
- Gloves never replace hand hygiene: clean hands before and after
- Nails no longer than the fingertip; no artificial nails with high-risk clients
Neutropenic precautions
- Severe neutropenia: ANC below 500/mm³, or expected to fall below 500 within 48 h
- Private room; strict hand hygiene
- No fresh or dried flowers or potted plants
- No rectal temperatures or rectal exams
- No ill staff or visitors; avoid crowds and recent live-vaccine recipients
- Fully cooked meat, fish and eggs; follow unit policy on raw produce
- Allogeneic stem cell transplant: protective environment (positive pressure, HEPA)
Sharps and needlesticks
- No recapping, bending or breaking; if unavoidable, one-handed scoop
- Activate safety devices; discard at point of use
- Replace containers at the fill line (about 3/4 full); never overfill
- Home teaching: FDA-cleared or heavy-duty plastic container; follow local disposal rules
- Wash with soap and water; flush mouth, nose or skin with water; eyes with water or saline
- Report immediately
- Get evaluated now: source and worker tested for HIV, HBV, HCV
- HIV PEP if indicated: start ASAP (within 72 h) for 28 days; don't wait for source results
Room assignment
- AIIR: negative pressure, at least 6 (existing) or 12 (new or renovated) air changes/h
- No AIIR: transfer; meanwhile mask the client, private room, door closed, staff in N95s
- Private-room priority: airborne, heavy cough or sputum, stool incontinence, uncontained drainage
- Shared room: beds 3 ft or more apart, curtain drawn
- Immune staff when possible: measles, mumps, varicella, disseminated zoster. Measles: N95 even if immune
- Non-immune pregnant staff avoid rubella
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Sources
- Siegel JD, Rhinehart E, Jackson M, Chiarello L; HICPAC. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. CDC (page updated November 27, 2023) Link
- CDC. Updates to the 2007 Isolation Precautions Guideline (latest update September 19, 2024) Link
- CDC/HICPAC. 2007 Isolation Precautions Guideline, Part III: Precautions to Prevent Transmission of Infectious Agents Link
- CDC/HICPAC. 2007 Isolation Precautions Guideline, Part IV: Recommendations Link
- CDC/HICPAC. 2007 Isolation Precautions Guideline, Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions (page updated September 11, 2026) Link
- CDC. Standard Precautions for All Patient Care (updated April 3, 2024) Link
- CDC. Transmission-Based Precautions (updated April 3, 2024) Link
- CDC. Sequence for Putting On and How to Safely Remove Personal Protective Equipment (poster CS250672-E) Link
- CDC. Clinical Safety: Hand Hygiene for Healthcare Workers (updated February 27, 2024) Link
- CDC. Clinical Overview of C. diff Infection (updated April 13, 2026) Link
- CDC. Infection Prevention and Control Strategies for Seasonal Influenza in Healthcare Settings (updated September 29, 2026) Link
- CDC. Implementation of Personal Protective Equipment Use in Nursing Homes to Prevent Spread of MDROs (Enhanced Barrier Precautions, updated April 2, 2024) Link
- Freifeld AG, et al. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients With Cancer: 2010 Update by the IDSA. Clin Infect Dis. 2011;52(4):e56-e93 Link
- CDC. Information on Preventing Infections During Chemotherapy (updated August 25, 2025) Link
- National Cancer Institute. Infection and Neutropenia during Cancer Treatment Link
- CDC/NIOSH. Bloodborne Infectious Diseases: Risk Factors and Emergency Needlestick Information (updated February 13, 2025) Link
- CDC. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV. MMWR Recomm Rep. 2001;50(RR-11) Link
- Kofman AD, Struble KA, Heneine W, et al. 2025 US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Post-exposure Prophylaxis in Healthcare Settings. Infect Control Hosp Epidemiol. 2025 (published September 15, 2025). doi:10.1017/ice.2025.10254 Link
- OSHA. 29 CFR 1910.1030 Bloodborne Pathogens Link
- OSHA. 29 CFR 1910.134 Respiratory Protection Link
- U.S. FDA. Best Way to Get Rid of Used Needles and Other Sharps (updated August 10, 2023) Link
- NCSBN. 2026 NCLEX-RN Test Plan (effective April 1, 2026) Link
- NCSBN. 2026 NCLEX-PN Test Plan (effective April 1, 2026) Link
- Federal Register. Documents mentioning the Healthcare Infection Control Practices Advisory Committee (search, newest first, accessed October 5, 2026) Link
- Pediatric Infectious Diseases Society. In The News: CDC Terminates Infection Control Advisory Committee (May 21, 2025) Link