Contact Precautions Overview

Contact Precautions are used in addition to Standard Precautions for patients with known or suspected infections that can be transmitted by direct contact with the patient (e.g. touching) or indirect contact with surfaces or items in the patient environment.

When to apply

Apply Contact Precautions for patients with:

MRSA colonization or active infection
VRE colonization or active infection
Multi-drug-resistant Gram-negative bacteria (CRE, MDR Acinetobacter, MDR Pseudomonas)
Clostridioides difficile infection (use soap and water, not alcohol gel)
Norovirus (suspected or confirmed)
Open or draining wounds that cannot be contained by a dressing
Significant fecal incontinence or uncontained body fluids in a patient with a contagious enteric pathogen

Patient placement

Single-occupancy room preferred. If unavailable, cohort with patients infected/colonized with the same organism.
Door may remain open unless airborne precautions also apply.

PPE

On room entry — before patient contact:

Gown (long-sleeved, fluid-resistant). Tie at neck and waist.
Gloves that cover the gown cuff.

On exit:

Remove gloves first — peel off, balling into the second glove.
Untie gown from the back. Roll it inside-out, away from the body.
Perform hand hygiene immediately after PPE removal.

For C. difficile: hand hygiene must use soap and water for at least 20 seconds. Alcohol-based gels do not kill spores.

Equipment

Dedicate non-critical patient-care equipment (BP cuff, stethoscope) to the patient if possible.
If shared equipment must be used, clean and disinfect before use on the next patient using a sporicidal agent for C. difficile rooms.

Discontinuation

MRSA / VRE / MDR-GNR: per facility policy; typically requires negative cultures from the original infection site and other body sites.
C. difficile: continue precautions for at least 48 hours after symptom resolution; some facilities continue through discharge.
Norovirus: continue at least 48 hours after resolution of vomiting and diarrhea.

Documentation

Record the start date, indication, and discontinuation date in the patient's chart and in the IPC tracking system.