Transmission-Based Precautions and Isolation

Foundations of Infection Control: Standard Precautions and PPE Sequences

Standard precautions form the baseline for all clinical encounters. These foundational practices apply to every single client receiving care in any healthcare setting, regardless of whether an infection is confirmed or even suspected. Hand hygiene stands at the center of these precautions and is strictly required at five critical moments: before touching a client, before performing a clean or aseptic procedure, after any potential exposure risk to body fluids, after touching a client, and after touching any client surroundings.

When direct care creates a risk of exposure to infectious agents, personal protective equipment must be worn correctly. Putting on equipment follows an established standard sequence to ensure comprehensive coverage: first the gown, followed by the mask or respirator, then goggles or a face shield, and finally the gloves. Clear signs detailing the specific transmission-based precautions required must always be placed prominently at the entrance of the client's room so that all team members prepare appropriately before entering.

Removing equipment safely prevents the healthcare worker from self-contaminating. The standard sequence for doffing equipment begins with the gloves, followed by the goggles or face shield, then the gown, and lastly the mask or respirator. An acceptable alternative sequence allows staff to peel off the gown and gloves together, followed by the eye protection and the respirator. Regardless of which doffing sequence is selected, hand hygiene must be performed immediately after the removal of personal protective equipment.