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The recommended practices have a strong evidence base. The continued occurrence of outbreaks of hepatitis B and hepatitis C viruses in ambulatory settings indicated a need to re-iterate safe injection practice recommendations as part of Standard Precautions. The addition of a mask for certain spinal injections grew from recent evidence of an associated risk for developing meningitis caused by respiratory flora. The accumulated evidence that environmental controls decrease the risk of life threatening fungal infections in the most severely immunocompromised patients (allogeneic hematopoietic stem-cell transplant patients) led to the update on the. Evidence that organizational characteristics (e.g., nurse staffing levels and composition, establishment of a safety culture) influence healthcare personnel adherence to recommended infection control practices, and therefore are important factors in preventing transmission of infectious agents, led to a new emphasis and recommendations for administrative involvement in the development and support of infection control programs. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007) Last update:. Continued increase in the incidence of HAIs caused by multidrug-resistant organisms (MDROs) in all healthcare settings and the expanded body of knowledge concerning prevention of transmission of MDROs created a need for more specific recommendations for surveillance and control of these pathogens that would be practical and effective in various types of healthcare settings. This document is intended for use by infection control staff, healthcare epidemiologists, healthcare administrators, nurses, other healthcare providers, and persons responsible for developing, implementing, and evaluating infection control programs for healthcare settings across the continuum of care. The reader is referred to other guidelines and websites for more detailed information and for recommendations concerning specialized infection control problems. PURPOSE Airborne Precautions refer to infection prevention and control interventions to be used in addition to Routine Practices to prevent transmission of airborne particles that remain suspended in the air, travel on air currents and are then inhaled by others who are nearby or who may be some distance away from the source patient, in a different room or ward (depending on air currents) or in the same room that a patient has left, if there have been insufficient air exchanges. Common microorganisms transmitted by the airborne route are Mycobacterium tuberculosis (TB), varicella virus (chickenpox virus) and measles virus. 2.0 DEFINITIONS Airborne Precautions – measures used for diseases that are spread by airborne transmission. This primarily occurs through dissemination of microorganisms by aerosolization. Organisms are contained in droplet nuclei which are small airborne particles, less than 5 microns in size that result from evaporation of large droplets. Organisms can also be contained in debris in dust particles that remain suspended in the air for long periods of time. These microorganisms are then widely dispersed by air currents and can be inhaled by susceptible hosts who may be some distance away from the source patient. Control of airborne transmission is the most difficult, as it requires control of air flow through special ventilation systems and use of respirators. Conditions/clinical presentations and specific etiologies requiring airborne precautions: Conditions/clinical presentation Specific etiologies Cough, fever, pulmonary infiltrate in person at risk for TB (pleuropulmonary or laryngeal TB) Rash, maculopapular with fever and one of coryza, conjunctivitis or cough * Rash, vesicular with fever Measles (rubeola) * Monkeypox Tuberculosis (pleuropulmonary or laryngeal) ■ nonpulmonary lesions, during procedures that may aerosolize tuberculi bacilli * Smallpox Varicella zoster virus * ■ varicella (chicken pox) * ■ zoster, disseminated * ■ zoster in immunocompromised patient *Use Airborne & Contact Precautions Infection Prevention and Control Section 04H-1H0200 (Airborne Precautions) Page 2 Note: in this document the term “patient” is inclusive of patient, resident or client. Aerosol-generating medical procedures (AGMPs) - are medical procedures that can generate aerosols as a result of artificial manipulation of a patient’s airway. Examples include intubation, manual ventilation, open endotracheal suctioning, CPR, bronchoscopy, sputum induction, nebulized therapy, surgery, autopsy, and non-invasive positive pressure ventilation (CPAP, BiPAP) Airborne Isolation Room – a single patient room that is equipped with special air handling (negative pressure) and ventilation capacity. Anteroom – is considered a clean area and is used to transition people in and out of the airborne isolation room when it is under negative pressure. An anteroom is used as a transitional space between the hallway and the airborne isolation room. This transition area is where the Healthcare Worker puts on their PPE when entering the Airborne isolation room. The HCW also will store all clean PPE in this area. See Anteroom Protocol Negative Pressure Room – also known as an Airborne Isolation Room; a negative pressure room that is a single-occupancy patient-care room used to isolate persons with a suspected or confirmed airborne infectious disease. N95 Respirators – specific masks that filter particles one micron in size, have a 95% filter efficiency and provide a tight facial seal with less than a