When to Escalate
The Transmission Problem Contact Precautions Interrupt
Contact precautions are added to standard precautions when an organism can spread through touching the patient or touching the patient’s contaminated environment.
Contact precautions are added to standard precautions when an organism can spread through touching the patient or touching the patient’s contaminated environment. Direct transmission occurs during activities such as bathing, repositioning, wound care, or other physical contact. Indirect transmission occurs when organisms move from a contaminated object—such as a bed rail, call bell, blood pressure cuff, or stethoscope—to another person. The purpose is to keep organisms on the patient’s skin, body fluids, or nearby surfaces from travelling on hands, clothing, or equipment. Common examples include methicillin-resistant *Staphylococcus aureus* (MRSA), vancomycin-resistant *Enterococcus* (VRE), *Clostridioides difficile*, and norovirus. A patient may be colonized without symptoms and still contaminate the environment, so contact precautions are based on transmission risk rather than fever or visible illness alone. Some infections have more than one route of spread. Contact precautions do not replace droplet or airborne precautions when the patient’s symptoms or diagnosis indicate those additional measures.