In a healthcare setting a use gowns, gloves and hand hygiene are the primary tools for preventing transmission of pathogens.
Standard procedures include hand hygiene on room entry and exit and after touching the environment, or before touching a sterile site and the addition of gloves, gowns, or both for patient care that involves risk for exposure to body fluids, mucous membranes, or intact skin.
Contact precautions are recommended in acute-care hospitals for patients infected with target multi-drug-resistant organisms and in patients who have been previously identified as colonized with target multi drug resistant organisms.
The primary indications for contact precautions in the US are colonization or infection section with MRSA or vancomycin resistant enterococcus.
Contact precautions require single patient rooms, that healthcare personnel where gowns and gloves for care, and the use of dedicated equipment.
Approximately 5-10% of patients in acute care facilities are placed in contact precautions.
Utilizing gowns and gloves require a significant effort on the part of healthcare personnel.
The goal of adherence to utilizing wearing gowns and gloves is 80%.
Contact precautions increases the financial and environmental costs.
Contact precautions is associated with decreased visitation rate by healthcare personnel by 25-50%.
Current recommendations by the CDC is for the use of personal protective equipment (PPE) be used for preventing the transmission of multi drug-resistant bacterial organisms from the clothing and hands of healthcare workers to patients.
When patients are being cared for an intensive care unit who are infected or colonized with a multi drug-resistant organism, healthcare workers using gloves and gowns self contaminate their hands in about 5% of care episodes (Morgan DJ et al).
Patients may have delays in hospital admission and discharge due to contact precautions.
Contact precautions may be associated with lower patient satisfaction, depression,anxiety and preventable adverse events including falls, pressure ulcers or hypoglycemia.
Protective gear should be impervious to fluids, cover all skin, easy to don, easy to remove with minimal risk for self contamination, provide maximum comfort for healthcare workers, and be easy to dispose up with minimal contamination of healthcare workers or the environment.
Little evidence exists that contact precushions prevent MRSA or VRE infections in endemic, non-outbreak setting.