Combination of Additional Precautions

Some microorganisms have more than one mode of transmission; therefore, a combination of additional precautions must be followed. Prior to care, perform a point-of-care risk assessment. Review the client’s diagnosis, reflect on your immunization status, determine the type of care that will be performed, and then assess what additional precautions are required. 

For example, influenza, which is a respiratory virus, requires droplet precautions. However, if those droplets are secreted directly or indirectly on inanimate objects like the client’s bed rails or call bell, then the virus can be transmitted through contact, which requires you to follow additional contact precautions depending on the care you will be providing the client. 




Another example would be if a child was diagnosed with chickenpox, which is caused by the varicella-zoster virus; then airborne precautions would be followed. However, if the child begins to itch and scratch the fluid-filled blistering rash, the virus can be transmitted through direct contact. Therefore, the child should be in a negative pressure room, with the door closed, with only immunized staff able to enter and wearing a N95 regulator mask, gown, and gloves. 

Depending on the care provide to the client, the additional precautions may vary. For example, client’s on bilevel positive airway pressure (BiPAP) overnight may have airborne precautions overnight, though may have droplet or no precautions throughout the day.


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Clinical Procedures for Safer Patient Care — Thompson Rivers University Edition by Renée Anderson, Glynda Rees Doyle, and Jodie Anita McCutcheon is used under a CC BY 4.0 Licence. This book is an adaptation of Clinical Procedures of Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon, which is under a CC BY 4.0 Licence. A full list of changes and additions made by Renée Anderson can be found in the About the Book section.


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Introduction to Infection Prevention and Control Practices for the Interprofessional Learner Copyright © by Michelle Hughes; Audrey Kenmir; Oona St-Amant; Caitlin Cosgrove; and Grace Sharpe is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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