1.4.5 When to Use Isolation Precautions

According to Public Health Ontario (2012b), the following common infections require isolation precautions. Additional details are provided for each infection:

• Influenza (seasonal). Implement droplet and contact precautions. Isolate the client in a single room, and continue precautions for 5 days after onset of illness. The influenza virus is a reportable disease.
• Norovirus. Implement contact precautions. Isolate the client in a single room, and continue precautions until 48 hours after resolution of symptoms. Outbreaks are reportable; notify Infection Control.
• Pneumonia. Droplet and contact precautions. Isolate the client in a single room, and continue precautions until etiology (cause) established or clinical improvement.
• Vancomycin-resistant enterococcus (VRE). Implement contact precautions. Isolate the client in a single room, and continue precautions until discontinued by Infection Control.
• Salmonella or Eserichia coli (E. coli) in pediatric or incontinent adult, if stool cannot be contained. Implement contact precautions. Isolate the client in a single room, and until salmonellosis or E. coli 0157:H7 are ruled out. This is a reportable disease; notify Infection Control.
• Clostridium difficile (C. Difficile or C. diff). Implement contact precautions. Isolate the client in a single room, and continue precautions until client has formed stool for at least two consecutive days. Outbreaks are reportable; you must notify Infection Control.
• Conjunctivitis. Implement contact precautions. Isolate the client in a single room, and continue precautions until viral etiology ruled out or for duration of symptoms.
• Gastroenteritis. Implement acute infectious and contact precautions. Isolate the client in a single room, and continue precautions until C. difficile and norovirus or other viral agents ruled out. Outbreaks are reportable; notify Infection Control. Different organisms require different treatment with regard to notification of Infection Control. If the specific organism is listed as infectious, it must be identified to Infection Control.
• Methicillin-resistant staphylococcus aureus (MRSA). Implement contact precautions, and droplet precautions if the client is producing sputum and coughing. Isolate the client in a single room, and continue precautions until discontinued by Infection Control.
• Varicella zoster (Shingles, Zoster) or Herpes zoster. Implement airborne precautions. Isolate the client in a single room with negative air flow and door closed, and continue precautions until all lesions have crusted and dried. Notify Infection Control. Only immune staff should enter the room.