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Apex Nursing

Chart — Infection Control

Common Organism Precautions

Quick reference for precaution type, PPE requirements, hand hygiene method, and key nursing considerations for common pathogens encountered in clinical practice.

Educational use only. Based on CDC isolation precaution guidelines. Facility protocols may require stricter precautions for specific organisms or outbreak settings. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.

All Organisms — Quick Reference

OrganismPrecautionGlovesGownMaskN95Hand Hygiene
MRSAContactABHR or soap+water
VREContactABHR or soap+water
C. difficileContactSoap + water ONLY
CREContact (enhanced at many facilities)ABHR or soap+water
ESBL organismsContactABHR or soap+water
ScabiesContactABHR or soap+water
InfluenzaDroplet (+ Standard)Sit.Sit.Surgical mask within 3–6 ftABHR or soap+water
RSVContact + Droplet✓ on room entry✓ on room entrySurg.ABHR or soap+water
Pertussis (Whooping cough)DropletSit.Sit.Surg.ABHR or soap+water
Meningococcal meningitisDropletSit.Sit.Surg.ABHR or soap+water
Tuberculosis (TB)AirborneSit.Sit.N95 (fit-tested) on room entryREQABHR or soap+water
Measles (Rubeola)AirborneSit.Sit.N95 (fit-tested) on room entryREQABHR or soap+water
Varicella / ChickenpoxAirborne + Contact✓ on room entry✓ on room entryN95 (fit-tested) on room entryREQABHR or soap+water
Herpes Zoster (localized)Contact (standard in immunocompetent with covered lesions)ABHR or soap+water
NorovirusContactSoap + water preferred

Sit. = Situational (when contact or splash risk anticipated) · REQ = Required

Organism Detail Cards

MRSAMDROContact
Nasal colonization is common; decolonization with mupirocin + CHG bathing. Soap and water for wound care. Clean equipment between patients.
Room: Private; dedicated equipmentHand hygiene: ABHR or soap+water
VREMDROContact
Survives on dry surfaces for weeks to months. Enhanced environmental cleaning required. No decolonization protocol available.
Room: Private; dedicated equipment; environmental cleaning criticalHand hygiene: ABHR or soap+water
C. difficileMDRO / GIContact
CRITICAL: ABHR does NOT kill C. diff spores — soap and water mandatory. Spores survive on surfaces months. Contact precautions for entire stay regardless of symptom resolution.
Room: Private with private bathroom; sporicidal (bleach-based) cleaningHand hygiene: Soap + water ONLY
CREMDROContact (enhanced at many facilities)
Very limited treatment options. Enhanced contact precautions may be required. Screen high-risk patients (recent foreign healthcare exposure). Remove invasive devices ASAP.
Room: Private; report to infection control immediatelyHand hygiene: ABHR or soap+water
ESBL organismsMDROContact
Most common in E. coli and Klebsiella. Common in UTIs and wounds. Antibiotic stewardship is key. Culture and sensitivity mandatory for treatment.
Room: Private preferredHand hygiene: ABHR or soap+water
ScabiesParasiticContact
Crusted (Norwegian) scabies: more contagious; strict contact precautions. Treat patient and close contacts simultaneously. Notify housekeeping for room terminal cleaning.
Room: Private; bag and launder all linens and clothingHand hygiene: ABHR or soap+water
InfluenzaRespiratoryDroplet (+ Standard)
Surgical mask is sufficient — N95 NOT required for droplet precautions alone. Patient wears mask during transport. Annual staff vaccination is primary prevention.
Room: Private preferred; spatial separation ≥3 ft if unavailableHand hygiene: ABHR or soap+water
RSVRespiratoryContact + Droplet
High-risk for immunocompromised and young infants. Both contact and droplet precautions required. Clean shared equipment between patients.
Room: Private preferredHand hygiene: ABHR or soap+water
Pertussis (Whooping cough)RespiratoryDroplet
Paroxysmal cough with inspiratory 'whoop.' Post-exposure prophylaxis with azithromycin for close contacts. Staff vaccination (Tdap) is primary prevention.
Room: Private preferredHand hygiene: ABHR or soap+water
Meningococcal meningitisRespiratoryDroplet
Life-threatening emergency. Post-exposure prophylaxis (rifampin or ciprofloxacin) for close contacts without PPE. Precautions can be discontinued 24 hours after effective antibiotic therapy is started.
Room: Private preferred; droplet precautions until 24 hours after antibiotic initiationHand hygiene: ABHR or soap+water
Tuberculosis (TB)AirborneAirborne
N95 is mandatory — surgical mask provides NO protection. AIIR door must remain closed. Patient wears surgical mask during transport (limits particle dispersal). Confirm AIIR negative pressure daily.
Room: AIIR — negative pressure, ≥12 ACH, door CLOSED at all timesHand hygiene: ABHR or soap+water
Measles (Rubeola)AirborneAirborne
Highly contagious (R0 ~12–18). Immune staff only when possible. Airborne particles remain infectious for up to 2 hours in a room after the patient leaves. Verify vaccination status of all staff.
Room: AIIR — negative pressure; immune (vaccinated or prior measles) staff preferredHand hygiene: ABHR or soap+water
Varicella / ChickenpoxAirborne + ContactAirborne + Contact
Requires BOTH airborne and contact precautions. Active (not crusted) lesions are infectious. Immune (vaccinated or prior varicella) staff preferred. Disseminated zoster also requires airborne + contact.
Room: AIIR — negative pressure; immune staff only for active lesion careHand hygiene: ABHR or soap+water
Herpes Zoster (localized)ContactContact (standard in immunocompetent with covered lesions)
Localized, covered zoster in immunocompetent host: contact precautions. Disseminated zoster or zoster in immunocompromised patient: airborne + contact (treat like varicella).
Room: Private preferred; keep lesions coveredHand hygiene: ABHR or soap+water
NorovirusGIContact
ABHR has limited effectiveness against norovirus — soap and water preferred. Highly contagious via fecal-oral route and aerosolization during vomiting. Restrict symptomatic staff.
Room: Private; strict environmental cleaning; restrict symptomatic staff from patient careHand hygiene: Soap + water preferred

NCLEX Pearls

  • TB = airborne precautions. N95 (fit-tested) + negative pressure room. Door stays CLOSED at all times.
  • C. diff and norovirus = soap and water only. ABHR does NOT kill spores.
  • Varicella (chickenpox) and disseminated zoster = airborne + contact precautions combined.
  • Localized zoster in an immunocompetent patient with covered lesions = contact precautions only.
  • Measles: airborne precautions; room remains infectious for up to 2 hours after patient leaves.
  • MRSA, VRE, C. diff, CRE = contact precautions (gloves and gown on room entry).
  • Influenza = droplet precautions. Surgical mask within 3–6 feet. N95 not required for routine care.
  • RSV = contact + droplet precautions combined.

Related Resources

Standards & sources

Fact-checked Jun 21, 2026

This page is written to align with CDC Isolation Precautions Guidelines / HICPAC. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →