CHECKLIST: CONTACT PRECAUTIONS - HCPro Blogs

Figure 10.5 Checklist: Contact Precautions
Name of Assessor Unit Date
Element Yes No Action Needed
CONTACT PRECAUTIONS—
GENERAL
Contact Precautions are used for patients
with known or suspected infections or
evidence of syndromes that represent an
increased risk for contact transmission,
including colonization or infection with
multidrug-resistant organisms.
Contact Precautions are discontinued
when signs and symptoms have resolved
or according to pathogen-specific
recommendations (see Appendix A).
PATIENT PLACEMENT—Acute-care
settings
Patients who require Contact Precautions
are placed in a single-patient room if
available.
If single-patient rooms are unavailable,

Element Yes No Action Needed
the following alternatives are applied:
• Single-room placement is
prioritized for patients with
conditions that may facilitate
transmission (e.g., uncontained
drainage, stool incontinence).
• Patients with the same
infection or colonization are
cohorted in the same room.
• If cohorting is done, patients
are physically separated (>3
feet) from each other, and
privacy curtain is drawn to
minimize opportunity for
direct contact.
• Protective attire is changed
and hand hygiene performed
between care of patients.
• Patients on Contact
Precautions are not placed in
the same room with patients
who have underlying

Element Yes No Action Needed
conditions that may increase
the risk of adverse outcomes
from infection, or that may
facilitate transmission (e.g.,
immunocompromised, open
wounds, prolonged length of
stay).
PATIENT PLACEMENT—Long-term
care settings
Decisions regarding patient placement are
made on a case-by-case basis, balancing
risks to other patients in the room and the
potential adverse psychosocial impact on
the infected or colonized patient.
PATIENT PLACEMENT—
Ambulatory Settings
Patients who require Contact Precautions
are placed in an examination room or
cubicle as soon as possible.
HAND HYGIENE AND GLOVES
Hand hygiene and glove use are observed

Element Yes No Action Needed
according to Standard Precautions and
whenever there is contact with patient’s
intact skin.
Hand hygiene and glove use are observed
whenever there is contact with surfaces
and articles in close proximity to the
patient (e.g., medical equipment or bed
rails).
GOWNS
Gowns are donned whenever it is
anticipated that clothing will have direct
contact with the patient or potentially
contaminated environmental surfaces or
items in the patient’s room.
Gowns are doffed and hand hygiene is
performed before leaving the patient’s
environment.
After gowns are doffed, ensure that
clothing and skin do not contact
potentially contaminated environmental
surfaces.

Element Yes No Action Needed
PATIENT TRANSPORT
Transport and movement of patients
outside the room are limited to medically
necessary purposes.
When transport is required, it is ensured
that infected or colonized areas of the
patient are contained and covered.
Contaminated personal protective
equipment (PPE) is removed and hand
hygiene performed prior to transporting
patient.
Clean PPE is donned when transport
destination is reached.
PATIENT CARE EQUIPMENT
Patient care equipment is managed
according to Standard Precautions.
Disposable patient care items are used
whenever possible.
Patient-dedicated noncritical equipment is
used to avoid sharing of equipment
among patients.
If use of common equipment or items is

Element Yes No Action Needed
unavoidable, items are cleaned and
disinfected before used on other patients.
Home care settings
Amount of patient care equipment
brought into the home is limited, and
when possible, equipment is left in the
home until patient is discharged from
home care services. Items are cleaned and
disinfected if unable to leave in home.
ENVIRONMENTAL MEASURES
Cleaning and disinfection of the rooms of
patients on Contact Precautions are given
highest priority.
High-touch surfaces (e.g., bed rails,
doorknobs, etc.) and equipment in the
patient’s immediate vicinity are cleaned
frequently.