[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Infection prevention and control](https://durgical.com/en/nursing/areas/infection/) › Transmission-based precautions: contact, droplet and airborne

# Transmission-based precautions: contact, droplet and airborne

- Safe practice

Measures added to standard precautions when a patient has, or may have, an infection spread by contact, droplets or the air.

Updated Nov 5, 2026

## Key points

- They are always added to standard precautions; they do not replace them.
- Contact: gloves and gown on entry; equipment dedicated to the patient.
- Droplet: surgical mask on entry; the patient wears a mask when leaving the room.
- Airborne: negative-pressure isolation room with the door closed, and a fit-tested N95 or higher respirator.
- They start on clinical suspicion, without waiting for confirmation.

On this page

- The basics Key points
- What it is
- What it requires
- Components
- How it is applied (and why)
- Common mistakes
- Elsewhere in DurgiPedia

- Safety The three types of transmission-based precautions
- In nursing practice

- Study Test yourself

- Connections Connections

## What it is

Transmission-based precautions are added to standard precautions when a patient is known or suspected to be infected or colonised with a transmissible or epidemiologically important microorganism. There are three types, by route: contact (through hands or the environment), droplet (large respiratory particles that fall nearby) and airborne (small particles that stay suspended and travel far). Each type sets the room, the PPE, transport and cleaning. They start on suspicion, without waiting for laboratory confirmation, and stop according to the organism and the patient's course.

## What it requires

- A visible sign on the door stating the type of precaution.
- PPE available outside the room, in the clean area.
- A single room when possible; if not, grouping only patients with the same infection.
- For airborne isolation: a negative-pressure room, with the pressure checked daily.

## Components

- Contact: single room or cohorting, gloves and gown on entry, non-critical equipment dedicated or disinfected before use on another patient.
- Droplet: single room or more than one metre of separation with the curtain drawn, mask on entry.
- Airborne: negative-pressure isolation room, air exhausted outdoors or HEPA-filtered, door closed, fitted respirator.

## How it is applied (and why)

- Identify the likely route of transmission and put the sign on the door — the whole team knows what protection to wear before entering.
- Place the patient in a single room or cohort only with patients who have the same infection — it limits exposure of others.
- Contact: put on gloves and gown on entry and remove them before leaving — hands and clothing carry the organism.
- Contact: use equipment dedicated to the patient or disinfect it before using it on another — it stops spread from bed to bed.
- Droplet: put on a surgical mask on entry — it blocks the large droplets that fall at short range.
- Airborne: keep the door closed and wear a fit-tested N95 or higher respirator — small particles stay suspended.
- Limit transport; if needed, the droplet or airborne patient wears a surgical mask — this protects the rest of the hospital.
- Clean a contact-isolation room at least daily, especially high-touch surfaces — it shrinks the environmental reservoir.
- Keep the precautions until the protocol says to stop — removing them early allows transmission.

## The three types of transmission-based precautions

| Type | Room | Staff protection | Examples |
| --- | --- | --- | --- |
| Contact | Single room or cohort with the same infection | Gloves and gown on entry | Multidrug-resistant bacteria (vancomycin-resistant enterococcus), Clostridioides difficile |
| Droplet | Single room or more than one metre of separation with a curtain | Surgical mask on entry | Influenza and other respiratory infections spread by droplets |
| Airborne | Negative-pressure isolation with the door closed | Fit-tested N95 or higher respirator | Pulmonary or laryngeal tuberculosis, measles, chickenpox |

## In nursing practice

- If no negative-pressure room is available, the patient wears a surgical mask, is placed in a closed room and transfer to a facility that has one is arranged.
- For measles or chickenpox, immune staff are preferred to enter the room.
- When an airborne-isolation patient is transported masked and with lesions covered, accompanying staff do not need a respirator.
- Immunosuppressed patients need different measures, which protect the patient.

## Common mistakes

- Wearing a surgical mask instead of a respirator when tuberculosis is suspected.
- Leaving the door of an airborne isolation room open.
- Using the same blood pressure cuff on another patient without disinfecting it.
- Waiting for the laboratory result before starting precautions.
- Forgetting standard precautions because the patient is already isolated.

## Test yourself

Think of the answer, then tap the question to see it.

## What protection do staff wear on entering the room of a patient on contact precautions?

Gloves and a gown, on top of standard precautions. Both are removed before leaving, followed by hand hygiene.

## What kind of room does a patient with suspected pulmonary tuberculosis need?

An airborne isolation room: negative pressure, air exhausted outdoors or HEPA-filtered and the door closed. Staff wear a fit-tested N95 or higher respirator.

## What does a patient on droplet precautions wear when they must leave the room?

A surgical mask, and transport is limited to what is strictly necessary.

## When are transmission-based precautions started?

As soon as the infection is suspected, without waiting for laboratory confirmation.

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## Elsewhere in DurgiPedia

- [The neutropenic and immunosuppressed patient (nursing)](https://durgical.com/en/immunology/the-neutropenic-and-immunosuppressed-patient/)

## Connections

## Related 2

- [Standard precautions](https://durgical.com/en/nursing/standard-precautions/)
- [Putting on and taking off personal protective equipment](https://durgical.com/en/nursing/putting-on-and-taking-off-personal-protective-equipment/)

[← All of nursing](https://durgical.com/en/nursing/)

Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Isolation Precautions: Summary of Recommendations (Guideline for Isolation Precautions, 2007)](https://www.cdc.gov/infection-control/hcp/isolation-precautions/summary-recommendations.html) (Centers for Disease Control and Prevention (CDC), 2007); [Transmission-based precautions for the prevention and control of infections: aide-memoire](https://qualityhealthservices.who.int/quality-toolkit/qt-catalog-item/transmission-based-precautions-for-the-prevention-and-control-of-infections-aide-memoire) (World Health Organization (WHO), 2022); [Nursing Fundamentals, 9.6 Preventing Infection](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/09:_Infection/9.06:_Preventing_Infection) (Open RN, Wisconsin Technical College System (LibreTexts copy, CC BY 4.0), 2021).

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Source: https://durgical.com/en/nursing/transmission-based-precautions-contact-droplet-and-airborne/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/transmission-based-precautions-contact-droplet-and-airborne/