🛡️ Safety & Infection Prevention · Lesson 1 of 6 · 7 min

Contact, Droplet, Airborne: Pick the Right Door

😷 Measles can hang in the air of a room for two hours after the client leaves. Influenza falls to the floor within a few feet. C. diff laughs at hand sanitizer. Three diseases, three completely different rooms.

💡 Key idea

Contact: gown and gloves. Droplet: surgical mask on entering the room. Airborne: N95 and a negative-pressure room. C. diff: soap and water, never sanitizer alone.

🧠 Why it matters

STANDARD precautions apply to everyone: hand hygiene, gloves for body fluids, and sharps safety. CONTACT precautions add a gown and gloves and a private room or cohorting: MRSA, VRE, Clostridioides difficile, scabies, RSV, rotavirus and draining wounds. For C. diff, wash with SOAP AND WATER because alcohol does not kill spores, and use bleach for cleaning. DROPLET precautions add a surgical mask, put on when entering the room: influenza, pertussis, mumps, rubella, meningococcal meningitis, pharyngeal diphtheria and mycoplasma pneumonia; the client wears a surgical mask when transported. AIRBORNE precautions require a negative-pressure room with the door closed and an N95 respirator fit-tested to you: tuberculosis, measles (rubeola), varicella and disseminated herpes zoster. A memory aid for airborne: My Chicken Hez TB, for measles, chickenpox, disseminated herpes zoster, tuberculosis. Varicella and disseminated zoster need airborne plus contact precautions.

🏥 In the real world

🚪 A new nurse puts a client with suspected tuberculosis in a regular private room with the door open and wears a surgical mask. Both choices fail: TB droplet nuclei are tiny and float; only a fitted N95 filters them, and only negative pressure keeps them out of the hallway. The exam will set exactly this trap with a plausible but wrong mask.

📌 Takeaways

Contact: MRSA, VRE, C. diff (soap and water), scabies, RSV
Droplet: flu, pertussis, mumps, rubella, meningococcal meningitis
Airborne: TB, measles, varicella, disseminated zoster: N95 plus negative pressure

📖 Terms in this lesson

Standard precautions: The hand hygiene, protective equipment matched to the expected exposure, and safe sharps and injection practices used with every client, regardless of diagnosis.

Contact precautions: Gown and gloves for organisms spread by touch, such as MRSA, VRE, C. difficile and scabies.

Droplet precautions: A surgical mask worn on entering the room of a client with influenza, pertussis, mumps, rubella or meningococcal meningitis.

Airborne precautions: An N95 respirator and a negative-pressure room for tuberculosis, measles, varicella and disseminated zoster.

Negative-pressure room: A room that pulls air inward and vents it outside so airborne organisms cannot escape into the hallway.

SPIDERMAN (droplet precautions): meningococcal Sepsis, Scarlet fever, Strep throat, Parvovirus, Pneumonia (some types), Pertussis, Influenza, Diphtheria, Epiglottitis, Rubella, Mumps, meningococcal Meningitis, Mycoplasma, Adenovirus: diseases needing a surgical mask on entering the room.

MRS. WEE (contact precautions): Multidrug-resistant organisms, Respiratory syncytial virus, Skin infections (scabies, impetigo, herpes simplex), Wound infections (draining), Enteric infections (C. difficile), Eye infections (viral conjunctivitis): the diseases that need a gown and gloves.

✅ Test yourself

Which client requires airborne precautions in a negative-pressure room?

A client with active pulmonary tuberculosis
A client with pertussis and a paroxysmal cough
A client with influenza who is coughing frequently
A client with MRSA in a draining surgical wound

Answer: A · A client with active pulmonary tuberculosis

Tuberculosis spreads by tiny airborne droplet nuclei. Influenza and pertussis are droplet; MRSA wound infection is contact.

After caring for a client with Clostridioides difficile, which hand hygiene is correct?

Alcohol-based hand rub for 20 seconds
Gloves alone are sufficient
Chlorhexidine wipes on the gloves
Soap and water

Answer: D · Soap and water

C. diff spores survive alcohol. Mechanical washing with soap and water removes them.

A client with bacterial (meningococcal) meningitis must go to CT. Which precaution is correct during transport?

Place a surgical mask on the client
No special precautions once outside the room
Staff wear N95 respirators and the client wears nothing
Cancel the test until isolation ends

Answer: A · Place a surgical mask on the client

Meningococcal meningitis is droplet; the client wears a surgical mask to contain droplets during transport.

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