History of Guidelines for Isolation Precautions in Hospitals
Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007)
Isolation precaution documents—a historical perspective.
Year (Ref) |
Document Issued |
Comment |
19701099
|
Isolation Techniques for Use in Hospitals, 1st ed.
|
- Introduced seven isolation precaution categories with color-coded cards: Strict, Respiratory, Protective, Enteric, Wound and Skin, Discharge, and Blood
- No user decision-making required
- Simplicity a strength; over isolation prescribed for some infections
|
19751100
|
Isolation Techniques for Use in Hospitals, 2nd ed.
|
- Same conceptual framework as 1st edition
|
19831101
|
CDC Guideline for Isolation Precautions in Hospitals
|
- Provided two systems for isolation: category-specific and disease- specific
- Protective Isolation eliminated; Blood Precautions expanded to include Body Fluids
- Categories included Strict, Contact, Respiratory, AFB, Enteric, Drainage/Secretion, Blood and Body Fluids
- Emphasized decision-making by users
|
1985-88780, 896
|
Universal Precautions
|
- Developed in response to HIV/AIDS epidemic
- Dictated application of Blood and Body Fluid precautions to all patients, regardless of infection status
- Did not apply to feces, nasal secretions, sputum, sweat, tears, urine, or vomitus unless contaminated by visible blood
- Added personal protective equipment to protect HCWs from mucous membrane exposures
- Handwashing recommended immediately after glove removal
- Added specific recommendations for handling needles and other sharp devices; concept became integral to OSHA’s 1991 rule on occupational exposure to blood-borne pathogens in healthcare settings
|
19871102
|
Body Substance Isolation
|
- Emphasized avoiding contact with all moist and potentially infectious body substances except sweat even if blood not present
- Shared some features with Universal Precautions
- Weak on infections transmitted by large droplets or by contact with dry surfaces
- Did not emphasize need for special ventilation to contain airborne infections
- Handwashing after glove removal not specified in the absence of visible soiling
|
19961
|
Guideline for Isolation Precautions in Hospitals
|
- Prepared by the Healthcare Infection Control Practices Advisory Committee (HICPAC)
- Melded major features of Universal Precautions and Body Substance Isolation into Standard Precautions to be used with all patients at all times
- Included three transmission-based precaution categories: airborne, droplet, and contact
- Listed clinical syndromes that should dictate use of empiric isolation until an etiological diagnosis is established
|
* Derived from Garner ICHE 1996