Edward Raby1
1 Fiona Stanley Hospital, Murdoch, WA 6150, Edward.Raby@health.wa.gov.au
Background: Transmission based precautions were introduced in the 1990s for infections with special clinical or epidemiological significance. Contact precautions are now recommended for a long list of clinical conditions as well as specific pathogens in national and international guidelines. These guidelines claim a strong theoretical rationale.
Method: A narrative review of the published evidence focusing on the effects of contact precautions.
Findings: Contact precautions are a complex bundle of interventions which typically includes use of gloves as well as aprons or gowns, dedicated equipment and physical isolation. The effects and application of individual components of this bundle are challenging to assess, especially across varied healthcare contexts with different pathogen epidemiology, clinical practices and built environment. Where discontinuation of contact precautions has been studied, results are generally favourable. Unintended consequences of contact precautions have been documented.
Conclusion: The current practice of contact precautions needs to be revised with careful consideration of the indications for use, the components of the contact precautions bundle and the importance of local context.