Contact Precautions

MRSA, C. diff, and scabies all spread by touch — but the PPE and room setup differ from other transmission-based precautions in ways the NCLEX loves to test.

Contact precautions prevent transmission of organisms spread by direct touch (skin-to-skin) or indirect touch (contaminated surfaces, equipment). They are used in addition to standard precautions — never as a replacement. Key organisms include MRSA, VRE, C. difficile, scabies, and draining wounds with resistant organisms. RSV in infants requires contact plus droplet precautions. The required PPE is a gown and gloves, donned before room entry and removed before exiting. No special mask or respirator is needed unless the organism also has a droplet or airborne component. The patient should be placed in a private room or cohorted with a patient who has the same organism. Dedicated equipment (stethoscope, blood pressure cuff, thermometer) stays in the room to avoid cross-contamination. For C. difficile specifically, hand hygiene must be performed with soap and water — alcohol-based sanitizers do not kill C. diff spores. Transport outside the room should be limited; when necessary, cover the infected or colonized area and ensure receiving departments are notified. Contact precautions remain in place until the provider discontinues them based on culture results or clinical resolution, not at the nurse's discretion.

Key Distinctions

Don't confuse contact precautions (gown + gloves, no mask) with droplet precautions (surgical mask required) or airborne precautions (N95 + negative-pressure room). Students frequently add a mask for contact-only organisms — the NCLEX will use that as a distractor. C. diff is the exception that breaks the alcohol-rub rule: soap and water only, because spores survive alcohol.

Clinical Pearl

Gown and gloves, no mask — that's contact. If you picture yourself hugging the pathogen to catch it, you need contact precautions.