4.4 Transmission-Based Precautions and Cleaning
Key Takeaways
- Transmission-based precautions add special steps for contact, droplet, or airborne risks.
- CNAs should follow posted isolation instructions and ask the nurse when unsure.
- Cleaning moves from clean areas to dirty areas and from high surfaces to lower surfaces when applicable.
- Soiled linen should be handled gently and kept away from the uniform.
- Report symptoms that may require isolation, such as new cough, diarrhea, fever, or draining wounds.
Beyond Standard Precautions
Some infections need extra precautions. The CNA does not decide the medical diagnosis, but the CNA must follow posted signs and facility rules.
| Precaution Type | Common CNA Focus |
|---|---|
| Contact | Gloves, gown, dedicated equipment, careful room exit |
| Droplet | Mask as directed, respiratory etiquette, distance |
| Airborne | Special room and respirator policy; ask nurse before entry |
| Protective | Protect high-risk resident from exposure |
Isolation Room Habits
Before entering, read the sign. Gather needed supplies before donning PPE so you do not leave repeatedly. Bring only what is necessary into the room.
After care, remove PPE correctly, perform hand hygiene, and handle equipment as contaminated unless policy says otherwise.
Cleaning And Disinfection
Cleaning removes soil. Disinfection kills many organisms on surfaces. CNAs may clean resident care items according to facility policy.
High-touch surfaces include:
- Call lights.
- Bed rails.
- Overbed tables.
- Wheelchair arms.
- Bathroom grab bars.
- Door handles.
- Shared equipment.
Linen Handling
Do not shake linen. Shaking releases organisms into the air. Roll soiled linen away from your body and place it in the correct hamper or bag.
Never place clean linen on the floor. Never use another resident's linen or supplies.
What To Report
Report symptoms that may signal infection spread:
- New diarrhea.
- Productive cough.
- Fever or chills.
- New rash.
- Drainage from wound.
- Burning urination.
- Sudden confusion.
The CNA's role is early observation. A timely report may prevent an outbreak.
Why should soiled linen not be shaken?
A CNA is unsure what PPE is required for an isolation room. What should the CNA do?