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11 X 1 1 1 '' 11 1" 1;I •' 1 � 1 1' 1 1 1 (Modified from CDC Guidelines) Airborne Precautions Private room is required that has: • Monitored negative air pressure in relation to surrounding areas • Six to twelve air changes per hour • Appropriate discharge of air outdoors or monitored high -efficiency particulate air (NEPA) filtration of room air before it is circulated to other areas Keep the door closed and the resident in the room. When a private room is not available, place the resident in a room with another resident with the same infection, but with no other infections (cohorting). Consider the epidemiological pattern of the microorganism and resident population when determining resident placement. Do not place a resident with MRSA infection or colonization in a room with another resident who has VRE infection or colonization. Respiratory protection, NEPA or N 95 respirator/mask, is needed when entering the room of a resident who is known to have, or suspected of having, pulmonary tuberculosis. Limit the movement and transport of the resident as much as possible, and if transport is necessary place a surgical mask on the resident during transport. If the facility does not have a negative air pressure room that meets all of these criteria, residents with suspected pulmonary tuberculosis will be transferred as soon as possible to an appropriate facility. Consider having the resident wear a surgical mask, if possible during transport, in waiting areas, or when others are present. Residents who have varicella (chickenpox), or rubeola or rubella (measles), will be cared for only by those with known immunity (i.e., they have already had the infection or have had adequate immunization with documented immunity). Employees with immunity need not wear respiratory protection. Residents with disseminated herpes zoster (disseminated shingles) will be transferred to a specially equipped facility if possible; if that is not possible, then droplet and Contact Precautions will be utilized. Droplet Precautions Private room is desirable; the door may remain open. If a private room is not available, place the resident in a room with another resident with the same infection, and with no other infections (cohorting). When cohorting is not achievable, maintain separation of at least 3 feet between the infected resident and other residents, staff, and visitors. Cubicle curtain may be utilized to prevent droplet transmission.