SICPs may be insufficient to prevent cross-transmission of specific infectious agents. Therefore, additional precautions known as transmission based precautions (TBPs) are required to be used by staff when caring for residents with a known or suspected infection or colonisation.

The way in which we describe transmission routes has changed. You can find out more about this in our ‘What’s changed?’ guide. Our Frequently Asked Questions (FAQs) resource provides answers to some of the common queries associated with the changes. 

Transmission routes

Transmission routes are the ways in which an infectious agent spreads from one place or person to another.  Some infectious agents can be transmitted by more than one route. 

Contact transmission route

Transmission of infectious agents from one person to another by direct physical contact (direct contact transmission) or indirectly through contact with a contaminated object or surface (indirect contact transmission).

Air transmission route

Transmission of infectious agents from one person to another (without touching) via body fluids that travel from the infected person through the air. Air-transmitted infectious agents can be transmitted by splashing or spraying of body fluid particles onto the mucosa and/ or by inhaling body fluid aerosols.

• Respiratory infections

Application of TBPs

Application of TBPs may differ depending on several factors. Clinical judgement and decisions should be made by staff on the necessary precautions. This should be based on the:

• suspected or confirmed infectious agent
• transmission route of the infectious agent
• care setting and procedures undertaken
• severity of the illness caused

Respiratory infections

Respiratory infectious agents are mainly transmitted via the air transmission route. To support the application of TBPs, respiratory infectious agents have been categorised into three groups: Respiratory 1 (R1), Respiratory 2 (R2) and Respiratory 3 (R3). 

These categories take into account:

• severity of illness associated with infection
• transmissibility
• associated availability of vaccination and treatments (prophylaxis)

Within care homes, respiratory infections are likely to fall within the R1 category which includes Rhinovirus (common cold), Influenzas A and B (flu), SARS-CoV2 (COVID-19) and Respiratory Syncytial Virus (RSV).

Appendix 11 provides details of infectious agents, associated presentation or disease, he type of precautions, optimal patient placement, isolation requirements and respiratory (‘R’) category (for respiratory infectious agents).

If you want to understand more about how each pathogen is categorised, this is described in the NIPCM glossary under 'respiratory categories'.

 

Further information on transmission based precautions can be found in the definitions of Transmission Based Precautions literature review.