The Guideline for Isolation Precautions in Hospitals contains many important changes from previous editions of the manual Isolation Techniques for Use in Hospitals:

1. Rather than recommending only an isolation system based on categories of isolation, we have included an alternative system: disease-specific isolation precautions. For the first time, hospitals can choose one of these alternative systems for isolation—or they can, of course, design their own system. Some hospitals may prefer to continue using the more familiar, convenient, and simple category-specific isolation precautions. Disease-specific isolation precautions, however, may be more economical, in that only the particular precautions to interrupt transmission of the specific disease are recommended, so time and materials are not spent on unnecessary precautions. With disease-specific isolation precautions, we recommend using a single instruction card on which the need for specific precautions can be shown by checking appropriate items and filling in blanks. When isolation categories are used, we still recommend using standard color-coded category-specific instruction cards; however, the colors have been changed and the cards have been revised to correspond to changes made in the category-specific recommendations.

2. Major changes have been made in the titles of and specifications for categories of isolation and the diseases or conditions requiring specific categories of isolation.

a. We have retained 3 categories of isolation (Strict Isolation, Respiratory Isolation, and Enteric Precautions) with modifications. We have substantially modified Enteric Precautions to minimize unnecessary use of gowns and gloves. This modification has permitted infections formerly under Excretion Precautions to be combined with those under Enteric Precautions. We have added and deleted diseases from Strict Isolation and Respiratory Isolation.

To use the new approaches introduced in this guideline most effectively, each hospital's infection control committee must thoroughly review the entire guideline and MAKE A DECISION regarding which of the alternative systems of isolation precautions to use.

The first step is for all members of the committee who will participate in this decision to review the entire guideline carefully. This is necessary because the Guideline for Isolation Precautions in Hospitals contains many changes in recommended procedures as well as format from the previous manual Isolation Techniques for Use in Hospitals. To facilitate this review, we have summarized the most important changes in the introduction to the guideline and have included the rationale for these changes in other sections of the document.

The second step is for the infection control committee to MAKE A DECISION as to whether their hospital will use System A, the Category-Specific System, or System B, the Disease-Specific System, both of which are thoroughly described in this guideline. Of course, in some hospitals the committee may decide instead to use the information and recommendations in this guideline to create their own system of isolation precautions. However, from a logistical point of view, the committee should not try to combine different elements taken from both systems, because mixing the 2 approaches may lead to confusion among hospital personnel who are expected to apply the isolation precautions in patient care. Personnel throughout the hospital who will be using isolation precautions should be trained to apply only the system that is officially adopted by the infection control committee.