About transmission based precautions (TBPs)

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 patients 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.

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:

Respiratory infections

Respiratory infectious agents are mainly transmitted via the air transmission route. To support the application of TBPs, respiratory infectious agents have been grouped into three respiratory (R) categories: R1, R2 and R3. 

These categories take into account:

Appendix 11 provides details of infectious agents, associated presentation or disease, the 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'.

Resources

Further information can be found in the Transmission Based Precautions Definitions literature review.