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STANDARD PRECAUTION

PRESENTED BY:
G. LYNNE CHANCY, MSN, ARNP, ACAGNP-B
ADJUNCT PROFESSOR OF NURSING
MAY 2016
DEFINITION
Standard Precautions
Previously known by various names including universal
precautions
Standard precautions are designed to reduce the risk of
transmission of bloodborne and other pathogens from
both recognized and unrecognized sources to a
susceptible host.
They are the basic level of infection control precaution
Hospital Infection is the result of a combination of
factors: Microbial source + Transmission +
Susceptible host = Infection
History of Infection Control
Year
Precautions
Infection Control Precautions
1877,191 Separates facilities, Antisepsis and disinfections ... etc
0
1985 UNIVERSAL PRECAUTIONS (guidelines for
protecting healthcare worker because the emergence
of HIV & other bloodborne pathogens)
1987 BODY SUBSTANCE ISOLATION ( focused on
protecting patients and health personnel from all
moist body fluids not just blood: semen, vaginal
secretions, wound drainage, sputum, saliva etc
1996 STANDARD PRECAUTIONS:Two level approach:
Standard Precautions which apply to all clients and
patients attending healthcare facilities
Transmission-based Precautions which apply only
to hospitalized patients
2007 ISOLATION PRECAUTIONS (new pathogens; SARS,
Avian Influenzae H5N1, H1N1)
Standard precautions Transmission-based precautio

Universal precautions
Airborne precaut
Body substance isolation
Droplet precauti

Contact precauti
Key Elements of Standard Precautions

1. Hand hygiene
2. Gloves
3. Mask, gogles, face masks PPE
4. Gown
5. Prevention of needle stick & injuries from sharp
instruments
6. Respiratory hygiene & cough etiquette
7. Environmental cleaning
8. Linens
9. Waste disposal
10.Patient care equipment
WHO, 2007
Definitions of Hand hygiene

Hand-washing
Washing hands with plain soap and water
Antiseptic hand-wash
Washing hands with water and soap or other
detergents containing an antiseptic agent
Alcohol-based hand-rub
Rubbing hands with an alcohol-containing
preparation
Surgical hand hygiene/antisepsis
Hand-washing or using an alcohol-based hand-
rub before operations by surgical personnel

Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no.
RR-16.
My five moments for hand hygiene
This I do believe !
The single most important thing that you can do to stop
the spread of any germs is to wash your hands
PPE
PPE Working Condition

gloves should be used when touching blood, body fluids,


secretions, excretions, or contaminated items and for
touching mucous membranes and nonintact skin.

gowns should be used during procedures and patient care


activities when contact of clothing and/or exposed skin
with blood, body fluids, secretions, or excretions is
anticipated. Aprons are sometimes used as PPE over
scrubs, such as in hemodialysis centers when
inserting a needle into a fistula.
Mask and should be used during patient care activities that are
goggles or a likely to generate splashes and sprays of blood, body
face shield fluids, secretions, or excretions.
Precaution for suspected Avian
Influenza :
Full Barrier Precaution
Activities at risk of sharp injury
Needle re-capping
Body fluids aliquoting
Open the tubes
Throw the sharps not to sharp container

HBV : 27 37%
( 30%)
HCV : 3 10 %
(3,0 %)
HIV : 0,2 0,4%
(0,3%)
Discard if 2/3 full
Transmission-Based Precautions
Used in addition to Standard Precautions for
Specified Patients
Designed for the Care of Specified Patients
known or suspected to be infected by
epidemiologically important pathogens spread by:
airborne, droplet, or contact transmission.
Droplet Transmission
For infectious agents with droplet nuclei >
5 microns
Examples:
Pertussis
Meningococcal meningitis
Precaution Examples:
Private room
Mask if within 3 of patient
Droplet Precautions
Prevent infection by
large droplets from
Sneezing
Coughing
Talking

Examples
Neisseria meningitidis
Pertussis
Influenza
Airborne Transmission
For infectious agents with droplet nuclei < 5
microns
Examples:
Tuberculosis
Measles
Precaution Examples
Isolation rooms under negative pressure
N95 or HEPA respirator use
Airborne Precautions for Avian
Influenza
Respiratory Protection
N95 respirator
Patient in isolation/cohorting
Patient Transport
Limit patient movement
and transport,
place a surgical mask
on the patient
Airborne isolation room, if available
Air exhaust to outside or
re-circulated with HEPA filtration
Linens
Handle, transport, and process used
linen in a manner which:
Prevents skin and mucous membrane
exposures and contamination of clothing.
Avoids transfer of pathogens to other
patients and or the environment.
Waste disposal
Ensure safe waste management.
Treat waste contaminated with blood, body
fluids, secretions and excretions as clinical
waste, in accordance with local regulations.
Human tissues and laboratory waste that is
directly associated with specimen
processing should also be treated as
clinical waste.
Discard single use items properly.
Patient care equipment
Handle equipment soiled with blood, body
fluids, secretions, and excretions in a
manner that prevents skin and mucous
membrane exposures, contamination of
clothing, and transfer of pathogens to other
patients or the environment.
Clean, disinfect, and reprocess reusable
equipment appropriately before use with
another patient.
Contact Precautions
For protection against skin-to-skin contact and physical
transfer of microorganisms to a host from a source
Precaution Examples:
Private room
Handwashing
Glove changes
Examples
Scabies
VRE

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