Medic-CE

Infectious Disease Prevention: Standard Precautions

Introduction:

In 1987, the Centers for Disease Control and Prevention, defined Universal Precautions as, “a set of precautions designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens when providing first aid or healthcare. Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious for HIV, HBV, and other bloodborne pathogens.” These precautions also apply to semen, vaginal secretions, as well as cerebrospinal, synovial, pleural, amniotic, and pericardial fluids.⁷

Universal precautions emphasize the routine use of blood and body substance precautions in every patient encounter, regardless of presumed infectious status. Other terms which may be used in conjunction with Universal Precautions include: Standard Precautions and Body Substance Isolation. The difference between the terms is that the term “Standard Precautions” incorporates important elements from both Body Substance Isolation and Universal Precautions and is, therefore, more inclusive. The following is a brief list of Standard Precautions.

Personal Protective Equipment:

Personal protective equipment is generally worn on top of work clothes and is designed to protect staff and patients from exposure to infectious fluids. Personal protective equipment includes: gloves, eye shields, gowns, and masks.

-Gloves:

Gloves are required anytime contact is to be made with the mucous membranes or non-intact skin of patients, as well as for touching blood and bodily fluids requiring Universal Precautions. Should a glove become torn, be sure and remove the gloves you are wearing, wash your hands, and put on a new set of gloves. If you anticipate a glove tear, wearing two gloves is always an option, so that if the top one rips it can be removed. Gloves should be disposed of properly and changed after contact with each patient. In addition, hands should be washed immediately after the removal of gloves.

It should also be noted that gloves do not provide complete protection against hand contamination, such as from hepatitis B virus or herpes simplex virus.

-Eye Shields:

Transmission of infectious diseases can occur by having bodily fluids penetrate your eyes. In order to protect your eyes from disease exposure, you should wear protective shields or goggles. It is important that these devices have side shields, as the fluid may not always come head on. If you wear glasses, side shields can be added to them.

-Gowns:

Gowns should be worn in any situation where significant splashing is anticipated, such as when delivering a baby or in major trauma. Disposable gowns should be used and, if at all possible, a change of uniform should be available to wear after caring for a patient involving a large splash.

-Masks:

Protective masks are available to prevent fluids from being splashed into your nose or mouth. A simple surgical mask can suffice for basic situations. However, if you suspect that a patient has tuberculosis, then a high-efficiency particulate air respirator (HEPA for short) or an N-95 respirator becomes necessary.

Equipment Disinfection and Disposal:

Disposable equipment should be used, where available. When reusable equipment is used, proper disinfection should be performed after each patient.

Waste products should be disposed of appropriately. Containers should be designated for contaminated waste, so that they can receive the proper transport and method of disposal.

Sharps Precautions:

All healthcare workers should take precautions to prevent injuries from sharps, which include: broken glass, scalpels, needles, or any object that can puncture the skin and that has potentially been contaminated with blood or bodily fluid. If possible, avoid the use or handling of sharps when not using them for patient care.

Avoid potentially risky practices, such as re-sheathing needles, carrying sharps around when not in immediate use, laying a sharp near you when finished using it instead of immediately disposing of it, or attempting to retrieve an item from within a sharps container.

Sharps containers should be assembled correctly and stored in a safe and secure place. They should be easily accessible to healthcare workers, but out of the way of patients. NEVER overfill a sharps container.

In case of sharp penetration of the skin, allow the wound to bleed, do not suck on it. Wash the affected area with copious amounts of soap and water and report the incident to your Designated Officer.

Linens:

Uniforms are a potential source of infection and should be changed daily and laundered appropriately. All uniforms that come in contact with patients should be decontaminated. Laundering of linens should be performed at sufficiently high temperatures and for an adequate period of time to destroy microorganisms. Your particular agency may provide such laundering equipment and or services. If laundry facilities are not available to you at your agency, then launder work linens separately at home with hot water.

Food Preparation on the Job:

Food should be prepared in a designated, clean environment, and only after your hands have been adequately washed.