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Standard Precautions and Hand Hygiene

Standard Precautions
Hand Hygiene

Standard Precautions

Standard Precautions is a nation-wide system of responding to patients in a hospital environment utilizing a careful and uniform manner that allows staff to deliver care safely and prevents the spread of communicable diseases to staff and other patients.

Healthcare workers and hospital volunteers will maintain a high standard of protection against direct contact with blood or body fluids of ALL patients. This level of care generally involves thoughtful appraisal of each task and the use of gloves or other protective garments for anticipated contact, always using common sense.

Two categories of disease, respiratory and immunocompromised host, will require additional identification.
You will see a green respiratory sign or a white immunocompromised host sign posted outside the entrance to these patients' rooms who are on these precautions.

Standard precautions are observed by all hospital staff, however, volunteers are not routinely asked to perform tasks that bring them into contact with blood or bodily fluids.

It is our philosophy that by learning and observing standard precautions, everyone is protected and prepared for the unexpected.

I. Indication

Standard Precautions are applied to prevent occupational exposure to blood, body fluids, secretions, and excretions from all patients and contaminated medical equipment. Consistent use of Standard Precautions can prevent transmission of nosocomial pathogens between patients.

II. Hand Hygiene

Hand hygiene is the single most important means of preventing the spread of infection. Hands must be disinfected with an alcohol hand rinse after providing care that involves touching the patient, and after removing gloves, gowns, or respiratory protection devices, or touching contaminated items or surfaces. If hands are visibly soiled then wash hands with soap and water, dry hands, and apply an alcohol-based hand rinse. Click here for hand hygiene procedures.

III. Patient Placement

There are no special placement requirements for Standard Precautions; however, patients should be placed in a private room if their blood and body fluids, including feces and urine, contaminate their environment.

IV. Personal Protective Equipment

A. Gloves
Clean, nonsterile gloves must be worn when touching blood, body fluids, secretions, excretions, mucous membranes, and contaminated medical equipment. Contaminated medical equipment includes in-use respiratory tubing and soiled respiratory equipment. Remove gloves after use and before touching noncontaminated items or surfaces and before providing care for another patient. Disinfect hands immediately after removing gloves to avoid transfer of organisms to other patients.
 
B. Gowns
Clean, nonsterile gowns must be worn to protect skin and to prevent soiling of clothing during activities that may generate splashes or sprays of blood, body fluids, secretions, or excretions. Remove a soiled gown immediately upon leaving the patientís room and disinfect hands to avoid transfer of organisms to other patients.
 
C. Mask, Eye Protection, Face Shield
A mask, in combination with eye protection or a faceshield, is worn to protect mucous membranes of the eyes, nose, and mouth during activities that may generate splashes or sprays of blood, body fluids, secretions, or excretions.

V. Engineering Controls

Safety devices, such as sheathed and protected needles, are used to prevent accidental needlestick or puncture. Place disposable syringes and needles, scalpel blades, and other sharp items in appropriate puncture-resistant containers. See Infection Control Policy on the Disposal of Infectious or Physically Dangerous Medical Waste.

VI. Patient Care Equipment/Supplies

Reusable patient care equipment must be disinfected with the hospital- approved disinfectant before use on another patient. See Guideline for the Cleaning Frequency of Hospital Equipment.

VI. Patient Care Equipment / Supplies

No special precautions are needed for patient transport.

VII. Visitors

No special precautions are needed for visitors. 
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Hand Hygiene

Hand hygiene is considered the single most important measure for preventing nosocomial infections.

I. Routine Patient Care

  1. Purpose

The purpose of hand hygiene for routine patient care is to reduce microbial contamination acquired by recent contact with infected or colonized patients or environmental surfaces. Hand hygiene includes both hand disinfection with an alcohol-based hand rinse and handwashing.

  1. Indications for hand disinfection include:
  • after ANY patient contact
  • before and after touching wounds
  • after situations for which microbial contamination of hands is likely, especially those involving contact with mucous membranes, blood or body fluids, secretions or excretions
  • after contact with inanimate surfaces likely to be contaminated
  • after removing gloves
  • before invasive procedures
  • after contact with patients on Contact Precautions for multiply antibiotic-resistant organisms
  • before contact with particularly susceptible patients, such as severely immunocompromised patients, recent transplants, and newborns
  1. Indications for handwashing:
  • when hands are visibly soiled, wash hands with soap and water and then use hand disinfection

II. Hand Disinfection Procedure

  1. Apply alcohol hand rinse (2-3 ml)
  2. Distribute to all surfaces of the hands including nailbeds. Rub hands until dry. Do not use water or paper towels.

III. Handwashing Procedure

  1. Pump paper towel dispenser to have towels readily accessible
  2. Turn on faucet
  3. Wet hands
  4. Apply handwashing soap
  5. Wash vigorously for at least 10 seconds, using friction over all surfaces of the hand with particular attention to fingertips and nails
  6. Rinse hands well in a downward position
  7. Dry hands
  8. Turn off the faucet using paper towels to avoid contamination from the faucet handle
  9. Discard towels in a trash receptacle
  10. Disinfect with alcohol hand rinse (see II)
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