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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 patient’s 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
- 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.
- 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
- Indications for handwashing:
- when hands are visibly soiled, wash
hands with soap and water and then use hand disinfection
II. Hand Disinfection
Procedure
- Apply alcohol hand rinse (2-3 ml)
- Distribute to all surfaces of the
hands including nailbeds. Rub hands until dry. Do not use water
or paper towels.
III. Handwashing
Procedure
- Pump paper towel dispenser to have
towels readily accessible
- Turn on faucet
- Wet hands
- Apply handwashing soap
- Wash vigorously for at least 10
seconds, using friction over all surfaces
of the hand with particular attention to fingertips and nails
- Rinse hands well in a downward position
- Dry hands
- Turn off the faucet using paper
towels to avoid contamination from the faucet handle
- Discard towels in a trash receptacle
- Disinfect with alcohol hand rinse
(see II)
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