to Standard Precautions
Standard precautions are infection prevention practices applied to all patients in all healthcare settings, regardless of their infection status. They form the foundational layer of infection control, protecting both patients and healthcare personnel from infectious agents.
Key Practices
Effective standard precautions begin with hand hygiene. This involves washing hands with soap and water or using an alcohol-based hand rub before and after patient contact, after touching contaminated surfaces, and after removing gloves. Proper hand hygiene reduces microorganism transmission.
Personal protective equipment (PPE) is another core practice, including gloves, gowns, masks, and eye protection. Healthcare workers select appropriate PPE based on the type of patient interaction and potential for exposure to blood, body fluids, or contaminated environments. Gloves are worn when touching blood, body fluids, secretions, excretions, or contaminated items, while gowns protect skin and clothing during procedures that may generate splashes.
Respiratory hygiene and cough etiquette are also integrated into standard precautions. This involves covering the mouth and nose when coughing or sneezing, using tissues, and performing hand hygiene afterward. Healthcare facilities also provide masks for individuals with respiratory symptoms and encourage maintaining a safe distance from others. These measures help contain respiratory droplets that can spread infections.
Safe injection practices are important. This includes using a sterile needle and syringe for each injection, preventing contamination of injection equipment and medication, and never reusing needles or syringes. Needles should not be recapped, bent, or broken, but rather immediately disposed of in puncture-resistant containers.
Proper handling of patient care equipment ensures that reusable medical devices are cleaned, disinfected, or sterilized appropriately before use on another patient. This process removes or destroys microorganisms, preventing cross-contamination. Environmental cleaning involves regularly disinfecting frequently touched surfaces in patient care areas to reduce the presence of pathogens.
Managing laundry and waste also falls under standard precautions. Contaminated laundry is handled with minimum agitation to prevent aerosolization of microorganisms, and infectious waste is segregated and disposed of according to established protocols. These practices, supported by guidelines from organizations like the Centers for Disease Control and Prevention (CDC), minimize infection risks.
Application to All Patients
The “standard” in standard precautions signifies their universal application to every patient encounter, regardless of the patient’s diagnosis or perceived infection status. This universal approach acknowledges that patients may be infected with pathogens without showing symptoms, or before their infection is identified. Assuming all blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes may contain transmissible infectious agents guides this practice.
This concept evolved from “universal precautions,” which primarily focused on bloodborne pathogens in the 1980s. The shift to “standard precautions” broadened the scope to include all body fluids, secretions, and excretions, recognizing that many pathogens are not exclusively bloodborne. Applying these precautions consistently eliminates the need to determine an individual patient’s infection status before providing care, ensuring consistent protection for everyone.
Protecting Everyone
Standard precautions provide a foundational layer of safety, protecting all individuals within healthcare settings. These practices reduce the risk of healthcare-associated infections (HAIs), which patients acquire during medical care. By consistently applying these measures, the chances of pathogens spreading from one patient to another, or from the environment to a patient, are greatly diminished.
Standard precautions also safeguard healthcare workers from exposure to infectious agents during their daily duties. Following guidelines for hand hygiene, PPE use, and safe handling of equipment minimizes direct contact with potentially infectious materials. This protection extends beyond the immediate patient care area, preventing the spread of pathogens into the wider community. These measures establish a defense against infectious diseases for patients, staff, and visitors.
Distinction from Other Precautions
While standard precautions are the baseline for infection control, certain situations necessitate additional protective measures known as Transmission-Based Precautions. These are employed when a patient is known or suspected to be infected or colonized with highly transmissible or epidemiologically important pathogens that require precautions beyond standard ones. Transmission-Based Precautions are always used in addition to, never as a replacement for, standard precautions.
Contact precautions are implemented for infections spread by direct or indirect contact with the patient or their environment. This often involves the use of gowns and gloves upon entry into the patient’s room, which are then removed before leaving. Examples include infections caused by Methicillin-resistant Staphylococcus aureus (MRSA) or Clostridioides difficile (C. diff).
Droplet precautions are used for diseases transmitted through large respiratory droplets generated during coughing, sneezing, or talking. Healthcare personnel typically wear a surgical mask when working within a certain distance of the patient, generally three feet. Common conditions requiring droplet precautions include influenza or pertussis.
Airborne precautions are reserved for infections spread by very small airborne particles that can remain suspended in the air for extended periods and travel over long distances. Patients requiring airborne precautions are typically placed in an airborne infection isolation room (AIIR) with negative air pressure. Healthcare workers entering these rooms wear a fit-tested N95 or higher-level respirator. Tuberculosis, measles, and varicella (chickenpox) are examples of diseases requiring airborne precautions.