Professional Documents
Culture Documents
Standard Precautions
Used in the care of all hospitalized persons regardless of their diagnosis
or possible infection status
Apply to:
Blood
All body fluids, secretions, and excretions except sweat (whether or
not blood is present or visible)
Nonintact skin and mucous membranes
Combine the major features of UP and BSI
Transmission-based Precautions
Used in addition to standard precautions
For known or suspected infections that are spread in one of three ways:
Airborne
Droplet
Contact
May be used alone or in combination but always in addition to standard
precautions
Managing Equipment Used for Isolation Clients
Many supplied for single use only
Disposed of after use
Agencies have specific policies and procedures for handling soiled
reusable equipment
Nurses need to become familiar with these practices
Bloodborne Pathogen Exposure
Report the incident immediately
Complete injury report
Seek appropriate evaluation and follow-up
Identification and documentation of the source individual when feasible
and legal
Testing of the source for hepatitis B, C and HIV when feasible and consent
is given
Making results of the test available to the source individual’s health care
provider
Testing of blood exposed nurse (with consent) for hepatitis B, C, and HIV
– please check these to match style used in book – fairly certain it should
be caped antibodies
Postexposure prophylaxis if medically indicated
Medical and psychologic counseling
Puncture/Laceration
Encourage bleeding
Wash/clean the area with soap and water
Initiate first aid and seek treatment if indicated
Mucous membrane exposure (eyes, nose, mouth)
Flush with saline or water flush for 5 to 10 minutes
Postexposure Protocol (PEP) for HIV
Start treatment as soon as possible preferably within hours after exposure
For “high-risk” exposure (high blood volume and source with a high HIV
titer), three drug treatment is recommended
For “increased risk” exposure (high blood volume or source with high HIV
titer), three-drug treatment is recommended
For “low risk” exposure (neither high blood volume nor source with a high
HIV titer), two-drug treatment is considered
Drug prophylaxis continues for 4 weeks
Drug regimens vary and new drugs and regimens continuously being
developed
HIV antibody tests should be done shortly after exposure (baseline), and 6
weeks, 3 months, and 6 months afterward
Postexposure Protocol (PEP) for Hepatitis B
Anti-HBs testing 1 to 2 months after last vaccine dose
HBIG and/or hepatitis B vaccine within 1 to 7 days following exposure for
nonimmune workers
Postexposure Protocol (PEP) for Hepatitis C
Anti-HCV and ALT at baseline and 4 to 6 months after exposure