STANDARD PRECAUTION

● They are set of guidelines

- help reduce the transmission of HAI in hospitals
- reduce the risk of transmission of microorganisms from
both recognized and unrecognized sources of infection in
hospitals.

When should Standard Precautions be used?

● They should be used by ALL health care workers at ALL times
when attending to ALL patients regardless of their diagnosis
and presumed infectious status.
Transmission Based Precautions
Transmission based precautions are additional infection
control precautions in health care, and the latest routine
infection prevention and control practices applied for patients
who are known or suspected to be infected or colonized with
infectious agents, including certain epidemiologically
important pathogens.
The type of infectious disease a patient has dictates the kind
of isolation precautions necessary to prevent spread of the
disease to others.
There are three different types of transmission precautions:
1.Contact Precautions—used for infections, diseases, or
germs that are spread by touching the patient or items in the
room (examples: MRSA, VRE, diarrheal illnesses, open
wounds, RSV).
2.Droplet Precautions—used for diseases or germs that are
spread in tiny droplets caused by coughing and sneezing
(examples: pneumonia, influenza, whooping cough, bacterial
meningitis).
3.Airborne Precautions—used for diseases or very small
germs that are spread through the air from one person to
another (examples: tuberculosis, measles, chickenpox).
 Transmission-Based Precaution Coding System

● Blue: Airborne Precaution

A
● Orange: Contact Precaution
C
● Green: Droplet Precaution
D
When patient is admitted, Transmission-based / Expanded Isolation Precaution is
ordered, coding system shall be implemented.

● The receiving or charge nurse shall place the appropriate color code, rectangular in shape
on the right upper corner of the metal cover of the patient’s chart.

● In executive, private, semi-private and multi-bed rooms, the rectangular color coded
plastic sign shall be placed on the door of patient’s rooms.

● All request forms for diagnostic procedure shall be properly marked with appropriate sign
and code while precautions are enforced.

● The nurse shall remind the auxiliary service staff to pay attention to the rectangular color
coded plastic sign and apply appropriate precautions.

● Nurses shall routinely check door signs, codes at the right upper corner of chart and other
forms to know the patient’s infection status so that they can apply appropriate precautions.
 PPE for Contact Precautions
Gown and gloves at entry point, before contact with a
patient or patient’s environment

Potentially contaminated objects include:

– Objects, such as tray tables and bedrails
– Medical equipment (e.g. Blood Pressure cuff)

Dedicated patient equipment is preferred

PPE removed at the point of exit, prompt hand hygiene

 PPE for Droplet Precautions
A face mask is worn upon entry into the patient room

Use Standard Precautions when handling items contaminated

with respiratory secretions

PPE must be removed at the point of exit; do not reuse

face masks

Hand hygiene follows PPE removal

 PPE for Airborne Infection Isolation
Particulate respirator (e.g. N95) or powered air
purifying respirator (PAPR) worn before entry

With a particulate respirator, perform a fit-check

before entering an area where they may be airborne
infectious disease
Scenario 1
You are a nurse working in the triage area of the Emergency
Department. A patient reports a cough with blood-streaked sputum for
almost two months with night sweats and an unintended 20-lb weight
loss. You suspect tuberculosis (TB).

What type of precautions would be appropriate?

a) Contact
b) Droplet
c) Airborne
d) Contact & Droplet
Scenario 2
A previously healthy 35 year-old woman is admitted to your
medical unit with fever, cough, and body aches for two days.
She tests positive for seasonal influenza.

What type of precautions would be appropriate?

a) Contact
b) Droplet
c) Airborne
d) Standard
Scenario 3
You are assisting in the admissions process for a patient being
directly admitted to your hospital. A 75 year-old male patient
presents with his daughter who tells you he’s had a large
draining wound on his hip that’s difficult to keep covered and
draining onto his linens.

You confirm this and suggest to the nurse the patient be placed into:
a) Contact Precautions
b) Standard Precautions
c) Droplet Precautions
d) Airborne Isolation Precautions
 HAND HYGIENE
Hands are the most common vehicle of transmission of organisms.

“HAND HYGIENE” has been recognized as the single most important way to
prevent the transmission of infectious agents. It can decrease infection rates
and is the most important procedure for preventing health-care acquired
infections.
Healthcare associated infections are major causes of death and morbidity
among hospitalized patients. The majority of HAI cases are preventable
through a combination of strategies including environmental control and
cleaning, use of isolation precautions, and use of personal protective
equipment (PPE) when appropriate.
Hand Hygiene Hand hygiene means cleaning your hands by
using either handwashing (washing hands with
soap and water), antiseptic hand wash, antiseptic
hand rub (i.e., alcohol-based hand sanitizer
including foam or gel), or surgical hand
antisepsis.
The main purpose of hand hygiene is to cleanse
the hands of pathogens (like bacteria or viruses)
and chemicals which can cause harm or disease.
Handwashing refers to washing hands with plain soap and water. Handwashing
with soap and water remains a sensible strategy for hand hygiene in non-
healthcare settings and is recommended by CDC and other experts.

Antiseptic hand wash refers to washing hands with water and soap or other
detergents containing an antiseptic agent.

Alcohol-based hand rub refers to the alcohol-containing preparation applied to

the hands to reduce the number of viable microorganisms. Use only, if hands are
not visibly solied.

Surgical hand hygiene / antisepsis refers to an antiseptic hand wash or antiseptic

hand rub performed preoperatively by surgical personnel to eliminate transient
and reduce resident hand flora. Antiseptic detergent preparations often have
persistent antimicrobial activity.
HANDWASHING AGENTS
● Soap
- Liquid soap is better than bar soap.

● 2% - 4% Chlorhexidine gluconate

● 7.5 % Povidone Iodine

 ALCOHOL HAND RUBS

● Used as an alternative to handwashing with soap and

water or disinfectants.
● Do not use for visibly soiled hands.
● Has a good immediate activity.
● Does not require drying with a towel
● Does not require a designated area for hand washing.
● Less time consuming and does not cause drying of skin.
 Personal Protective Equipment

“specialized clothing or equipment worn by an

employee for protection against infectious
materials”

PPE Use in Healthcare Settings

 Types of PPE Used in Healthcare
Settings
• Gloves – protect hands
• Gowns/aprons – protect skin and/or clothing
• Shoe cover – protect feet and shoes
• Masks and respirators– protect mouth/nose
– Respirators – protect respiratory tract from airborne
infectious agents

PPE Use in Healthcare Settings

 Types of PPE Used in Healthcare
Settings
• Goggles – protect eyes

• Face shields – protect face, mouth, nose, and

eyes

PPE Use in Healthcare Settings

Sequence* for Donning PPE
• Gown first
• Mask or respirator
• Goggles or face shield
• Gloves
*Combination of PPE will affect sequence – be practical

PPE Use in Healthcare Settings

Donning
PPE
 Sequence for Removing PPE
• Gloves
• Face shield or goggles
• Gown
• Mask or respirator

PPE Use in Healthcare Settings

 Where to Remove PPE
• At doorway, before leaving patient room or in
anteroom*
• Remove respirator outside room, after door
has been closed*
* Ensure that hand hygiene facilities are available at the point
needed, e.g., sink or alcohol-based hand rub

PPE Use in Healthcare Settings

How to
Remove
How to
Remove