Standard Precautions are the basic steps used to prevent transmission of pathogens (organisms that can cause disease). Standard Precautions should be consistently practiced with all patients, in all patient care environments. As a patient there may be times that you need to be your own advocate and encourage your health care provider to follow standard precautions to protect both yourself and other patients.
Standard Precautions include:
- Hand Hygiene. Hand hygiene is the most important practice when it comes to preventing the spread of infections. Proper hand hygiene can be performed using an alcohol based hand gel or foam or by using soap and water. If your hands are visibly dirty you should choose soap and water. Your health care provider should perform hand hygiene upon entering and when exiting the patient care area (exam room, hospital room, chemotherapy administration room), before and after touching you and after removal of gloves. Although you are not the healthcare provider it is important that you, as the patient (or your visitors), perform hand hygiene frequently to prevent the transmission of pathogens.
- Respiratory Hygiene. Respiratory hygiene is used to prevent the transmission of pathogens that can cause respiratory infections. Respiratory hygiene includes covering your nose and mouth while sneezing and coughing, with either your elbow or a tissue. If you use a tissue it should then be disposed of in the trash. After contact with any secretions from a cough or sneeze, hand hygiene should be performed.
- Personal Protective Equipment (PPE). PPE is equipment worn by health care professionals to protect them from contact with infectious agents, and therefore to prevent transmitting possible pathogens from patient to patient. PPE includes gloves, face shields, surgical masks, goggles, respirator masks and gowns. Your health care provider will put these on depending upon the type of situation. Gloves should always be worn when there is the possibility of hands coming in contact with bodily fluid from the patient. A gown, face shield and goggles may be used if there is a chance that a bodily fluid could be splashed on to the health care provider. After removal of any PPE, proper hand hygiene should be performed.
- Injection Safety. Being stuck by a needle that has been used can transmit blood borne pathogens from the patient to the healthcare provider. It is important that needles not be reused and disposed of immediately after use into a container designed for disposal of syringes and needles. Many injections have a safety mechanism that retracts the needle into the syringe once the medication is infused. This mechanism should always be used to prevent a health care provider from moving around a room with an open needle.
- Medical Equipment/Environmental Cleaning/Waste Disposal. It is important that standards are set in every facility regarding the cleaning of equipment, linens and patient care settings, including exam rooms and hospital rooms. Visibly soiled equipment and spaces should be properly cleaned with an appropriate chemical agent or detergent. One-time use equipment, such as probes placed on thermometers, should be disposed of after use. Linens should be changed after use in an exam room and as frequently as needed (at a minimum, daily) in a hospital room. Trash should be discarded of properly. Any trash soiled with a bodily fluid should be disposed of in a trashcan meant for clinical waste. Trashcans to be used for clinical waste will be marked and are often red.
If a patient has symptoms of certain infections, they may be placed on "isolation precautions". Types of isolation precautions include contact, droplet and airborne and each involve different protective equipment. A patient may be placed on one of these types of precautions until further testing can either rule out or confirm the infection. The types of isolation precautions are detailed below.
Contact precautions are used when caring for patients with a potential or confirmed infection that is spread by direct or indirect contact with the patient or the patient’s environment. Contact precaution techniques may differ between inpatient and outpatient facilities, depending on the protocols at the institution in which you are being treated.
A patient placed on Contact Precautions should be moved to a private room when available. Health care providers and visitors will be instructed to wear gloves and a gown for any interaction with the patient, including in the patient’s hospital room. The gowns and gloves should be discarded of appropriately when exiting the room followed by proper hand hygiene.
Some of the most common organisms requiring a patient to be placed on contact precautions include:
- MRSA – Methicillin-resistant staphylococcus aureas
- VRE – Vancomycin-resistant enterococci
- C. diff – Clostridium difficile (Hand hygiene must be performed with soap and water. C. diff is a spore which cannot be removed with use of an alcohol based gel or foam.)
Droplet Precautions are used to prevent the spread of pathogens found in respiratory secretions or by coming in contact with mucous membranes. The pathogens are not infectious over a long distance so no special handling of the air is necessary. However, a private room is suggested, along with use of a disposable mask by all visitors and health care providers. Upon exiting the room the mask should be removed and discarded appropriately, and proper hand hygiene should be performed. If a patient is traveling outside of his or her environment, it is suggested that they also wear a mask to prevent transmission of the infection or virus.
Some of the most common organisms requiring a patient to be placed on droplet precautions include:
- Influenza – Flu
- Viral Respiratory tract infections including adenovirus, parainfluenza, rhinovirus and RSV.
Airborne precautions are used for patients who have an infection that remains infectious over long distances when suspended in the air. Patients placed on airborne precautions will be moved to a negative pressure room. A negative pressure room is equipped with a ventilation system in which the air removed from the room is not introduced into the hallway or into any other rooms. The door to the room must remain closed. This prevents the spread of pathogens that can remain in the air for long distances.
Prior to entering the room, all visitors and providers entering the room must put on a respirator mask, which you should be properly fitted for. The mask should be disposed of after exiting the room and proper hand hygiene should be performed. Depending on the institution in which you are being cared, for a gown and gloves may also have to be worn and the removed prior to exiting in the room. The respirator mask should always be removed after exiting the room. Patients will be asked to wear a mask when traveling outside of the patient care room.
Some of the most common organisms requiring a patient to be placed on airborne precautions include:
- Measles – Rubeola
- TB - Tuberculosis
- Herpes Zoster – Disseminated Shingles (Actively open skin sores. If the sores are crusted and healing, only contact precautions are required.)
Prevention of the spread of pathogens is key to preventing infections. If you have any questions regarding standard precautions or isolation precautions contact your nurse or care provider. Institutions may vary in practice.
Centers for Disease Control. Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. 2014.
World Health Organization. Health-care facility recommendations for standard precautions. 2007.