Standard Precautions in Infection Control

Standard Precautions

• Standard precautions are routine infection control measures applying to all patients in all healthcare settings.
• These precautions aim to prevent the transmission of infectious agents among patients and healthcare workers.
• Their goal is to promote safe medical procedures.

Nosocomial Infection

• Nosocomial infections (HAIs) are infections acquired during healthcare, not present at admission.
• They can arise in various healthcare settings (hospitals, long-term care, ambulatory) and even after discharge.
• Such infections include occupational infections affecting staff.

Types of Infection Transmission

• Direct transmission occurs through contaminated medical equipment, implants, or devices
• Indirect transmission involves contaminated medical staff, or visitors
• Infection can also be transmitted via hospital facilities.

Standard Precautions Outline

• Define nosocomial infection
• Define standard precautions
• Hand hygiene
• Personal protective equipment (PPE) usage
• Instrument reprocessing
• Aseptic techniques
• Environmental cleaning and disinfection
• Waste management

Hand Hygiene and PPE

• Hand hygiene is vital, particularly when caring for patients with acute respiratory illnesses.
• Appropriate PPE usage is crucial.

Standard Precautions and Isolation

• Preventative practices are used for all clients regardless of diagnosis or present infection.

Standard Precautions Apply To

• Blood, body fluids, secretions, and excretions (except sweat), regardless of visible blood.
• Non-intact skin
• Mucous membranes.

Standard Precautions Practice

• Applying these precautions to all clients is a crucial practice in preventing infections.
• These procedures represent the most effective way to reduce the risk of infections for patients and caregivers.

Barrier Precautions

• Barrier precautions are to minimize blood and body fluid exposure.
• PPE (masks, gowns, gloves) are used as barriers between individuals and microorganisms, preventing transmission.

Aspects of Standard Precautions

• Hand hygiene
• Gloves
• Mask/Eye/Face protection
• Gowns
• Client-care equipment
• Environmental control
• Linen
• Occupational health
• Blood-borne pathogens
• Placement of clients

Hand Hygiene

• Essential aspect of standard precautions to prevent cross-contamination between body sites on a single client.
• Hand hygiene should be practiced between tasks and procedures on a client

Gloves

• Wear gloves when touching blood, body fluids, secretions, excretions, or contaminated items.
• Change gloves between tasks.
• Remove gloves promptly after use and clean hands immediately afterward.
• Assess patients for latex allergies.

Mask, Eye Protection, Face Shield

• Protect mucous membranes (eyes, nose, mouth) when procedures or care activities might cause splatter or spray of blood, body fluids, secretions, or excretions (e.g. splashes).

Gowns

• Protect skin and clothing from soiling.
• Select appropriate gowns based on anticipated fluid exposure.
• Remove soiled gowns promptly after use.
• Cleanse hands after removing gowns.

Donning and Removing PPE

• Proper procedures exist for donning (putting on) and removing gowns and masks.

Client Care Equipment

• Single-use items are discarded.
• Reusable equipment must be cleaned and sterilized before reuse.

Instrument Reprocessing

• Processing healthcare instruments to ensure safety for reuse.
• Single-use items are not reprocessed.

Decontamination

• Removal of contamination - sterilization, disinfection, and cleaning.

Sterile

• Absence of all microbial life.
• Aseptic technique aims to minimize contamination from pathogens.
• 　Sterile technique intends to completely eliminate microorganisms (pathogenic and non-pathogenic).

Clean

• Absence of extraneous organic contamination.
• Removal of non-essential matter.
• Use of cleaning agents (detergents and alcohol).

Disinfection

• Removing or destroying microbes (except spores).

Aseptic Techniques

• Methods to reduce the risk of post-procedure infection.
• Procedures include handwashing, surgical scrubs, using barriers, client preparation, maintaining a sterile field and proper operative procedure.

Sterile Technique

• Free of all microorganisms.
• Common in operating rooms and specialized diagnostic areas.
• Utilized in various procedures like injections, dressing changes, and catheterization.

Sterile Field

• A microorganism-free zone.
• Complies with surgical asepsis principles when setting up a sterile field.
• All items in a sterile field must be sterile.
• Sterile items moving out of sight or below waist height are compromised.

Sterile Field (continued)

• Prolonged exposure to airborne microorganisms can compromise sterility.
• Fluids flow with gravity, carrying microorganisms to sterile surfaces via capillary action.
• Sterile field edges are not sterile.
• Consciousness, alertness, and integrity are crucial for maintaining surgical asepsis.

Establishing and Maintaining a Sterile Field

• Process for sterile field preparation: opening wrapped packages, and maintaining the sterile field while handling sterile items (flaps, etc.)

Environmental Cleaning

• General cleaning of surfaces to maintain cleanliness.
• Involves the physical removal of organic material (soil, dirt), followed by drying.

Disinfection - Methods

• Reducing the count of viable organisms; steam, boiling water, and chemical disinfectants are used.

Low-Temperature Steam

• Kills most bacteria and viruses via moist heat.
• Utilizes dry saturated steam at 73°C for over 10 minutes.
• Effective for items with lumens.
• Unfit for heat-sensitive items.

Chemical Disinfectants

• Destroys microorganisms via physical or chemical processes.
• Sensitivity to microorganism varies with different chemical or physicochemical agents.

Sterilization

• Eliminating all viable microorganisms and viruses (including spores).
• Common methods encompass autoclaves, hot air ovens, ethylene oxide, low-temperature steam, sporicidal chemicals, radiation, and gas plasma.

Sterilization (or sterilization)

• Elimination of all transmissible agents (bacteria, viruses, prions) from surfaces, equipment, food, or biological mediums.
• Distinguishable from disinfection processes where only disease-causing organisms are removed.

Autoclaves

• Steam under pressure sterilization above100°C.
• Used for material, where steam and pressure are directly in contact with material.
• 　Require a 3-minute sterilization at 134°C (or 15 minutes at 121°C.)
• Using color change indicator tape for evaluation.
• Suitability, and not suitable , for heat-sensitive objects.

Heat Sterilization

• 　Autoclave method involves using steam heated to 121°C at 103 kPa (15 psi) for 15 minutes.
• Inactivates various microorganisms (fungi, bacteria, viruses, and bacterial spores).
• Prions may not be always eliminated.

Waste Management

• Categorizing and managing different healthcare waste types.
• Different types are hazardous (potentially harmful like chemical and radioactive agents, infectious agents), non-hazardous, general, or clinical.
• Proper disposal is required to avoid risks.

Disposal of Waste

• General waste (tissues, plastic items that don't contain body fluids)
• Clinical waste (contaminated items with bodily fluids, like gauze with blood, etc)
• Sharp bin for sharp items.

Steps of Medical Waste Management

• Waste is sorted, stored temporarily, handled correctly, and finally disposed of.

Infectious Waste and Sharps

• Sorting at the emergence point(immediate area where it was created) is crucial.
• Non-hazardous waste manages similarly as regular waste.
• Sharps require disposal in safety boxes to prevent re-use.
• Need proper equipment management (segregation, incineration, etc).
• Treatment of blood in municipal sewer systems may be possible after the treatment.