5.2 Standard Precautions
Karen Piette, MHS, CMA and Kristen Hosey
Due to the nature of their profession, healthcare workers can be exposed to blood through needlestick injuries, other sharps injuries, mucous membrane contact, and skin exposure (Occupational Safety and Health Administration, n.d.). They are at increased risk of bloodborne pathogen exposure due to their close work with patients. Standard precautions are important practices that should be used for all patient care, at all times. According to the Centers for Disease Control (CDC, 2019d), standard precautions include handwashing and the use of personal protective equipment (PPE) to protect healthcare providers from infection and prevent the spread of infection from patient to patient. The proper use of standard precautions prevents the spread of bloodborne pathogens. Bloodborne pathogens are microorganisms, such as viruses and bacteria, that are carried in blood and cause diseases such as Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV).
Hand hygiene is an important aspect of standard precautions and includes both the proper use of hand sanitizer and effective handwashing at appropriate times during patient care. It is the most widely known form of standard precautions, yet, on average, healthcare providers clean their hands less than half of the times they should (CDC, 2019b). The CDC offers many resources to help healthcare providers understand the importance of hand hygiene in healthcare settings. Remember, healthcare workers encounter more sick people than employees in any other work settings do. Therefore, understanding and practicing good hand hygiene is essential for both their own safety and the safety of the patients they serve.
In the healthcare field, it is vital to utilize Personal Protective Equipment (PPE) in order to minimize exposure to bloodborne pathogens and injury. PPE act as a barrier to infectious materials by blocking the transmission of contaminants from bodily fluids, blood, and respiratory secretions (U.S. Food and Drug Administration, 2020). Healthcare workers are exposed to bodily fluids, medical equipment, and sharp instruments. PPE consists of equipment worn by workers to minimize exposure to hazards that cause workplace injuries or illnesses. PPE that can be worn in the healthcare setting include gowns, masks or respirators, goggles, face shields and gloves. PPE should also be donned (put on) and doffed (taken off) in a specific order to prevent contamination.
Respiratory hygiene and cough etiquette are important standard precautions to prevent the spread of respiratory infections. Covering the mouth and nose with a tissue when coughing or sneezing, followed by appropriate hand hygiene, may stop the spread of infection through respiratory droplets. Healthcare facilities should ensure the availability of materials to support these practices.
Sharps safety and needlestick prevention are also important standard precautions in healthcare settings. Sharps are devices, such as needles, that can penetrate the skin, causing injury and spreading bloodborne pathogens. Needlestick exposures to bloodborne pathogens are a serious problem, resulting in approximately 385,000 cases a year (CDC, 2019c). Sharps should be immediately disposed of in a sharps container after use. Sharps injuries are primarily associated with the transmission of diseases such as hepatitis B and C, HIV, and at least 20 other pathogens (CDC, 2019c).
The Occupational Safety and Health Administration (OSHA, n.d.) requires healthcare employers to have an exposure control plan to eliminate the hazards of occupational exposure to bloodborne pathogens, as outlined in OSHA’s bloodborne pathogens standard. Healthcare workers must complete bloodborne pathogen training, which provides an overview of exposure risks and the appropriate use of PPE.
Attributions
- Figure 5.3: Medical personnel don PPE before entering a COVID-19-positive, non-critical patient’s room. (50199060167).jpg by Petty Officer 3rd Class Jacob L Greenberg/U.S. Navy in the Public Domain
Microorganisms that are carried in blood and cause disease in people.
Minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient in any and all healthcare settings.
Equipment worn to minimize exposure to hazards that cause workplace injuries or illnesses.
Cleaning hands either by hand washing or antiseptic handwash.
Small droplets produced by exhalation such as coughing or sneezing consisting of saliva and mucous derived from the respiratory tract.