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Get Standard Precautions Right

Universal precautions was originally defined back in 1983 by the CDC (Center for Disease Control). It outlined the minimum behaviors required by health care workers to reduce the spread of blood borne pathogens such as HIV and Hepatitis C.

It included the techniques of proper hand hygiene and personal protective equipment when there was a reasonable expectation of coming into contact with blood. 

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Over the course of several years the concept of isolation and protection from blood borne pathogens was refined and revised until 1996.

At that time, the CDC incorporated Body Secretions Isolation precautions (all moist body secretions were considered suspect for transmission of pathogens) with Universal precautions (blood borne pathogens) and the term for these new guidelines was Standard Precautions.

The guidelines consider all patients to have the capacity to carry pathogens through blood or bodily secretions even though there are no outward signs of infection. Using protective barriers in instances where a healthcare worker is in contact with these substances protects the worker and subsequently, other patients from becoming carriers of a disease.

The bodily fluids include everything but sweat regardless of whether there is blood in it or not.

This all sounds very good until you watch a few people think they are performing standard precautions when in actuality all they are doing is wasting gloves and other PPE (Personal Protective Equipment.)

  • Gloves NOT needed to change a bed unless there is feces or urine on the sheets.
  • Gloves NOT needed to take vital signs on a patient.
  • You can recap an unused sterile needle used to draw up a med but not yet used on the patient. No contamination to you is possible. If you do accidentally stick yourself, just throw out the needle/syringe and redraw the medication for the patient.

Standard Precautions Are For
Every Patient You See

As a nurse, you should know what these precautions mean and how to proceed.

  • Sanitize hands before donning gloves.
  • Sanitize hands after taking gloves off.
  • Do not recap used needles. Use the safety shield attached to the needle that flips over the needle end.

Use gloves when dealing with blood or body fluids (other than sweat) as in:

  • Venipuncture
  • Emptying catheter bags
  • Injections
  • Wound care
urinary down drain bag

Another type of isolation, droplet precautions are used when splashing fluids may occur:

Additional PPE should be used if you plan to irrigate a wound with a syringe. The force of the water could potentially splash from the wound into your face.

Suctioning tracheostomies can cause some forceful coughing of the patient and some sputum being splashed in your face. . Take the precaution of wearing a face shield.

Immediately after completing a procedure, remove gloves and wash your hands. DO NOT leave your gloves on and proceed with other care of the patient. You will simply be spreading the (potential) pathogens all over the room. Then when anyone touches those areas without gloves they are picking up pathogens you left behind.

Example: If you are gloved, performing wound care with the new dressings sitting on the over bed table, when finished, you should take the gloves off and wash your hands before putting the patient’s belongings back on the table. 

Who Is Being Protected

Most patients do not understand the difference between sterile and clean. Nor do they understand that the Standard Precautions with non-sterile gloves are to protect you against them not the other way around. Educate your patients as to the reason for doing what you do!!

Above and beyond Standard Precautions, there are Isolation precautions:

  • Contact precautions 
  • C-Diff contact precautions
  • Droplet Precautions
  • Airborne Precautions (small droplets that stay airborne)
  • Reverse Isolation

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