21/08/2016. Safe Patient Care Keeping our Residents Safe. What are Standard Precautions? Why Standard Precautions
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1 Safe Patient Care Keeping our Residents Safe 2016 What are Standard Precautions? Standard Precautions are a set of evidence based infection prevention practices that apply to all patients, regardless of their suspected or confirmed infection status, in any setting in which healthcare is delivered. Why Standard Precautions Within any setting where healthcare is provided both patients and staff are at risk of acquiring an infection 1
2 The Chain of Infection The purpose of Standard Precautions is to break the chain of infection focusing particularly but not exclusively on the mode of transmission, portal of entry and susceptible host sections of the chain. History of Isolation precautions Prior to 1985 precautions only taken with patients with a suspected/known infection Universal precautions in response HIV/AIDS No test, long incubation period, no way of identifying suspect cases Healthcare workers demanded action to protect themselves Universal Precautions CDC Atlanta HCW s were advised to treat all blood as potentially infectious Blood and all body fluids with visible blood present treat as infectious Wear protective equipment if exposure possible Specific measures for handling needles & other sharp devices Report all needle stick injuries 2
3 Standard Precautions 1996 Standard Precautions replaced Universal Precautions (Garner et al) HCW s advised to take precautions with all blood, body fluids, non-intact skin and mucous membranes. Hand Hygiene, PPE, Patient Placement, Decontamination of Equipment & Environment, Safe Sharps, Spills & Exposure Management, Handling of Linen. Additional Precautions for known infections based on mode of transmission Contact, Droplet and Airborne Precautions. Standard Precautions: 2007 Emergence of new pathogens such as SARS and Avian flu, coupled with continued occurrence of outbreaks of hepatitis B and hepatitis C viruses in ambulatory settings, CDC amended the 1996 guidelines Recommendation made on Non-acute healthcare LTCF, ambulatory care settings & home care and non healthcare settings were health care is delivered Transmission Risks for Special Patient Population Precautions to Prevent Transmission of Infectious Agents Standard Precautions Transmission based Precautions Droplet, Contact & Airborne Standard Precautions Hand hygiene Use of personal protective equipment (PPE) Management of spillages of blood and body fluids Appropriate patient placement Management of sharps Safe injection practices Respiratory hygiene and cough etiquette Management of needle stick injuries Management of waste Management of laundry Decontamination of reusable medical equipment Decontamination of the environment. 3
4 Transmission of HIV & HCV from a nursing home patient to HCW 35 yr old Nursing Home Aid - Jan 2000 No non-occupational risk factors identified Cared for 1 HIV-infected patient from Dec 99 - Feb 2000 No specific exposure to blood Numerous exposures to the patients body fluids urine, faeces coffee ground like emesis Chapped & abraded hands - landscape Patient was not known to be infected with HCV Beltrami et al (2003) Transmission of HIV and hepatitis C virus from a nursing home patient to a health care worker. American Journal of Infection Control 31; Conclusion Transmission may have been prevented in this situation by- Adherence to Standard Precautions Exposure management plan Provision of Personal Protective Clothing Engineering & work practice controls to eliminate percutaneous injuries Transmission Based Precautions In Healthcare setting additional precautions called Transmission Based Precautions will be implemented dependant on the route of transmission of the microorganism Contact Precautions e.g Gastroenteritis, C.difficile, Shingles Droplet Precautions e.g Influenza, mumps Airborne Precautions e.g TB, measles, chickenpox In residential care facilities the focus is on Standard Precautions at all times for all clients. 4
5 Transmission Based Precautions Before implementing TBP consider The individual The setting The infectious agent The presence of other vulnerable persons The type of procedure/activities being undertaken in the environment Please discuss individual cases with your local IPCN Contact Precautions Droplet Precautions 5
6 Airborne Precautions 6
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