Standard precautions are work practices that provide a first-line approach to infection prevention in the healthcare environment.
This replaces older obsolete terms that were previously used including:
- Universal Precautions, which were techniques used to minimise the risk of transmission of blood-borne infections – includes handling all body fluids, sharps and waste.
- Body Substance Isolation, which involved isolation of all body substances undergoing medical treatment (goes further than Universal Precautions and includes – hand hygiene, use gloves, gown, mask, eye protection, face shield depending on anticipated exposure)
- to protect patient and staff from infection in the healthcare environment
- should be adopted by all healthcare workers in all facilities at all times
- used regardless of suspected or known infection status
- based on the principle that all blood and body fluids, secretions and excretions, may contain transmissible infectious agents
STANDARD PRECAUTIONS APPLY AT ALL TIMES
This is essential because people maybe:
- placed at risk of infection from others who carry infectious agents
- infectious before signs or symptoms of disease are recognised or detected
- at risk from infectious agents present in the surrounding environment, including environmental surfaces or from equipment
- at an increased risk of transmission associated with specific procedures and practices
Standard precautions include:
- hand hygiene, before and after every episode of patient contact (‘WHO’s 5 moments’)
- the use of personal protective equipment
- the safe use and disposal of sharps
- routine environmental cleaning
- reprocessing of reusable medical equipment and instruments
- respiratory hygiene and cough etiquette
- aseptic non-touch technique (ANTT)
- waste management
- appropriate handling of linen
- unit policy development and integration:
-> when to use protective clothing
-> care of patient linen
-> disposal of contaminated garbage
-> disposal of contaminated sharps
-> disinfection, sanitisation and sterilisation of all reusable equipment
-> housekeeping (mopping, dusting, cleaning)
- single use drug ampoules, vials and syringes
- use of disposable items (Guedel airways)
- vaccination of staff
- responsibility to team leader to ensure compliance of other staff
- education (in-service, orientation programs, posters and articles)
- adherence to 5 moments of hand hygiene
- readily availability of equipment (gloves, masks, sharps bins, eye protection)
- availability of alcohol-based hand gel
- sinks: positioning, design to allow hand-free function
- survey compliance
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.