2 Standard PrecautionsA. Equipment and methods that prevent the transmissionof microorganisms from one person to another1. Established early in the AIDS epidemic2. Prior to the diagnosis of AIDS, PPE was used onlyin identified infectious process.(Once AIDS was better understood, PPE wasuniversally applied to all patients)
3 B. These are applied to all patients/residents at all times because not all diseases are readilyobservable.1. Gloves should be worn at all times; handsshould be washed for a minimum of 10seconds and gloves changed when movingfrom one patient to another
4 2. Depending on the activity performed on the patient, the nature of the patient’sillness, and the amount of exposure to bloodand the amount of exposure to blood andbody fluids, other PPE should be worn.a. Gown and goggles if patient iscoughing, bleeding or has drainagefrom wounds or body orifices
6 4. All sharps (needles, razors, etc.) should be disposed of immediately inbiohazardous puncture proof sharpscontainers located in each room.
7 5. Never carry needles or sharps from one location to another. If necessary, to doso, never point toward another personor yourself. KEEP POINT TOWARDTHE FLOOR OR CEILING.
8 6. All unknown spills or waste should be treated as potentially hazardous.
9 C. Involves the following: 1. Gloves2. Mask3. Goggles4. Gowns5. Cap6. Handwashing7. Methods for handling human waste, spillsand labeling of hazardous substances
10 D. Transmission-based precautions 1. Airbornea. Diseases that are spread through the airb. Examples include chickenpox, measles, TB
11 2. Dropleta. Diseases spread by droplets, as ina sneeze or coughb. Examples include certain types ofmeningitis, pneumonia, pertussis,influenza, mumps, German Measles
12 3. Contacta. Diseases spread by contact with infectedskin or objectsb. Examples include herpes, impetigo,diphtheria, scabies, AIDS, MRSA
13 4. Reverse or Protective Isolation a. This concept is the opposite of everyother transmission-based precautionb. It involves protecting the patient/resident from any infectious processcarried by the health care providersor the publicc. Necessary for patients with immunedeficiency/suppressed systems:AIDS patients, transplant patients,cancer chemotherapy patients
14 E. How airborne precautions work 1. Patient’s room must be private unless bothpatients have the same disease2. Room may have special ventilationequipment3. The door of the room must remain closed4. Staff and visitors must wear masks
15 5. If staff has more direct prolonged contact with the patient, it is advisableto wear gloves, gown , hair coveringdepending on the activity6. Patients should leave the room as littleas possible and wear a mask if they doleave
16 F. How droplet precautions work 1. Similar to airborne, but droplet travels nomore than three feet2. Therefore room should be private orpeople with same disease3. If patients with different diseases are placedin the same room, they should be separatedby at lease three feet
17 4. Staff and visitors within three feet of patients need to wear masks.5. If staff has more direct prolonged contactwith the patient, it is advisable to weargloves, gown, hair covering, goggles,depending on the activity.6. Patients should leave the room as little aspossible and wear masks when they leave
18 G. How contact precautions work 1. May be private or have people with samediseases together2. Everyone entering the room must weargloves and change them whenever soiled3. Gowns, mask, goggles, hair covering, shouldbe worn depending on length of contact andactivity4. All must wash their hands and avoid touchingobjects before leaving the room
19 5. Patients should leave the room as little as possible and avoid contact with otherpeople or objects6. Use biohazardous waste bags to disposeof any trash or items leaving the room7. Equipment such as thermometer ,bloodpressure equipment should remain in theroom, and disinfected properly whenprecautions have been discontinued
20 H. Reverse Isolation1. The health care provider puts on anynecessary equipment to preventexposing the compromised patientto any microorganisms2. The equipment is determined by thecare that is to be given
21 ExposureA. Should a known exposure occur to a microorganismi.e. HIV, the exposure must be reported to thesupervisor of the unitB. An incident report must be completedC. Depending on the exposure, the area should becleaned with an antiseptic solution, and if necessary,appropriate blood tests should be completed.
22 D. Follow-up must be done as required by policy (either facility or CDC)Application of personal protective equipmentA. Hands must be washed prior to application,according to protocolB. This equipment is clean, not sterile
23 C. Order of application1. Gown2. Cap3. Mask4. Gloves – sterile gloves might be requireddepending on what care is to be given (e.g.assisting with some sterile procedure)
24 D. Order of Removal1. Gloves first by never touching the outsideof the glove2. Hook the finger inside the cap and pullcap off3. Reach behind the gown and untie,pulling the gown off and touching onlythe inside of the gown; roll it inside outas removing
25 4. Finally pull ties of mask and remove, being careful to avoid touching hair5. In airborne transmission, the maskshould be removed just before leavingthe room ( or if there is an outsidefoyer for application and removal ofPPE it should be removed there)6. Lastly, hands should be washedaccording to protocol
26 7. When removing equipment, all should be placed in the proper biohazardous container8. When biohazardous containers are full, theyshould be removed from the patient’s room tdouble bagging. Two people should do this-one on the inside of the room, one on theoutside to receive the contaminated items andhelp place them in the proper protective bags.The person inside the room only touches theinside of the receiving biohazardous bag; theperson outside the room only touches theoutside of the receiving biohazardous bag