STANDARD PRECAUTION

Key points:

Are methods to reduce the risk of transmission of bloodborne and other

pathogens from both recognized and unrecognized sources (WHO)
Are the minimum infection prevention measures that apply to all
patient care, regardless of suspected or confirmed infection status or
the patient, in any setting where health care is delivered (CDC)
Universal Precaution + Body Substance Isolation = STANDARD
PRECAUTION
The components of Standard Precaution is Hand Hygiene and Use
of PPE
CDC extended components: (1) Respiratory Hygiene, (2) Safe
Injection Practices and (3) Safe Handling of Potentially Contaminated
Equipment or Surfaces in the Patient Environment
Gloves should be worn if hands will come into contact with patients
body fluids and when touching patients exposed mucous membranes
and non-intact skin
Mask should be used if patients have respiratory symptoms and/or for
colonized patients undergoing aerosolizing procedures/treatment
Eye protection (goggles/face shield) should be worn when patient
care activities are likely to cause splashing/sprays of body fluids
Gown must be used during procedures when contact of clothing or
exposed skin with blood, body fluids and secretions is anticipated
Respiratory Hygiene is a source control measure developed during
the severe acute respiratory syndrome (SARS) outbreak
Elements of Respiratory Hygiene includes: coughing/sneezing
etiquette; education of health workers, patients, and visitors; posted
signages with instructions to patients and family members; and spatial
separation with respiratory secretions in common waiting areas
Cough Etiquette: cover your cough/sneeze with a tissue or
handkerchief. Use clothes if tissue/hanky is not available; throw tissue
at appropriate waste bin (INFECTIOUS) and wash hands to prevent
spread of infection
Safe Injection Practices: avoidance of recapping as much as
possible, if not = one hand scoop technique is advised
Safe handling of potentially contaminated equipment or
surfaces in the patient environment: use PPE as much as possible
to prevent spreading and acquiring infection from colonized patients
Transmission-based Precautions are additional infection control
precautions in healthcare which are applied for patients who are known
to be infected with infectious agents
Contact Precaution must be instituted for patients with generalized
rashes and exanthems, stool incontinence and draining wounds/lesions
with uncontrolled secretions

Disposable patient care equipment is advised (if possible) for patients

under Contact Precaution
Rooms with patients under Contact Precaution should be given priority
during cleaning
Placing a patient in a private room is recommended for Contact
Precautions, especially if colonized with MDROs (Multiple-Drug
Resistant Organisms)
In the ambulatory setting, a patient under contact precaution should
be separated and placed in an examination/treatment room
Pathogen-Specific Recommendations for Contact Precaution: C.
difficile,
Rotavirus,
Hepatitis
A,
Herpes
simplex,
Impetigo
(Streptococci), Lice, Scabies
Droplet Precaution should be done for patients suspected or known
to be infected with microorganisms spread by respiratory droplets
Respiratory droplets are greater than 5 micrometers (um) in size,
travels up to 3 feet, and can be spread through talking, sneezing,
coughing and aerosol-generating procedures
Aerosol-generating procedures includes, but not limited to: suctioning,
collection of respiratory specimen, resuscitation, ET intubation
Surgical masks should be worn by HCW and patient, especially during
transfer/movement from one area to another
Change PPE in between patients, as much as possible.
Pathogen-Specific Recommendations for Droplet Precaution: Diptheria,
Influenza, Mumps, Pertussis, Meningococci
Airborne Precaution is used for patients known or suspected to be
infected with agents that are transferred through the airborne route
Infectious Droplet Nuclei are dried residue formed by evaporation
of droplets or thru aerosolization
A patient under Airborne Precaution should be placed in a single room
with continuous negative pressure, with the exhaust directed
outside of the facility
In the ambulatory setting, the patient should be placed in a wellventilated area, preferably far from other patients
A surgical mask should be placed on the patient especially during
transfer to another area
An N95 respirator should be used when caring for patients under
Airborne Precaution as it will protect against airborne particles less
than 0.3 microns in diameter (95% efficiency)
Pathogen-Specific
Recommendations
for
Airborne
Precaution:
Tuberculosis, MERS-CoV, Measles, Chickenpox
Isolation is instituted to promote prevention of infectious diseases
from: (1) a patient to other patients, (2) a patient to HCWs and (3)
from HCWs/outsiders to the patient
Strict isolation will be used for patients with known disease/s that are
spread through the air

Contact Isolation, Droplet Isolation, Airborne Isolation

Reverse Isolation should be done to protect an immunocompromised
patient against possible infections coming from visitors, family
members and HCWs