Submitted by: JAINAL, RASHEENA A.

MIDEL, CHRISTLEN BSN-IIIC

Submitted to: Prof. MARIA FE MIDEL ADVISER

Fundamentals of Standard Precautions Hand Hygiene 1. Hand hygiene is the single-most important measure to reduce the risks of transmitting microorganisms. 2. Cleaning hands with soap and water or alcohol-based waterless hand rubs as promptly and thoroughly as possible between patient contacts; after contact with blood, body fluids, secretions, excretions and contaminated equipment or articles; and after gloves are removed is vital for infection control. It may be necessary to clean hands between tasks on the same patient to prevent cross-contamination of different body sites. 3. Waterless hand cleaners are recommended unless there is visible soil on the hands. Gloves 1. Gloves are worn to provide a protective barrier and prevent gross contamination of the hands of health care workers and to reduce the transmission of microorganisms to patients. 2. Wearing gloves does not replace the need for hand hygiene because gloves may have small, inapparent defects or may be torn during use, and hands can become contaminated during removal of gloves. 3. Gloves also must be changed between patients to prevent infections. Patient Placement 1. Patient placement is a significant component of isolation precautions. A private room is recommended for a patient with poor hygienic habits or highly transmissible or epidemiologically significant microorganisms. 2. When a private room is not available, two patients infected with the same organism can share a room; this is known as cohorting. 3. A private room with appropriate air handling is important for microorganisms spread by airborne transmission. Limiting the Movement of Patients 1. Limiting the movement of patients with virulent or epidemiologically important microorganisms reduces transmission. 2. When transport is necessary, appropriate barriers (such as masks and impervious dressings) are worn by the patient, and personnel in the area to which the patient is to be taken are notified. When appropriate, patients are taught how they can assist in preventing transmission. Masks and Goggles or Face Shields 1. In order to protect the mucous membranes of the eyes, nose, and mouth, masks and goggles or face shields are worn by health care workers during patient care when there is likelihood of splashes or sprays of blood, body fluids and secretions. 2. A surgical mask is worn by hospital personnel to provide protection against spread of infectious large-particle droplets during close patient contact. Respiratory Protection 1. When caring for patients with known or suspected tuberculosis, health care workers are to wear an N95 respirator, a high efficiency particulate air filter respirator, or a powered air-purifying respirator. Gowns 1. Gowns are worn to prevent contamination of clothing and to protect the skin of personnel from blood and body fluid exposures. 2. Impermeable gowns, leg coverings, boots, or shoe covers provide greater protection to the skin when splashes or large quantities of infective material are anticipated. 3. Gowns are also worn during the care of patients infected with epidemiologically important pathogens to reduce transmission from patients or items in the environment to other patients. These gowns are removed when leaving the patients environment and hands are washed.

Care of Equipment 1. Soiled linen should be handled, transported, and laundered in a manner that avoids transfer of microorganisms to patients, personnel, and environments. 2. No special precautions are needed for dishes, glasses, cups, or eating utensils because the combination of hot water and detergents used in hospital dishwashers is sufficient for decontamination. 3. Patient-care equipment that is soiled with blood, body fluids, secretions and excretions must be handled in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other patients and environments. Reusable equipment must be reprocessed and cleaned appropriately before use for another patient. Single-use items must be discarded properly. 4. Care must be taken to prevent injuries from needles, scalpels, and other sharp objects. Used needles must never be recapped using both hands, removed from syringes, bent, broken or otherwise manipulated. Used needles and sharps must be disposed of into puncture-resistant containers, which are located as close as is practical to the area of use. 5. Mouthpieces, resuscitation bags, or other ventilation devices are used instead of mouth-to-mouth resuscitation methods. Transmission-based Precaution Techniques Airborne Precautions 1. Designed to reduce the risk of airborne transmission of infectious agents through dissemination of droplet nuclei (small-particle residue of evaporated droplets that may remain suspended in the air for a long periods) or dust particles containing the infectious agent. 2. Microorganisms carried in this manner can be dispersed widely by air currents and may become inhaled by or deposited on a susceptible host within the same room or over a longer distance from the source patient. Therefore, special air handling and ventilation are required. 3. Examples of illnesses requiring Airborne Precautions: measles, varicella (including disseminated zoster), TB. 4. Place the patient in a private room that has: a) Monitored negative air pressure in relation to the surrounding areas. b) At least 6 to 12 changes per hour. c) Appropriate discharge of air outdoors or monitored high-efficiency filtration of room air before recirculation. Keep the room door closed and the patient in the room. 5. Wear respiratory protection when entering the room of a patient with known or suspected pulmonary TB. 6. Health care workers who are susceptible should not enter the rooms of patients known or suspected to have measles (rubeola) or chickenpox (varicella). If susceptible individuals must enter the room, they should wear a surgical mask. Persons immune to rubeola or varicella need not wear a mask. 7. Limit the transport of the patient from the room to essential purposes only. If transport is necessary, minimize patient dispersal of droplet nuclei by placing a surgical mask on the patient. Droplet Precautions 1. Designed for care of patients known or suspected to be infected with microorganisms transmitted by droplets (large particles) that can be generated by the patient when coughing, sneezing, talking, or during the performance of procedures. 2. Examples of illnesses requiring Droplet Precautions: a) Invasive Haemophilus influenza type b disease, including meningitis, pneumonia, epiglottitis, and sepsis. b) Invasive Neisseria meningitides disease, including meningitis, pneumonia, and sepsis. c) Diphtheria, Mycoplasma pneumonia, pertussis, pneumonic plague, streptococcal pharyngitis,pneumonia, or scarlet fever in infants and young children d) Adenovirus, influenza, mumps, parvovirus B19, rubella. 3. Place the patient in a private room. a) When a private room is not available, place patients with the same microorganism together (cohorting). b) If neither of these is possible, maintain spatial separation of at least 3 feet between the infected patient and other patients and visitors. 4. Special air handling and ventilation are not necessary, and the door may remain open.

5. Wear a mask when working within 3 (0.9 m) of the patient. 6. Limit the transport of the patient from the room to essential purposes only. If transport is necessary, minimize dispersal of droplets by masking the patient. Contact Precautions 1. Used for patients known or suspected to be infected or colonized with epidemiologically important microorganisms that can be transmitted by direct contact with the patient (hand or skin-to-skin contact that occurs when performing patient care activities that require touching the patients skin) or indirect contact (touching) with environmental surfaces of patient care items in the patients environment. 2. Examples of microorganisms requiring Contact Precautions: a) Methicillin (Oxacillin)- resistant Staphylococcus aureus (MRSA [ORSA]). b) Vancomycin- resistant Enterococcus. c) Vancomycin-intermediate-resistant S. aureus, also known as glycopeptides-resistant S. aureus. d) Clostridium difficile (when patient has diarrhea). e) For diapered of incontinent patients, Escherichia coli 0157:H7, shigella, hepatitis A, and rotavirus. f) Respiratory syncytial virus, parainfluenza virus, or enteroviral infections in young children; diphtheria; herpes simplex virus (primary cases) g) Impetigo, major (noncontained) abscesses,cellulitis or decubiti h) Pediculosis, scabies, staphylococcal furunculosis in infants and young children. i) Zoster 3. Place the patient in a private room or in a room with a patient who has the same microorganism. 4. In addition to wearing gloves as outlined under Standard Precautions, wear gloves when entering the room. a) Change gloves after contact with infective material, such as feces and wound drainage. b) Remove gloves before leaving the patients environment and wash hands immediately with an antimicrobial soap or alcohol-based waterless antiseptic agent. c) After glove removal and hand hygiene, make sure that hands do not touch potentially contaminated environmental surfaces or items in the patients room. 5. In addition to wearing gloves for Standard Precautions, wear a gown when entering the room if there is likely to be contact with the patient or environmental surfaces, or if the patient has diarrhea, an ileostomy, colostomy, or wound drainage not contaminated by a dressing. a) Remove the gown before leaving the patients environment. b) After gown removal, make sure that clothing does not contact potentially contaminated surfaces. 6. When possible, dedicate the use of noncritical patient care equipment to a single patient. 7. Thoroughly clean and disinfect reusable equipment before use for another patient.