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MoonDragon's Women's Health Pregnancy Information
STANDARD PRECAUTIONS
& INFECTION CONTROL

Handling Blood, Bodily Fluids, Non-Intact Skin & Mucous Membranes


For "Informational Use Only".
For more detailed information, contact your health care provider
about options that may be available for your specific situation.




INFECTION CONTROL PRECAUTIONS



  • Standard Precautions
  • Droplet Precautions
  • Contact Precautions
  • Airborne Precautions
  • References





  • STANDARD PRECAUTIONS

    Use Standard Precautions, or the equivalent, for the care of all patients.

    Standard Precautions apply to (1) blood; (2) all body fluids, secretions, and excretions except sweat, regardless of whether or not they contain visible blood; (3) non-intact skin; and (4) mucous membranes. Standard Precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in hospitals, clinics, nursing homes, general laboratories, and home health care.

    HANDWASHING (HAND DECONTAMINATION)

    When hands are visibly dirty or visibly soiled with blood or other body fluids:
    • Use an alcohol-based hand rub or wash with an antimicrobial soap and water.

    Decontaminate hands before:
    • Having direct contact with patients.
    • Donning sterile gloves before sterile procedures.
    • Moving from a contaminated-body site to a clean-body site during patient care.

    Decontaminate hands after:
    • Contact with a patient's intact skin.
    • Contact with body fluids or excretions, mucous membranes, non-intact skin, and wound dressings, inanimate objects in the immediate vicinity of the patient.
    • Removing glove.

    Before eating and after using a restroom:
    • Wash with either antibacterial or non-antimicrobial soap and water.

    If exposure to Bacillus anthracis is suspected or confirmed:
    • Wash with either antimicrobial or non-antimicrobial soap and water. The physical action of washing and rinsing the hands under such circumstances is recommended because alcohols, chlorhexidine, iodophors, and other antiseptic agents have poor activity against spores.

    MoonDragon's Proper Handwashing Technique

    PROTECTIVE GLOVES

    Wear gloves (clean, non-sterile gloves are adequate) when touching blood, body fluids, secretions, excretions, and contaminated items. Put on clean gloves just before touching mucous membranes and non-intact skin.

    Change gloves between tasks and procedures on the same patient after contact with material that may contain a high concentration of microorganisms. Remove gloves promptly after use, before touching non-contaminated items and surfaces, and before going to another patient, and wash hands immediately to avoid transfer of microorganisms to other patients or environments.

    PROTECTIVE GOWNS

    Wear a gown (a clean, non-sterile gown is adequate) to protect skin and to prevent soiling of clothing during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. Select a gown that is appropriate for the activity and amount of fluid likely to be encountered. Remove a soiled gown as promptly as possible and wash hands to avoid transfer of microorganisms to other patients or environments.

    ENVIRONMENTAL CONTROL

    Ensure that the hospital or facility has adequate procedures for the routine care, cleaning, and disinfection of environmental surfaces, beds, bedrails, bedside equipment, and other frequently touched surfaces, and ensure that these procedures are being followed.

    LINEN

    Handle, transport, and process used linen soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures and contamination of clothing and that avoids transfer of microorganisms to other patients and environments.

    OCCUPATIONAL HEALTH & BLOODBORNE PATHOGENS

    Take care to prevent injuries when using, cleaning, and disposing of sharp instruments.

    Never recap used needles, manipulate them using both hands, or use any other technique that involves directing the point of a needle toward any part of the body; rather, use either a one-handed "scoop" technique or a mechanical device designed for holding the needle sheath.

    Do not remove used needles from disposable syringes by hand, and do not bend, break, or otherwise manipulate used needles by hand. Place used sharp items in appropriate puncture-resistant containers.

    Use mouthpieces, resuscitation bags, or other ventilation devices as an alternative to mouth to mouth resuscitation methods in areas where the need for resuscitation is predictable.

    PATIENT PLACEMENT

    Place a patient who contaminates the environment or who does not (or cannot be expected to) assist in maintaining appropriate hygiene or environmental control in a private room.





    DROPLET PRECAUTIONS

    Droplet transmission involves contact of the conjunctiva or the mucous membranes of the nose or mouth of a susceptible person with large-particle droplets (larger than 5 micrometer in size) containing microorganisms generated from a person who has a clinical disease or who is a carrier of the microorganism. Droplets are generated from the source person primarily during coughing, sneezing, or talking and during the performance of certain procedures such as suctioning and bronchoscopy.

    Transmission via large-particle droplets requires close contact between source and recipient persons, because droplets do not remain suspended in the air and generally travel only short distances, usually 3 feet or less, through the air. Because droplets do not remain suspended in the air, special air handling and ventilation are not required to prevent droplet transmission.

    PROTECTIVE MASK

    In addition to wearing a mask as outlined under Standard Precautions, wear a mask when working within 3 feet of the patient. (Logistically, some medical facilities may want to implement the wearing of a mask to enter the room.)

    PATIENT PLACEMENT

    Place the patient in a private room. If a private room is not available, place the patient in a room with a patient(s) who has active infection with the same microorganism but with no other infection (cohorting). When a private room is not available and cohorting is not achievable, maintain spatial separation of at least 3 feet between the infected patient and other patients and visitors. Special air handling and ventilation are not necessary, and the door may remain open.

    PATIENT TRANSPORT

    Limit the movement and transport of the patient from the room to essential purposes only. If transport or movement is necessary, minimize patient dispersal of droplets by masking the patient.





    CONTACT PRECAUTIONS

    Direct-contact transmission involves skin-to-skin contact and physical transfer of microorganisms to a susceptible host from an infected or colonized person, such as occurs during patient-care activities that require physical contact. Direct-contact transmission also can occur between two patients (e.g., by hand contact), with one serving as the source of infectious microorganisms and the other as a susceptible host. Indirect-contact transmission involves contact of a susceptible host with a contaminated intermediate object, usually inanimate, in the patient's environment.

    PATIENT PLACEMENT

    Place the patient in a private room. If a private room is not available, place the patient in a room with a patient(s) who has active infection with the same microorganism but with no other infection (cohorting).

    PROTECTIVE GLOVES & HANDWASHING

    In addition to wearing gloves as outlined under Standard Precautions, wear gloves (clean, non-sterile gloves are adequate) when entering the room.

    Change gloves between tasks and procedures on the same patient after contact with material that may contain a high concentration of microorganisms. Remove gloves promptly after use, before touching non-contaminated items and surfaces, and before going to another patient or leaving the room, and wash hands immediately.

    After glove removal and handwashing, ensure that hands do not touch potentially contaminated environmental surfaces or items in the patient's room to avoid transfer of microorganisms to other patients or environments.

    PROTECTIVE GOWN

    In addition to wearing a gown as outlined under Standard Precautions, wear a gown (a clean, non-sterile gown is adequate) when entering the room if you anticipate that your clothing will have substantial contact with the patient, environmental surfaces, or items in the patient's room. Remove the gown before leaving the patient's environment. After gown removal, ensure that clothing does not contact potentially contaminated environmental surfaces to avoid transfer of microorganisms to other patients or environments.

    PATIENT TRANSPORT

    Limit the movement and transport of the patient from the room to essential purposes only. If the patient is transported out of the room, ensure that precautions are maintained to minimize the risk of transmission of microorganisms to other patients and contamination of environmental surfaces or equipment.

    PATIENT-CARE EQUIPMENT

    When possible, dedicate the use of non-critical patient-care equipment to a single patient (or cohort of patients infected or colonized with the pathogen requiring precautions) to avoid sharing between patients. If use of common equipment or items is unavoidable, then adequately clean and disinfect them before use for another patient.





    AIRBORNE PRECAUTIONS

    Airborne transmission occurs by dissemination of either airborne droplet nuclei (small-particle residue [5 micrometer or smaller in size] of evaporated droplets that may remain suspended in the air for long periods of time) or dust particles containing the infectious agent. 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, depending on environmental factor; therefore, special air handling and ventilation are required to prevent airborne transmission.

    PATIENT PLACEMENT

    Place the patient in a private room that has: (1) monitored negative air pressure in relation to the surround areas; (2) 6 to 12 air changes per hour; and (3) appropriate discharge of air outdoors or monitored high-efficiency filtration of room air before the air is circulated to other areas in the facility. Keep the room door closed and the patient in the room. If a private room is not available, place the patient in a room with a patient who has active infection with the same microorganism but with no other infection (unless otherwise recommended).

    RESPIRATORY PROTECTION

    Wear respiratory protection (N95 respirator) when entering the room of a patient with known or suspected infection.

    PATIENT TRANSPORT

    Limit the movement and transport of the patient from the room to essential purposes only. If transport or movement is necessary, minimize patient dispersal of droplet nuclei by placing a surgical mask on the patient, if possible.





    REFERENCES

    Garner JS, Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996:17:53-80, and Am J Infect Control 1996;24:24-52.

    Web Version, 11/2004, at: www.cdc.gov/ncidod/hip/ISOLAT/ISOLAT.HTM

    CDC/HICPAC. Hand Hygiene in Health care Settings. MMWR October 25, 2002 / 51 (rr16); 1-44





    HANDWASHING LINKS

  • Washing Hands Quiz
  • CDC: An ounce of Prevention Keeps the Germs Away
  • CDC: Why is Handwashing Important




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