STANDARD PRECAUTIONS

• applies to all patients receiving care in the facilities, regardless of

their diagnosis or presumed infection status.
• designed to reduce the risk of transmission of microorganisms from:
• blood;
• all body fluids, secretions, and excretions, except sweat, regardless of
whether or not they contain visible blood;
• non-intact skin;
• mucous membranes.
HAND HYGIENE

• prevents the spread of infection

• hand washing
• water, soap and friction for a minimum of 20 seconds.
• alcohol-based hand sanitizer
• consists of taking a small amount of the product and vigorously
rubbing the surface of your hands, including in between your fingers,
under your fingernails, and around your thumbs until the hands are
dry.
 PROPER STEPS ON PERFORMING HAND HYGIENE
Washing Hands with Soap and Water
1. Wet both hands. 1. Dry thoroughly with paper towels.
2. Obtain 2-3 “pumps” of soap in the palm of one hand. 2. Do not touch faucet/sink/counter.
3. Vigorously rub all surfaces of both hands. 3. Do not touch door knob with your clean, bare hands.
4. Scrub for at least a full 15 seconds. 4. Keep paper towel in hand while opening door.
5. Rinse well. 5. Discard towel in trash.

Using Alcohol-based Hand Sanitizer

1. Apply enough sanitizer to open palm. 1. Rub fingertips of each hand in opposite palm.
2. Rub hands together palm to palm. 2. Rub each thumb clasped in opposite hand.
3. Rub in between and around fingers. 3. Rub each wrist clasped in opposite hand.
4. Rub back of each hand with palm of other hand. 4. Keep rubbing hand surfaces until hands are dry.
• Hand Hygiene should be performed:
•
Before and after any contact with patients. Before donning sterile
gloves. Before eating, preparing and serving food. Before applying
make-up and handling contact lenses. After contact with body fluids,
mucous membranes, non-intact skin and wound dressings. After
removing gloves (clean or dirty). After using the bathroom, sneezing,
coughing or blowing your nose.
Hands Must be Washed with Soap and Water:

• When hands are visibly soiled or contaminated.

• Before eating or preparing food.
• After using the restroom.
• After removing gloves if gloves are visibly soiled with blood or body
fluids.
• After every 5-10 applications of the alcohol-based hand rub (follow
the manufacturer’s guidelines).
• When contact with Clostridium difficile (c-diff), Bacillus anthracis
(anthrax) or Norovirus is suspected.
Use Alcohol-based Hand Rub or Wash Hands with
Soap and Water
• Before direct contact with patients.
• After contact with patient’s intact skin.
• After contact with inanimate objects (medical equipment, bed, etc.) in
patient’s immediate area.
• After removing gloves (if gloves not visibly soiled with blood or body
fluids).
• Before start of shift and end of shift.
•
• Patients are encouraged to remind their healthcare providers to
wash/clean their hands prior to providing care. Staff should encourage
patients to perform hand hygiene.
•
• REMEMBER
• An alcohol-based hand rub is the recommended agent for all other
hand antisepsis indications unless the hands are visibly dirty, or soiled
with blood, body fluids, or after contact with C. difficile
FINGERNAILS

• Natural nails must be clean, with tips less than 1/4 inch long. If fingernail polish is
worn, it must be in good condition, free of chips, and preferably clear in color.
Hand jewelry with stones and crevices should not be worn as germs are difficult
to remove from crevices and stones may tear gloves.
•
• Artificial fingernails are not permitted for those who have direct contact with
patients (who touch the patient as part of their care or service), handle
instruments or patient care equipment, supplies, food, specimens, or
medications.
•
•  Artificial fingernail is defined as any material applied to the fingernail for
the purpose of strengthening or lengthening nails (e.g., tips, acrylic, gel,
porcelain, silk, jewelry, overlays, wraps, fillers, superglue, any appliqués other
than those made of nail polish, nail-piercing jewelry of any kind, etc.).
CLEANING AND DISINFECTION

• Patient care equipment must be cleaned with a facility-approved

detergent/disinfectant and follow manufacturers’ instructions for
appropriate contact time. Only clean equipment is stored in the clean
equipment area.
•
• Equipment will not be stored on or immediately around the sink to avoid
contamination. All other equipment that is not cleaned or cannot be
cleaned immediately after use shall be removed. Only soiled equipment is
stored in the soiled or “dirty area”. If it is unclear whether patient care
equipment has been cleaned, it must be cleaned before patient use.
•
RESPIRATORY HYGIENE/COUGH ETIQUETTE

• Individuals with signs and symptoms of a respiratory infection or a cough should:

• Cover the nose/mouth when coughing or sneezing.
• Use tissues to contain respiratory secretions and dispose of them in the nearest
trash can after use.
• Wash hands or use alcohol-based hand sanitizer after having contact with
respiratory secretions and contaminated objects/materials.
• Utilize the “Respiratory Hygiene Stations” which have been installed in the lobby
areas and in the out-patient clinics to obtain masks and tissues if needed.
• Sit at least three feet away, (if possible) from others in common waiting area.
• Healthcare Workers: Precautions to minimize exposure to respiratory droplets
• Healthcare workers should wear a mask for close contact with coughing patients,
such as when examining a patient with symptoms of a respiratory infection,
particularly if fever is present.
TRANSMISSION-BASED/ISOLATION PRECAUTIONS

• In addition to Standard Precautions, follow Transmission-Based

Isolation Precautions for any patient diagnosed with or suspected of
having a contagious disease. Know the precautions and work
practices to use in your work area or job duties to prevent exposure
to blood or body fluids or to airborne infections. Report suspected
exposure or outbreak of communicable diseases to your supervisor.
Supervisors are to report these exposures or outbreaks to Infection
Prevention & Control and Employee Health.
Three categories of isolation: Droplet, Airborne,
and Contact Precautions.
For patients known or suspected to be infected with pathogens transmitted by large respiratory droplets that travel short distances (<3 ft.) and are generated by
a patient who is coughing, sneezing or talking, such as, Influenza, Bacterial Meningitis, Mumps, Scarlet Fever, Pertussis, and Rubella.

DROPLET

PPE Needed: Surgical/barrier mask, gloves and gown.

For patients known or suspected to be infected with microorganisms transmitted by small respiratory droplets from person to person by the airborne route over
long distances (less than or >3 ft.) such as, Measles, Tuberculosis, Severe Acute Respiratory Syndrome (SARS), Smallpox and Chickenpox. These patients must be
placed in a negative pressure room with the door kept closed. If negative pressure room is not available, patient is to be placed in a private room with the door
closed and is to be transferred to appropriate setting or sent home as appropriate as soon as possible.

AIRBORNE

PPE Needed: N95 or PAPR respirator is required when entering the room.

For patients with known or suspected infections 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 patient’s dry skin) or indirect contact (touching) with environmental surfaces or patient care items in the
patient’s environment. Infections such as MRSA, VRE, and C. difficile require the use of gown and gloves.

CONTACT

PPE Needed: Gown and gloves.

• Patients with need for Droplet or Airborne Precautions and/or who
are coughing are to wear a Surgical/Barrier Mask when in a room or
enclosed area/building.
• Isolation Sign should be posted at the door of room or cubicle area.
• Notification is to be made to other Departments if patient on
isolation precautions is sent to other areas, e.g., Lab, Radiology, EKG,
etc. For Airborne or Droplet Isolation the patient should wear a
surgical mask and be escorted to other department by a HCW.
PERSONAL PROTECTIVE EQUIPMENT (PPE)

• PPE’s such as gown, gloves, mask, goggles, and face shield are barriers that should be
used to prevent exposure to blood, body fluids, and airborne organisms (i.e. during direct
contact with the patient, indirect contact with the patient’s environment, or during
procedures that may produce splashes). PPE is for workforce members and patients.
•
• PPE Guidelines:
•
• Must be applied prior to an anticipated exposure.
• Caution must be used not to contaminate the environment during patient care activities
(i.e. during specimen collection and patient transport).
• Remove and discard at the conclusion of the activity prior to leaving the work area
(except for the N95 respirator which must be discarded outside of the room).
• Single use only and are not to be used between patients.
• Hand hygiene performed after removal.
• Gloves:
• Do not substitute for hand hygiene.
• Must be changed between patients.
• Must be removed if damaged/torn/punctured.
• Must be worn when hands have any open areas, cuts, or abrasions.
• Disposable gown.