Standard Precautions
Standard precautions pertain to the minimum required practices applicable for ALL health workers, patients, and visitors to achieve basic infection control and prevention.
Standard precautions include PPE (personal protective equipment), hand hygiene, and environmental control.
- Hand hygiene is known to be the simplest, most important way to prevent the spread of diseases.
- Handwashing: wash hands for 40 to 60 seconds using soap and water.
- Handrubbing with sanitizer or alcohol: rub hands with alcohol/sanitizer until hands are covered. The best way is to rub your hands until they dry.
- Personal Protective Equipment for the skin, hair, mucous membranes, airway, and basic clothing includes:
- Gowns
- Caps
- Gloves
- Masks
- Face shields or goggles
- Environmental control is the responsibility of health facilities to ensure that they have enough procedures for the regular disinfection, sanitation, and cleaning of environmental surfaces and that these protocols are strictly implemented.
Transmission-Based Precautions
Transmission-based precautions come in when standard precautions alone wouldn’t suffice against the spread of infection. These practices are based on the mode of transmission (airborne, droplet, contact) of the identified infectious agent.
Airborne Precautions
Used for patients with infections from pathogens that can spread through airborne transmission. Examples are droplets that can stay in the air for a long period of time. These are residues from the droplet nuclei (from the saliva of the patient while laughing or speaking). The size may be 5um or smaller. Dust particles may also harbor pathogens.
- Place the patient in a negative pressure room (6 to 12 air changes per hour)
- Use PPE such as a respirator that can filter 95% of air, an example is N95 or PAPR (powered air-purifying respirator)
- Diseases with this precaution:
- Aspergillosis: if there is a massive infection on the soft tissue
- Herpes zoster
- Measles
- Monkeypox
- Severe acute respiratory syndrome (SARS)
- Smallpox
- Tuberculosis: this may be pulmonary or laryngeal
- Tuberculosis (extrapulmonary): this may be lesions that are draining
- Varicella-zoster
Droplet Precautions
This is the precaution used when a patient is suspected to have or already has a known infection that can be spread through droplet transmission. Droplets are particles that come from respiratory secretion. The secretions came from coughing or sneezing. It can stay in the air for a limited time. It is about the size of +/- 5 microns. Exposure from this infection is within 3 to 6 feet.
- The preferred room for this case is a private room. The patient can share the room with patients having the same infection.
- PPE: surgical mask used within 6 feet from the patient
- Diseases under this precaution are:
- Adenovirus
- Diphtheria
- Haemophilus influenzae type b: meningitis or epiglottitis
- Influenza, pandemic
- Neisseria meningitidis: this may be pneumonia, sepsis, or meningitis
- Mumps
- Mycoplasma pneumonia
- Parvovirus B19
- Pertussis
- Yersinia pestis: or the mnemonic plague
- Group A Streptococcus: such as pneumonia, pharyngitis, scarlet fever, or serious invasive disease.
- Rhinovirus
- Rubella
- Severe acute respiratory syndrome (SARS)
- Crimean-Congo, Ebola, Marburg, and Lassa fever viruses: these are viral hemorrhagic fevers
Contact Precautions
This precaution is used when a patient has known or suspected infection from pathogens. It may spread either through indirect or direct contact. Indirect contact means physical contact with things that patients have touched.
- The patient can be placed in a private room. If the room is needed for sharing, patients with the same infection can room in.
- PPE used are gloves and gowns. Hand hygiene should be done after exposure to the patient. The patient should have their own types of equipment to use to avoid the spread of the infection.
- Diseases or conditions under contact precaution are:
- An abscess that is draining too much
- Adenovirus: pneumonia
- Burkholderia cepacia in patients with cystic fibrosis
- Bronchiolitis
- Clostridium difficile
- Congenital rubella
- Viral conjunctivitis
- Cutaneous diphtheria
- Staphylococcal furunculosis
- Rotavirus
- Hepatitis A
- Herpes simplex: neonatal, disseminated, or severe
- Herpes zoster: disseminated
- Human metapneumovirus
- Impetigo
- Lice: found on the head
- Monkeypox
- Multidrug-resistant organism: or it may have colonized
- Parainfluenza virus
- Poliomyelitis
- Infected pressure ulcer
- Respiratory syncytial virus: young children, infants, or immunocompromised adults
- Staphylococcal scalded skin syndrome: also Ritter’s disease
- Scabies
- Severe acute respiratory syndrome (SARS)
- Smallpox
- Staphylococcus aureus skin infection: patients having a major infection
- Group A streptococcus skin infection
- Tuberculosis
- Vaccinia
- Varicella-zoster
- Lassa, Ebola, Marburg, and Crimean-congo fever viruses
- Wound infection
