Definition/IntroductionThe Centers for Disease Control (CDC) and the Occupational Safety and Health Administration (OSHA) are the regulating bodies of infection control, prevention, and awareness. Show
Precautions are preventative steps needed to be taken by healthcare team members and staff at healthcare facilities to prevent the spread of infections. There are universal standard precautions are the minimum infection prevention steps defined by the CDC as[1]:
In addition to universal standard precautions, the Center for Disease Control (CDC) defines additional types of proper personal protective equipment (PPE) required for each kind of precaution. Signs defining the precaution category should be easily visible and placed on each patient's room explaining the PPE needed and the type of isolation in effect. The main types of transmission-based precautions defined by the CDC result from direct or indirect patient contact, bloodborne products, droplet, and airborne. Each kind of transmission-based precaution is dependent on the type of infection or pathogen the patient or source has, as outlined as follows: 1. Contact precautions:
2. Bloodborne precautions:
3. Droplet precautions:
4. Airborne precautions:
Whenever interacting with any patient in a healthcare facility, healthcare team members and visitors need to adhere to and comply with PPE and infection control signs. It is also essential to wash hands thoroughly with soap and water before and when leaving a patient's room to ensure the safety of the patient and oneself. Issues of ConcernDespite efforts made by the CDC, OSHA, and internal policies by healthcare organizations, infection control, and safety rules frequently get broken. An observational study analyzing adherence to contact precautions showed 27.9% of nurses and nursing assistants adhered to proper personal protective equipment (PPE) in comparison to 100% of infectious disease physicians and 85.7% of housekeeping staff.[8] Being on the front lines of patient interactions, physicians, nurses, and nursing assistants are the foundation of infection control, and should be aware of PPE and utilize them as expected. Prevention of infections in healthcare systems is critical in overall disease control and morbidity and mortality. Health-care workers should be aware of bloodborne pathogens and consider safer practices and procedures when handling objects potentially contaminated with blood or bodily fluids to prevent injuries and the possible spread of infections. Studies have shown that awareness of technique and safety precautions can lead to decreased bloodborne infection transmission.[9] A retrospective cohort study also found that patients in isolation rooms requiring PPE received less attention and care from health care staff. The study determined that isolation precautions lead to poorer outcomes, more extended hospitalizations, and increased readmissions to healthcare facilities.[10] These factors together also contribute to increased healthcare costs and time and increased morbidity and mortality of treatable infectious organisms. Clinical SignificanceInfection control through the use of personal protective equipment (PPE) and alert signs designed by the CDC, OSHA, and individual internal policies in healthcare facilities is critical for proper patient care and prevention of prolonged hospitalizations and decreasing healthcare costs. While awareness of precautions is appreciated, adherence to following the precautions appears to be lacking.[11] All healthcare team members and visitors to healthcare facilities must abide by those policies to encourage safe practices and reduce the spread of infections. Nursing, Allied Health, and Interprofessional Team InterventionsHealth-care team members, including physicians, nurses, and nursing assistants, should pay close attention to proper PPE use and isolation precautions for the personal safety and safety of the patients. It is also crucial for team members to enforce isolation precautions on visitors and other members not complying with standard protocols to reduce infection transmission within the workplace.[12] In the retrospective cohort study by Tran K. and Bell C. et al., patients on isolation precautions on average had a 17% increase in hospital stays and a 23% increase in healthcare cost due to lack of attention by healthcare staff.[10] Health-care members must provide consistently high-quality care and attention to any patient, regardless of social or health status. [Level 3] Team members in any healthcare organization should be aware of the length of stay increase as well as the lack of quality care in isolation precaution patient populations. Nursing, Allied Health, and Interprofessional Team MonitoringNursing and other healthcare team members should make every effort to consistently provide high-quality care and help enforce CDC, OSHA, and internal organization infection control rules and guidelines. When care is compromised, or there is a risk of infection transmission, it should be brought to the attention of supervisors and managed, so that patient care takes precedence. Review QuestionsReferences1.Broussard IM, Kahwaji CI. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Dec 15, 2021. Universal Precautions. [PubMed: 29262198] 2.Patrick MR, Hicks RW. Implementing AORN recommended practices for prevention of transmissible infections. AORN J. 2013 Dec;98(6):609-28. [PubMed: 24266933] 3.Beekmann SE, Henderson DK. Protection of healthcare workers from bloodborne pathogens. Curr Opin Infect Dis. 2005 Aug;18(4):331-6. [PubMed: 15985830] 4.Beltrami EM, Williams IT, Shapiro CN, Chamberland ME. Risk and management of blood-borne infections in health care workers. Clin Microbiol Rev. 2000 Jul;13(3):385-407. [PMC free article: PMC88939] [PubMed: 10885983] 5.Ochmann U, Wicker S. [Needlestick injuries of healthcare workers]. Anaesthesist. 2019 Aug;68(8):569-580. [PubMed: 31218431] 6.Ather B, Mirza TM, Edemekong PF. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): May 22, 2022. Airborne Precautions. [PubMed: 30285363] 7.Paton R, Tolhurst N, Perisa M, Dempsey K, Tallon J. What mask to use? Aust Nurs Midwifery J. 2014 Nov;22(5):31. [PubMed: 29235820] 8.Katanami Y, Hayakawa K, Shimazaki T, Sugiki Y, Takaya S, Yamamoto K, Kutsuna S, Kato Y, Ohmagari N. Adherence to contact precautions by different types of healthcare workers through video monitoring in a tertiary hospital. J Hosp Infect. 2018 Sep;100(1):70-75. [PubMed: 29317259] 9.Lee R. Occupational transmission of bloodborne diseases to healthcare workers in developing countries: meeting the challenges. J Hosp Infect. 2009 Aug;72(4):285-91. [PubMed: 19443081] 10.Tran K, Bell C, Stall N, Tomlinson G, McGeer A, Morris A, Gardam M, Abrams HB. The Effect of Hospital Isolation Precautions on Patient Outcomes and Cost of Care: A Multi-Site, Retrospective, Propensity Score-Matched Cohort Study. J Gen Intern Med. 2017 Mar;32(3):262-268. [PMC free article: PMC5330996] [PubMed: 27752880] 11.Ndu AC, Arinze-Onyia SU. Standard precaution knowledge and adherence: Do Doctors differ from Medical Laboratory Scientists? Malawi Med J. 2017 Dec;29(4):294-300. [PMC free article: PMC6019545] [PubMed: 29963283] 12.Peponis T, Cropano MC, Larentzakis A, van der Wilden MG, Mejaddam YA, Sideris CA, Michailidou M, Fikry K, Bramos A, Janjua S, Chang Y, King DR. Trauma team utilization of universal precautions: if you see something, say something. Eur J Trauma Emerg Surg. 2017 Feb;43(1):145-150. [PubMed: 27084540] What type of PPE is used for droplet precautions?Droplet precautions means wearing a face mask (also called a surgical mask) when in a room with a person with a respiratory infection. These precautions are used in addition to standard precautions, which includes use of a face shield or goggles as well as gown and gloves if contact with blood/body fluids is possible.
What 4 items of PPE should you have?4 - Personal Protective Equipment (PPE). Gloves.. Aprons.. Masks.. Eye Protection.. What are the 4 types of precautions?Infection Control and Prevention - Transmission-based precautions. Contact Precautions. ... . Droplet Precautions. ... . Airborne Precautions. ... . Eye Protection.. |