Standard Precautions Lecture Flashcards
5/21/19
Universal/Standard precautions
Infection control practices used to prevent transmission of infectious agents transmitted via blood, body secretions, non-intact skin, or mucus membranes not only to healthcare providers but also patients and hospital/clinic guests through assumption that all fluids listed are infectious with all blood borne pathogens, implemented standard in all patient care interactions
What bodily fluids do standard precautions ignore?
-Feces, nasal secretions, vomit, saliva, sweat, tears, and urine (unless containing frank blood)
3 types of standard precautions
Primary - Immunizations, PPE, work practices
Secondary - Post exposure prophylaxis (PEP)
Expanded - Techniques specific to highly contagious diseases to limit exposure such as negative pressure rooms or isolation
Occupational exposure
Exposure to blood (concentrated or frank), or other body fluids to which standard precautions apply as a result of work
3 Common modes of exposure
1) Percutaneous injury - penetration of skin by needle or other sharp object formerly in contact with blood/body fluid/etc
2) Mucus membrane exposure - Contact of mucus membrane (eyes, nose, mouth) with fluid, tissues, or specimen
3) Non-intact skin exposure - Contact with fluid, tissues, or specimen
What bodily fluids to standard precautions typically include?
-Semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, and amniotic fluid
What is the overwhelming majority of exposure types?
Percutaneous injury
Transmission based precautions
Secondary tier of techniques to be used in conjunction with standard precautions in regards to patients with specific infectious agents such as airborne, droplet, or contact
Examples of airborne transmitted pathogens
- Mycobacterium tuberculosis
- Varicella virus
- Measles, mumps, influenza
- Pertussis
- Anthrax
N-95 respirator
Very efficient respiratory protective devices that block 95% of .3 micron or greater particles
Examples of droplet transmitted pathogens
- Adenovirus
- Measles
- Mumps
- Influenza
- Mycoplasma pneumoneae
- Diptheria
- Pertussis
- Niesseria meningitidis
Examples of contact transmitted pathogens
- HIV
- HBV
- HCV
- MDR Bacteria (multiple drug resistant)
- MRSA
- VRSA (vancomycin resistant staph aureus)
- Cdiff
- Herpes
- Ecoli
Seroconversion
Time period in which a specific antibody develops and becomes detectable in blood, transition from seronegative to seropositive, indicative of exposure
Disease with highest seroconversion rate post needle stick injury (NSI)
Hepatitis B (up to 30%)
Incidence of hepatitis B occupational infection has decreased because of…
The hepB vaccine introduction
Most common type of hepatitis in clinical practice
HepC
Side effects of HCV exposure
Chronic hepatitis (70-80% of patients) Cirrhosis of liver (20%) and increased risk of liver cancer Liver cancer (5%)
Issue with labeling specimens of potential/confirmed infected patients
Assume that those not labelled require less care - all should be treated with same level of standard precaution
Steps to handle blood spill
1) Clean area with absorptive towels
2) clean area with soap and water
3) Disinfect area with 1:10 solution of bleach
Steps to handle contaminated reusable equipment
Heat sterilization or mycobacteriocidal cleanser
If something is falling…
let it drop
Places where gloves/gown should not be worn and why
- Nurses station
- Hallways
- Near clean supplies
This exposes these clean areas with pathogens potentially from the contaminated gown/gloves
Sharp resonsibility
The user, unless delegated to someone else present in the room at the time
Percentage of healthcare workers who do not engage in adequate infection control measures
> 50%
