STANDARD PRECAUTIONS

Standard precautions include both Universal Precautions (UP), or blood and body fluid precau-tions, designed to decrease the risk of transmitting bloodborne pathogens, and Body Substance Isolation, designed to decrease the risk of transmission of pathogens from moist body substances and healthcare-associated infections (HAIs). UP includes all blood and body fluids or secretions except sweat.

1. Gloves should be worn during phlebotomy and any time there is a risk of exposure to blood or body fluids or contaminated items.

2. Needles and sharps should be properly disposed of in puncture-resistant containers. Needles should not be recapped or otherwise manipulated by hand after use.

3. Hands should be washed immediately and thoroughly with plain non-antimicrobial soap after routine contact and after routine glove removal. Hands should be washed immediately and thoroughly with an antimicrobial agent or after any contamination with blood or body fluids.

4. Protective clothing and eyewear should be worn if there is a potential for splashing of fluids. Use a mask when performing high-risk, prolonged procedures such as spinal canal puncture.

5. Respiratory hygiene and cough etiquette include:• “Education of healthcare facility staff, patients, and visitors• Posted signs, in language(s) appropriate to the population served, with instructions to

patients and accompanying family members or friends• Source control measures (e.g., covering the mouth/nose with a tissue when coughing and

prompt disposal of used tissues, using surgical masks on the coughing person when tolerated and appropriate)

• Hand hygiene after contact with respiratory secretions• Spatial separation, ideally >3 feet, of persons with respiratory infections in common waiting

areas when possible. Covering sneezes and coughs and placing masks on coughing patients are proven means of source containment that prevent infected persons from dispersing respiratory secretions into the air.” (CDC, 2007).

6. Spills should be cleaned with an EPA-approved germicide or a 1 : 10 solution of household bleach while one is wearing gloves.

7. Soiled linen should be handled as little as possible and bagged at the location where it was used.8. Infective waste should be disposed of according to institutional protocol and local law.9. When possible, persons with highly transmittable or epidemiologically important organisms

are placed in a private room with separate toilet and hand-washing facilities.10. Transportation of infected persons requires the use of appropriate barriers such as masks and

impervious dressings.11. An awareness of the emergence of new pathogens (SARS-CoV, Avian influenza) and known

pathogens (C. difficile, norovirus, community acquired MRSA) and concern for the threat of bioweapons attacks are addressed in the 2007 guidelines. For managing a bioterrorism event the infection control issues to be addressed include:• “Identifying persons who may be exposed or infected• Preventing transmission among patients, healthcare personnel, and visitors• Providing treatment, chemoprophylaxis or vaccine to potentially large numbers of people• Protecting the environment including the logistical aspects of securing sufficient numbers

of airborne infection isolation rooms (AIIR) or designating areas for patient cohorts when there are an insufficient number of AIIRs available

• Providing adequate quantities of appropriate personal protective equipment• Identifying appropriate staff to care for potentially infectious patients (e.g., vaccinated

healthcare personnel for care of patients with smallpox).”

Condensed from the Centers for Disease Control and Prevention Guideline for Isolation Precautions (2007). Available at http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html.