Hospital Infection Prevention and Control

Doctors, nurses, and other hospital staff follow many precautions and protocols to help prevent the spread of infection within healthcare facilities.

Healthcare workers are trained to follow the rules outlined by the Centers for Disease Control and Prevention (CDC), known as standard precautions.

Standard precautions apply to all patients and their care. They include basic hygiene practices, such as washing hands and disinfecting equipment, as well as safety guidelines that must be used when handling blood or handling needles.

This article explores the many simple but strict standard precautions that medical staff follow to protect their patients and themselves from infection. It also discusses other measures to be taken in certain circumstances.

Transmission type

Any infection that occurs after exposure to bacteria while in the hospital is called a hospital-acquired infection (also known as a nosocomial infection).

To understand the “why” behind Standard Precautions, it’s helpful to first review all the ways germs can spread or spread in a healthcare setting.

indirect contact

This is a common way the disease spreads in hospitals. When an infected person touches and contaminates objects or surfaces that an uninfected person subsequently touches.

This is called pollutant spread.It usually occurs with bacterial infections such as Escherichia coli (E.coli) or staphylococcus (staph) and viral infections such as the flu or norovirus.

contact directly

Transmission can occur when a sick person comes into contact with other people. In hospitals, this often results in the same types of viral and bacterial infections that are spread through indirect contact.

spray or splash

When someone sneezes or coughs, they exhale droplets that can reach another person’s eyes, nose or mouth, or be inhaled within about 6 feet. COVID-19 and the common cold can spread this way.

Medical procedures such as extubation (removal of a tube placed to aid breathing) also often lead to splashes and splashes, which is why healthcare workers wear protective equipment.

inhale

Certain bacteria or viruses can be airborne or suspended in the air, including the bacterial infection tuberculosis (TB) and the viral infection measles.

These particles can linger and travel in air currents over long distances, such as from room to room, and be inhaled by others.

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sharps damage

This is when blood-borne pathogens or bacteria carried in the blood enter the body through used needles or instruments that have not been properly handled or cleaned. Examples include human immunodeficiency virus (HIV) and hepatitis B virus.

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Infection-causing germs can be spread in hospitals through direct or indirect contact, coughing and spraying, inhalation of airborne particles, or contact with contaminated needles or tools.

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Standard Considerations

Standard precautions are the minimum precautions used in all patients to prevent the spread of infection. In addition to hospitals, they are used in various forms of healthcare facilities, including doctors’ offices and long-term care facilities.

Usually, every patient is considered to be infected, even if there is no disease. This means following standard precautions without exception.

Bloodborne Infection Protocol

To prevent the spread of blood-borne pathogens, all patients take precautions to avoid direct contact with:

  • Blood
  • semen
  • vaginal discharge
  • amniotic fluid
  • cerebrospinal fluid
  • Extracted tissue or organ
  • Fluid drawn from joints, lungs, heart, or abdominal cavity (peritoneum)

Standard precautions are especially important to protect hospital staff and patients from an ever-expanding range of drug-resistant bacteria. These pathogens have evolved to the point that they are no longer effectively treatable with standard drugs.

Resistant bacteria include methicillin-resistant Staphylococcus aureus (MRSA), carbapenem resistant Enterobacteriaceae (CRE) and vancomycin-resistant Enterococcus (VRE).

Precautions to prevent blood-borne infections are also known as universal precautions.

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Hygiene Protocol

Hygiene protocols have been added to the standard precautions above for all types of bodily fluids and substances that may carry infection. This includes saliva, sputum, urine, feces, vomit, and nasal secretions.

These are strictly followed as part of Standard Precautions and include:

  • Regularly clean surfaces, instruments and objects using chemical disinfectants or disinfection techniques such as steam
  • Wash your hands often with plain soap for general handwashing or use antibacterial soap in specific situations
  • Certain vaccines are recommended for hospital staff, including the hepatitis B vaccine and the annual flu shot
  • Quarantine patients with certain infections or isolate those who have been exposed to infectious diseases to see if they get sick

Thorough hand washing with soap and water can remove more than 90% of bacteria from the skin’s surface. Antibacterial soap will further remove bacteria, viruses and other disease-causing pathogens.

Respiratory hygiene is also a standard precaution. This is to help reduce infections that are spread through coughing and sneezing. Hospitals typically issue instructions to patients and staff about cough coverings and immediately alert staff about respiratory symptoms.

In the early days of the COVID-19 pandemic, about 6 percent of hospitalized cases recorded in 13 states were hospital employees. Without standard precautions, including hygiene protocols, the rate could be higher.

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Standard precautions are the minimum precautions medical staff take for all patients to prevent the spread of infection. They include general hygiene practices and avoiding direct contact with blood and body fluids.

Examples of rules to follow

Some of the key rules that are part of Standard Precautions include:

  • Always use barrier protection.
  • Use disposable gloves when working around blood and body fluids.
  • Change gloves between patients.
  • Wash hands immediately after removing gloves or touching blood or body fluids.
  • Use glasses, goggles, face shields, face shields and waterproof gowns to protect against splashes.
  • Establish routine care, cleaning and disinfection procedures for surfaces, especially frequently touched surfaces.
  • Handle equipment and clothing with care and wear gloves when handling any soiled items.
  • Handle containers with puncture-resistant sharps.
  • Do not bend, break, or put the cap back on the needle.
  • Use resuscitation equipment instead of mouth-to-mouth resuscitation.
  • Immediately disinfect all visibly contaminated surfaces and equipment.

Transmission-Based Precautions

Transmission-based precautions are second-tier precautions that are specific to patients who are known or suspected to have certain types of infections. Use them in addition to standard precautions for these patients.

These include potentially serious airborne infections such as COVID-19, tuberculosis (TB) and measles.

If there is a known or suspected risk of such transmission, precautions for hospital staff to take include:

  • Isolate the patient from others (although patients with the same infection (e.g. COVID-19) can share a room).
  • Stand at least three feet (preferably six feet) from the patient.
  • Wear a medical mask or other designated personal protective equipment (PPE) before entering the room.
  • Avoid touching surfaces unnecessarily.
  • Wash your hands vigorously after leaving the room.

How hospital floors pose an infection risk

Additional precautions may be implemented in cases involving serious pathogens or declared epidemics. Among them:

  • Patients may be isolated in negative pressure rooms. The air from these rooms is extracted rather than re-entered into any adjoining rooms or hallways.
  • Special ultraviolet (UV) lamps can be installed to help kill harmful pathogens.
  • If airborne pathogens are involved, anyone entering the room may need to wear a special N-95 mask, which filters particles as small as 0.1 to 0.3 microns.

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Transmission-based precautions are precautions taken in patients who are known or suspected to have certain infections, such as easily transmitted airborne diseases. Patients may be isolated, and medical staff may wear additional protective gear while treating them.

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generalize

Standard Precautions are precautions that hospital staff use in all patient care to prevent the spread of infection.

This includes hand washing, proper handling and disinfection of equipment, and the use of protective gear when possible contact with infectious material.

When a patient is known or suspected to have certain infections, such as TB or COVID-19, additional transmission-based precautions are taken, such as isolating the patient and using personal protective equipment.

VigorTip words

Hospital-acquired infections are a concern for both patients and hospital staff. While healthcare workers must follow these protocols, remember that if you are a patient or even a visitor, you can also play a role in preventing infection.

These steps are useful even outside of a medical setting. Many of the same precautions that hospital staff take, such as washing hands and disinfecting surfaces, can be implemented at home if a family member becomes ill or if the local health department declares an outbreak of infection.

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