Infection Prevention Control In Hospitals

Precautions To Protect Staff and Patients From Germs that Cause Illness

There are many precautions and protocols that hospital staff, including doctors and nurses, follow to help prevent the spread of infections within a hospital.

To do so, healthcare workers are trained to adhere to rules outlined by the Centers for Disease Control and Prevention (CDC) that are known as standard precautions.

Standard precautions apply to all patients and their care. They include basic hygiene practices, such as hand washing and disinfecting equipment, and safety guidelines when dealing with blood or handling needles.

This article will explore the many simple, though strict, standard precautions that hospital staff follow to protect patients and themselves from getting infections.

Doctors and nurses walking around a hospital
Precautions for doctors and nurses. Caiaimage / Robert Daly / Getty Images

Types of Transmission

Transmission refers to how germs that cause infections reach a person.

Infections, especially those that are bacterial or viral, can spread in hospitals in several different ways.

Any infection that you get after you were exposed to germs while in a hospital are known as hospital-acquired infections. These are a type of healthcare-associated infections and are sometimes called nosocomial infections.

Types of transmission in a hospital include:

  • Indirect contact: A frequent way illness is spread in hospitals is when an infected person touches—and contaminates—an object or a surface that an uninfected person then touches. This is referred to as fomite transmission.
  • Direct contact: Spread can occur when a sick person touches someone else.
  • Sprays or splashes: When someone sneezes or coughs, they expel droplets that can reach another person's eyes, nose, or mouth or get inhaled from a short distance.
  • Inhalation: Certain bacteria or viruses can become airborne, or suspended in the air. The airborne particles can then linger in air currents over great distances and then get inhaled by other people.
  • Sharp injuries: This is when a bloodborne infection, which means it is carried within blood, enters a person through a used needle or instrument that wasn't properly handled or cleaned.

Recap

Germs that cause infections can be spread in hospitals through direct or indirect touch, getting sprayed by a cough, inhaling airborne particles, or being exposed to contaminated needles or tools.

Standard Precautions

Standard precautions are the minimum precautions that are used for all patients to prevent the spread of infections.

As a rule, every patient is treated as if they have an infection even if they have no disease. This means that standard precautions are followed without exceptions.

For example, in order to prevent the spread of bloodborne illnesses, precautions are taken to avoid direct contact with blood, semen, vaginal secretions, amniotic fluid, cerebrospinal fluid, extracted tissues or organs, or fluids extracted from the joints, lungs, heart, or abdominal cavity (peritoneum).

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

Strictly speaking, universal precautions involve only the above listed bodily fluids but, in practice, the protocols also apply to saliva, sputum, urine, feces, vomit, nasal secretions, or any fluid that may be tainted with blood.

Standard Precaution Rules

Some of the key rules to prevent the spread of bloodborne illness, are:

  • Use barrier protection at all times.
  • Use disposable gloves when working around blood and body fluids.
  • Change gloves between patients.
  • Immediately wash hands after removing gloves or when exposed to blood or bodily fluids.
  • Use glasses, goggles, masks, face shields, and waterproof gowns to protect from splashes.
  • Use puncture-resistant sharps disposal containers.
  • Never recap (put cap back on), bend, or break needles.
  • Use resuscitation equipment in place of mouth-to-mouth resuscitation.
  • Immediately sterilize all overtly contaminated surfaces and devices.

Standard precautions also protect hospital workers and patients from an ever-widening range of drug-resistant bacteria, including methicillin-resistant Staphylococcal aureus (MRSA)carbapenem-resistant Enterobacteriaceae (CRE), and vancomycin-resistant Enterococci (VRE).

Hygiene Protocols

To reduce the risk of infection for hospital staff and other patients, several hygiene protocols are strictly followed as standard precautions.

These include:

  • Regularly cleaning surfaces, instruments, and objects with chemical disinfectants or sterilizing techniques, such as steaming
  • Frequent hand washing with plain soap for routine handwashing or an antimicrobial soap in specific circumstances
  • Recommending certain vaccinations for hospital staff, including for hepatitis B and the annual flu shot
  • Isolating patients with certain infections or quarantining those who were exposed to a contagious disease to see if they become sick.

Adequate handwashing with soap and water removes more than 90% of superficial contaminants. Antimicrobial soaps will further remove bacteria, viruses, and other disease-causing pathogens.

Respiratory Hygiene

Respiratory hygiene is also a standard precaution. It is to help reduce infections spread by coughing and sneezing.

Hospitals will often give instructions to patients and staff about covering a cough and alerting staff immediately about respiratory symptoms.

Recap

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

Transmission-Based Precautions

Transmission-based precautions are a second tier of standard precautions that are specifically for patients who are known or suspected to have certain types of infections.

These include potentially serious airborne infections like COVID-19, tuberculosis (TB), or measles.

Among the precautions that hospital staff use if there is a known or suspected risk of such transmission:

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

Droplets vs. Aerosolized Particles

The transmission-based precautions vary based on whether an infection involves respiratory droplets (larger than 5 microns) or aerosolized airborne particles (smaller than 5 microns).

Aerosolized particles are tiny and lightweight, which means they can linger longer in the air. In addition, the smaller the particle is, the farther it can travel and the deeper it can go into the lungs.

Types of Airborne Infections

The types of infections that can potentially be spread by aerosolized particles include:

In cases where a serious pathogen is involved or an epidemic has been declared, other precautions may be implemented. Among them:

  • The patient may be isolated in a negative pressure room. These are rooms in which the air is drawn out and not redirected into any adjoining rooms or hallways.
  • Special ultraviolet (UV) lights may be installed to help kill the offending pathogen, such as in certain cases of tuberculosis.
  • If an airborne pathogen is involved, anyone entering the room may be required to wear a special N-95 mask that can filter out particles as small as 0.1 to 0.3 microns.

Recap

Transmission-based precautions are those taken with patients known or suspected to have certain infections, such as airborne illnesses that spread easily. Patients may be isolated and medical staff may wear additional protective gear when treating them.

Summary

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

This includes hand washing, proper handling and disinfecting of equipment, and the use of protective gear whenever there is the potential for exposure to infectious material.

When a patient is known or suspected to have certain infections, such as TB or COVID-19, there are additional transmission-based precautions that are taken, such as patient isolation and use of personal protective equipment.

A Word From Verywell

Hospital-acquired infections are a concern for both patients and hospital staff. During the early part of the COVID-19 pandemic, about 6% of hospitalizations documented in 13 states were hospital employees.

Without standard precautions, including hygiene protocols, the rate could have been higher.

Many of the same precautions taken by hospital staff, such as hand washing and disinfecting surfaces, can be applied at home if ever a family member falls ill or an outbreak of infection is declared by your local health department.

By understanding the principles behind these precautions, you can better protect yourself and your family.

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13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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