Infection Prevention Control in Hospitals

Why Doctors and Nurses Don't Get Sick More Often

It seems that when one child is sick at home, everyone in the house gets sick. But in the hospital, it's not just one person who is ill; there may be hundreds of people with different kinds of illnesses and infections. Yet, the doctors and nurses who take care of these individuals can usually avoid getting sick by taking a few standard precautions.

To avoid illness, nurses, doctors, and other hospital staff follow a few simple (yet strict) rules to keep themselves safe from infections and other potentially hazardous contagions.

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

These include hospital hygiene protocols to protect themselves from nosocomial (hospital-acquired) infections and universal precautions to prevent the spread of disease from potentially contaminated body fluids.

Hospital Hygiene Protocols

In hospitals, infectious microorganisms can be transmitted in several different ways. Some are transmitted while sneezing or coughing when a bacteria or virus becomes airborne. Others can be transmitted from person to person via touch.

But, the most frequent route of transmission is indirect contact. This 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.

To reduce the risk of infection not only to hospital staff but to other patients, several protocols are strictly followed. These include:

  • Regularly disinfecting surfaces, instruments, and objects with approved antimicrobial agents or sterilizing techniques
  • Frequent handwashing (with plain soap for routine handwashing or an antimicrobial agent for specific circumstances)
  • Isolating (and, in some cases, quarantining) patients with known or suspected transmittable infections
  • Mandating certain vaccinations for hospital staff, including for hepatitis B and the annual flu shot

Handwashing with soap and water removes more than 90% of superficial contaminants. Antimicrobial soap will further remove bacteria, viruses, and other disease-causing pathogens, but only if used for several minutes.

Universal Precautions

Universal precautions is a term used to describe the practice of avoiding contact with a patient's bodily fluids by using nonporous articles. As a rule, every patient is treated as a potential vector for infection even if they have no disease. This means that universal precautions are adhered to without exception or variation.

As a rule, no one should ever come into direct contact with blood, saliva, sputum, semen, vaginal secretions, amniotic fluid, cerebrospinal fluid, extracted tissues or organs, or fluids extracted from the joints, lungs, heart, or abdominal cavity (peritoneum).

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

Universal Precaution Rules

Among the key rules governing universal precautions:

  • 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, bend, or break needles.
  • Use resuscitation equipment in place of mouth-to-mouth resuscitation.
  • Immediately sterilize all surfaces and devices after use.
  • Seek appropriate care if there is possible bloodborne exposure, including post-exposure prophylaxis for HIV.

Universal 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).

Strictly speaking, universal precautions involve only the abovelisted bodily fluids but, in practice, also applies to urine, feces, vomit, nasal secretions, or any fluid that may be tainted with blood.

Airborne Precautions

There are also precautions to avoid infections spread by coughing and sneezing. These include potentially serious infections like Neisseria meningitides (meningococcus), respiratory syncytial virus (RSV), and COVID-19.

Among the precautions used in people who have or are suspected of having an airborne-transmittable infection:

  • 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 surgical face mask before entering the room.
  • Avoid touching surfaces unnecessarily.
  • Wash hands vigorously after leaving the room.

Droplets vs. Aerosolized Particles

The precautions may be stricter depending on whether the infection involves droplets (larger than 5 microns) or aerosolized particles (smaller than 5 microns). The smaller the particle is, the farther it can travel and the deeper it can go within the lungs.

Among the infection that can be spread by aerosolized particles are tuberculosis, varicella (chickenpox), herpes zoster (shingles). and influenza. People who are immunocompromised are at particular risk.

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.
  • 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. Face shields or goggles may also be needed.
  • Special ultraviolet (UV) lights may be installed to help kill the offending pathogen, such as in certain cases of tuberculosis.

A Word From Verywell

Hospital-acquired infections are a concern not only to patients but to hospital staff as well. During the early part of the COVID-19 pandemic, around 17% of hospitalizations in Scotland involved hospital employees, according to a 2020 study in the journal BMJ. Without adherence to hospital hygiene protocols and universal precautions, the rate could have been higher.

Many of the same precautions taken by hospital staff can be applied if ever a family member falls ill or an outbreak of infection is declared by your local health department. By understanding the principle behind these precautions, you can better protect yourself and your family from harm.

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Article Sources
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  1. World Health Organization. 14. Hospital hygiene and infection control. 2019.

  2. Centers for Disease Control and Prevention. Recommended vaccines for healthcare workers. Updated May 2, 2016.

  3. Amoran O, Onwube O. Infection control and practice of standard precautions among healthcare workers in northern NigeriaJ Glob Infect Dis. 2013;5(4):156-63. doi:10.4103/0974-777X.122010

  4. Broussard IM, Kahwaji CI. Universal precautions. StatPearls. Updated March 16, 2019.

  5. Fernstrom A, Goldblatt M. Aerobiology and its role in the transmission of infectious diseasesJ Pathog. 2013;2013:493960. doi:10.1155/2013/493960

  6. Al-Benna S. Negative pressure rooms and COVID-19. J Perioper Pract. 2021 Jan-Feb;31(1-2):18-23. doi:10.1177/1750458920949453

  7. Chua MH, Cheng W, Goh SS, et al. Face masks in the new COVID-19 normal: Materials, testing, and perspectives. Research (Wash D C). 2020;2020:7286735. doi:10.34133/2020/7286735

  8. Mamahlodi MT. Potential benefits and harms of the use of UV radiation in transmission of tuberculosis in South African health facilities. J Public Health Afr. 2019 May 3;10(1):742. doi:10.4081/jphia.2019.742

  9. Shah ASV, Wood R, Gribben C, et al. Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: Nationwide linkage cohort study. BMJ. 2020;371:m3582. doi:10.1136/bmj.m3582