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NHMRC

B1 Standard Precautions

Summary

It is essential that standard precautions are applied at all times. This is because:

  • people may be placed at risk of infection from others who carry infectious agents;
  • people may be infectious before signs or symptoms of disease are recognised or detected, or before laboratory tests are confirmed in time to contribute to care;
  • people may be at risk from infectious agents present in the surrounding environment including environmental surfaces or from equipment; and
  • there may be an increased risk of transmission associated with specific procedures and practices.

Standard precautions consist of:

  • hand hygiene, before and after every episode of patient contact;
  • the use of personal protective equipment;
  • the safe use and disposal of sharps;
  • routine environmental cleaning;
  • reprocessing of reusable medical equipment and instruments;
  • respiratory hygiene and cough etiquette;
  • aseptic non-touch technique;
  • waste management; and
  • appropriate handling of linen.

Standard precautions should be used in the handling of: blood (including dried blood); all other body substances, secretions and excretions (excluding sweat), regardless of whether they contain visible blood; non-intact skin; and mucous membranes.

Evidence supporting practice

The majority of the recommendations in this section have been adapted from:9

  • Boyce JM & Pittet D, Healthcare Infection Control Practices Advisory C, Force HSAIHHT (2002) Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep 51: 1–45;
  • Grayson L, Russo P, Ryan K et al (2009) Hand Hygiene Australia Manual. Australian Commission for Safety and Quality in Healthcare and World Health Organization;
  • Pratt RJ, Pellowea CM, Wilson JA et al (2007) epic2: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England. J Hosp Infect 65S S1–S64;
  • Siegel JD, Rhinehart E, Jackson M et al (Healthcare Infection Control Practices Advisory Committee), (2007) Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. United States Centers for Disease Control; and
  • Sehulster LM & Chinn RYW (2003) Guidelines for Environmental Infection Control in Health-care Facilities. Recommendations of the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Chicago IL: American Society for Healthcare Engineering/American Hospital Association.
  • World Health Organization (2009) Guidelines on Hand Hygiene in Health Care.

Further review of the evidence elicited good quality evidence on the use of alcohol-based hand rubs in reducing transmission of infectious agents.

Maiwald (2009) Systematic review of the efficacy of alcohol preparations and other agents for hand hygiene in the healthcare setting. Project report to the National Health and Medical Research Council (NHMRC), Canberra ACT, Australia.

The following Australian guidelines were also consulted during the development of this section:

  • RACGP (2006) Infection Control Standards for Office Based Practices (4th edition); and
  • Australian Dental Association (2008) Guidelines for Infection Control.
Footnotes:
  1. These guidelines were selected based on analysis using the AGREE tool, which ensures that guidelines have been developed in a rigorous, transparent and robust manner. This process is discussed in detail in Appendix 2.