MIP 802
Clinical Microbiology
STANDARD PRECAUTIONS
DR OSUAGWU C.S
Infection prevention and control is
everybody’s business
• Understanding the modes of transmission of infectious organisms is
important for control
• knowing how and when to apply the basic principles of infection prevention is
critical to the success of an infection control program.
• This responsibility applies to everybody working and visiting a
healthcare facility
• including administrators, staff, students, patients, their family.
Interruption of the chain of
infection is a strategy to limit
the spread of infection.
• Infection requires three main elements
• a source of the infectious agent
• a mode of transmission
• a susceptible host.
The modes of transmission
• In healthcare settings infectious agents can be transmitted by:
• Contact
• Droplet
• Airborne
Contact transmission
• Direct transmission occurs when the transfer of microorganisms
results from direct physical contact between an infected or colonized
individual and a susceptible host,
• for example a HCW’s contaminated hands touch a vulnerable site (such as a
wound) on a patient.
• Indirect transmission involves the passive transfer of an infectious
agent to a susceptible host via an intermediate object or fomite.
• Examples of intermediate objects include instruments, bed rails, bed, tables
and other environmental surfaces.
Methods of reducing the spread of
infection
• Standard Precautions
• Transmission based Precautions
Airborne transmission
• Airborne transmission refers to infectious agents that are spread via
droplet nuclei (residue from evaporated droplets) containing infective
microorganisms.
• These organisms can survive outside the body and remain suspended
in the air for long periods of time.
• They infect others via the upper and lower respiratory tracts.
Droplet transmission
• Droplet transmission occurs when respiratory droplets generated via
coughing, sneezing or talking makes contact with susceptible mucosal
surfaces, such as the eyes, nose or mouth.
• Transmission may also occur indirectly via contact of contaminated fomites
with hands and then mucosal surfaces.
• Respiratory droplets are large and are not able to remain suspended
in the air thus they are usually dispersed over short distances.
Standard precautions
• Consider the blood and body fluids of everyone to be potentially
infections
• applied to everyone, regardless of their perceived or confirmed
infectious status
• ensures a basic level of infection prevention and control.
• as a first-line approach to infection prevention and control in the
healthcare environment minimizes the risk of transmission of
infectious agents from person to person, even in high-risk situations.
Standard precautions include:
• Hand hygiene, before and after every episode of patient contact (ie 5
Moments for Hand Hygiene)
• Use of personal protective equipment (PPE)
• Safe use and disposal of sharps
• Routine environmental cleaning
• Respiratory hygiene and cough etiquette
• Aseptic non-touch technique
• Waste management
• Appropriate handling of linen.
Hand Hygiene
Hand hygiene
• before and after contact with every patient is
among the most important means of preventing
the spread of infection
• after any contact with blood, body fluids and
contaminated items.
• whether or not gloves were worn
14
This diagram shows the areas
on hands often missed during
hand washing. The steps set
out in the following slides will
ensure that all areas of your
hands have been washed /
decontaminated adequately
and thoroughly. (Taylor 1978)
Points to remember
Wash hands that are visibly dirty or contaminated
with body fluids with soap and water
If hands are NOT visibly soiled or
contaminated, use an
alcohol-based hand product
Ensure that hands are completely
dry before starting any activity
Hand Hygiene: Respiratory Infection 19
Control in Health Care Facilities
Step 1: How to handrub with
alcohol-based formulation
1. Apply 2 ml of the alcohol
product in cupped hand,
covering all surfaces
20
Steps 2, 3, & 4: How to
handrub with alcohol-based
formulation
2 3 4
2. Rub 3. Right 4. Palm to
hands palm palm over palm with
to palm left dorsum fingers
with interlaces
interlaced
fingers and
vice versa
21
Steps 5, 6, and 6: How to
handrub with alcohol-based
formulation
5 6 7
5. Backs of 6. Rotational 7. Rotational
fingers to rubbing of rubbing
opposing left thumb backwards and
palms with clasped in forwards with
fingers right hand clasped fingers
interlocked and vice of right hand
versa in left palm
and vice versa
22
Step 8: How to handrub with
alcohol-based formulation
8
8. Your hands
are now dry
and safe
23
Remember!! Use clean water to
wash and rinse hands
Before and after contact with every patient
Thoroughly clean all parts of hands
Use soap and clean water if visibly soiled
Use alcohol hand rub for other times or when sinks
are not handy
Dry hands completely before next patient contact
Hand Hygiene: Respiratory Infection Control in Health Care
25
Facilities
Personal protective equipment (PPE)
Type of PPE depend
on performed tasks
and risk assessment
Personal Protective Equipment
(PPE) • Mask: N-95/FFP2
respirator
• Gloves
• Disposable long sleeved
cuffed gown or coverall
• Protective eyewear:
goggles or faceshield
• Cap
• Plastic apron (splashing
of blood, secretions,
excretions)
• Rubber gloves and
heavy duty gloves
• Rubber boots
Cleaning and disinfection
• Clean surfaces with soap and water before disinfection
• Proteinaceous materials inactivates disinfectants
Cleaning Up
• Use 0.5% chlorine solution for
• Body fluids, toilets and bathrooms, gloved hands, floors, beds and mattress
covers
• Use 0.05% chlorine solution for
• Bare hands, skin, shoes
• Thermometers
• Laundry
• Plates, cups, etc.
Diluting Household bleach
0.1% = 1 in 5 =1000ppm
Injection safety policy
• Limit the use of needles and other sharp objects as much as possible.
• Limit the use of phlebotomy and laboratory testing to the minimum
necessary for essential diagnostic evaluation and patient care.
• If the use of sharp objects cannot be avoided, ensure the following
precautions are observed:
Sharps precautions
• Never replace the cap on a used needle.
• Never direct the point of a used needle towards any part of the body.
• Do not remove used needles from disposable syringes
by hand, and do not bend, break or otherwise
manipulate used needles by hand.
• Never re-use syringes or needles
• Dispose of syringes, needles, scalpel blades and other sharp objects in
appropriate, puncture-resistant containers.
Accidental exposure
• safely stop current task
• leave the patient care area, and safely remove PPE.
• Wash the affected skin surface or injury site with soap and water.
• Irrigate mucous membranes (e.g. conjunctiva) with copious amounts
of water
• Report exposure
Infection prevention and control is
everybody’s business
• Understanding the modes of transmission of infectious organisms is
important for control
• knowing how and when to apply the basic principles of infection prevention is
critical to the success of an infection control program.
• This responsibility applies to everybody working and visiting a
healthcare facility
• including administrators, staff, students, patients, their family.
In summary
• Treat blood and body fluids as infectious
• Wash hands , wash hands and encourage others to wash hands
• Use protective barriers, consistently, as needed
• Always clean contaminated areas
• Dispose of sharps and contaminated objects appropriately, follow
policy
THANK YOU FOR
LISTENING
