Standard Precautions in Nursing: Definition & Application

Instructor: Lisa Cauthen

Lisa is a Registered Nurse with a 14 years of experience and a Masters Degree in Nursing Education. She has certifications in CPN, ACLS, PALS, and NRP.

Standard precautions are the cornerstone of infection prevention and are to be used by every nurse for every patient every time. This lesson defines standard precautions and gives practical applications for nursing staff.

Before Standard Precautions

In the 1980s the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) pandemic rocked the nursing and healthcare worlds. The World Health Organization, Centers for Disease Control, and Occupational Health and Safety Administration focused on one question: ''How do healthcare personnel in all practice settings provide care to infected patients while protecting themselves from acquiring the disease?'' Their answer: standard precautions.

What are Standard Precautions?

Standard precautions were first established in 1996 by the Centers for Disease Control (CDC) with a goal of preventing the spread of communicable diseases in hospitals and healthcare settings. They have since become one of the cornerstones of infection prevention.

The CDC recommends standard precautions be used by nursing and healthcare workers for the care of all patients at all times, regardless of their diagnosis or presumed infection status. While there are many components of standard precautions, those centered around nursing care include hand hygiene, use of personal protective equipment (PPE), and care and cleaning of the environment.

Applying Standard Precautions

Hand Hygiene

Hand hygiene, or cleansing of the hands, is a major component of standard precautions and one of the most effective methods to prevent transmission of pathogens associated with healthcare. Hand hygiene can be performed by washing with soap and water or using an antiseptic foam or gel to kill pathogens on the skin. The CDC recommends washing with soap and water when the hands are visibly dirty, before eating, and after using the restroom, and when caring for a patient with a known or suspected spore-forming infection. The use of an alcohol based antiseptic foam or gel is appropriate for all other hand hygiene needs.

Nurses should perform hand hygiene before and after all patient contact as well as before donning and after removing gloves. Other times hand hygiene should be performed include after touching a potentially contaminated surface such as the over-bed table in a patient's hospital room.

A nurse washes her hands
Hand Hygiene

Personal Protective Equipment

Personal protective equipment (PPE) refers to the clothing and devices designed to protect the wearer's body from exposure to infection. PPE can include gloves, face masks, gowns, and more. The nurse's use of PPE should be guided by the anticipated exposure to blood and body fluids. For example, when performing venipuncture only gloves may be needed, while during intubation the use of gloves, gown, and face shield or mask, and goggles is necessary. PPE should always be removed before leaving a patient's room and entering a common area such as a hallway.

Gloves should be worn whenever there is a chance of coming in contact with blood or body fluids, with broken skin, and mucous membranes. Gloves should be changed between patients and even changed on the same patient between tasks when potentially infectious material is handled.

A face mask is worn to cover the mouth and nose during activities that are likely to generate splashes of blood, body fluids, and respiratory secretions. Some face masks have attached shields to protect the eyes as well. Goggles can also be worn to protect the eyes. Personal eyeglasses are not considered sufficient protection.

A gown can be worn to protect the skin and cover clothing during activities that may generate splashes or sprays of blood or body fluids.

Nurses wear PPE to change the linen on the bed of an infected patient.
Nurses Wear PPE

Care and Cleaning of the Environment

Routine cleaning and disinfecting of patient equipment and potentially contaminated surfaces and objects in the environment (such as doorknobs) is essential to reducing the transmission of pathogens. Housekeeping surfaces such as floors and walls do not need to be disinfected unless visibly soiled with blood or body fluids. These steps are taken to reduce the risk of infection transmission between the many members of the healthcare team including nursing and environmental services.

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