1. Standard precautions
DR Soha AL Marsafy
Infection control consultant

2. Goals
 Definition of standard precaution
 Understand the role of standard and transmission-based
precautions
 Describe differences between standard precautions and
transmission-based precautions
 Elements of standard precaution
 Summarise the purpose of personal protective equipment
 PPE Identify the steps for donning (putting on) PPE
 Identify the steps for doffing (removing) PPE

3. Standard Precautions
 Definition:
 They are the foundation of all precautions to prevent
transmission of infections associated with healthcare.
 They are applied to all patients receiving healthcare, regardless
of their diagnosis or presumed infection status.
 They are designed to reduce the risk of transmission of
microorganisms from both recognized and unrecognized
sources of infection in hospitals.
 The basic concept of Standard Precautions is to treat all
patients’ blood or body fluids as if they are infectious material

4. Standard Precautions
 Standard Precautions are a group of infection prevention
practices that include hand hygiene and use of gloves, gowns,
masks, eye protection, or face shields depending on anticipated
exposure.
 They are applied to:
1) Blood
2) All body fluids, secretions, and excretions except sweat,
regardless of whether or not they contain visible blood
3) Non intact skin
4) Mucous membranes.

6. Standard and Transmission based
precautions protect who and what?
6
Patient
/client
Health
workers
Healthcare
Environment
The triangle demonstrates the linking of the
healthcare environment, health worker and
patient/client.
The connection or relationship with pathogenic
microorganisms and healthcare, is we
(patient/clients, health workers and visitors) may
potentially become exposed to them through direct
or indirect contact within the healthcare
environment.
Protection from exposure is assisted by
understanding and practicing standard and
transmission-based precautions.

8. 8
Patient Object HCW Hands Patient

9. Transmission-based precautions
• Used when standard precautions alone, are not enough to interrupt
the transmission of a pathogenic microorganism
• Used in addition to standard precautions
• Know the route of transmission for the infection of communicable
disease
• There are three types of transmission-based precautions, depending
on how transmission occurs
o Contact precautions
o Droplet precautions
o Airborne precautions
9

10. Direct contact

11. indirect contact

12. Droplet transmission

13. air transmission

14. Standard Precautions include :
 Hand hygiene.
 Use of personal protective equipment (e.g.,
gloves, masks, eyewear).
 Safe injection practices
 Sterile instruments and devices.
 Clean and disinfected environmental surfaces.
 Waste segregation &Sharps safety
 Respiratory hygiene / cough etiquette.
 Lumber puncture precaution

15. Hand hygiene

18. Remove items before HH
18
Remove rings, watches, etc.
that will interfere with
effective hand hygiene, and
roll up your sleeves
Note: Nail polish, artificial and
false nails must not be worn in
clinical environments.
Artificial or false nails
continue to demonstrate
increased opportunity for
transmitting pathogenic
microorganisms.

21. PPE for infection prevention
 PPE is worn for standard and/or transmission based
precautions:
o When there is risk of exposure to blood and body
substances
o When caring for patients, or in a healthcare
environment where there is a risk of transmission of
pathogenic microorganism or communicable disease
Clinical Excellence Commission 21

24. PPE for Contact Precautions
Clinical Excellence Commission 24
 Close contact
Apron + Gloves
The minimum
requirement when
providing care
(close contact)
Gown + Gloves
A gown may be
required if expected
to provide close and
prolonged care
or

25. Clinical Excellence Commission 25
• Eye protection
• Surgical Mask
If prescription glasses
are worn, eye protection
must fit over glasses
Note: prescription glasses are not designed to
protect the wearer from exposure to splash
and fluid from blood and body substances.
PPE for Droplet Precautions
 based on Risk Assessment choose either

26. PPE for Airborne Precautions
Clinical Excellence Commission
26
Note the different mask for droplet and airborne precautions: remember, how transmission
or movement of microorganisms occurs?
What differences can you spot between the two masks (surgical and P2/N95 masks)?
P2/N95 masks come in different
shapes and colors.
Local supply and availability may vary.

27. Instrument reprocessing

28. ‫سبولدينج‬ ‫تصنيف‬
: Spaulding classification
‫سطح‬ ‫تالمس‬ ‫ادوات‬
‫السليم‬ ‫الجلد‬
‫جهاز‬
‫والسماعة‬ ‫الضغط‬
)
‫احادية‬ ‫ادوات‬
‫االستخدام‬
‫الخطورة‬ ‫منخفضة‬ ‫ادوات‬
‫الخطورة‬ ‫متوسطة‬ ‫ادوات‬
‫عالية‬ ‫ادوات‬
‫الخطورة‬
‫الجلد‬ ‫سطح‬ ‫تخترق‬ ‫ادوات‬
‫مثل‬ ‫المخاطيه‬ ‫واالغشيه‬
(
‫االدوات‬
‫الجراحيه‬
)
‫االغشيه‬ ‫مع‬ ‫تتعامل‬ ‫ادوات‬
‫غير‬ ‫االجزاء‬ ‫او‬ ‫السليمه‬ ‫المخاطيه‬
‫مثل‬ ‫بالجلد‬ ‫السليمه‬
(
‫المناظير‬
‫الحنجرة‬ ‫او‬ ‫المرنه‬
)
‫مره‬ ‫استخدامها‬ ‫اعادة‬ ‫يجوز‬ ‫ال‬ ‫ادوات‬
‫او‬ ‫تطهيرها‬ ‫اعادة‬ ‫يجوز‬ ‫وال‬ ‫اخرى‬
‫االستخدام‬ ‫بعد‬ ‫تعقيمها‬

29. Safe injection

31. 31
Best practice for administering Injection
1. Select safe medicines:
 Proper handling / Check expiry / Label clearly / proper storage conditions
2. Use of sterile equipment
 Use needle and syringe from sealed package
3. Avoid contamination
 Wash hands/ Prepare on clean surface
4. Reconstitute drugs or vaccines safely
Use new sterile syringe and needle for each reconstitution
Use the correct diluents/water for injection
5. Dispose of injection wastes and sharps properly
Immediate disposal of needle and syringe in puncture- and leak-proof
container
6. Public health education

32. 32
AREAS OF A STERILE SYRINGE AND NEEDLE THAT SHOULD
NOT BE TOUCHED
 Discard any needle that has been touched or
contaminated in a safety box
DO NOT EVER TOUCH

33. 33

34. 34
Do not open glass vials with bare fingers
Use clean pliers, two small hinges, clamps made from clean
bent bottle caps, rigid pieces of plastic or a carved piece of
wood. While rigid materials protect fingers best, even a piece
of gauze is better than the use of bare hands.

35. 35
35
disposal of sharps After use, immediately put
sharps in a puncture-proof sharps container
Open containers
should not be used
to collect sharps
Put the sharps box
at the work site
where injections are given

37. ‫األكياس‬
‫السوداء‬
(
‫مخلفات‬
‫غير‬
‫خطرة‬
)
(
‫المخلفات‬ ‫شبيه‬
‫المنزليه‬
)
‫الحمراء‬ ‫األكياس‬
(
‫خطرة‬ ‫مخلفات‬
)
‫األمان‬ ‫صندوق‬
(
‫خطرة‬ ‫مخلفات‬
)
(
‫الكسر‬ ‫وسهل‬ ‫حاد‬ ‫هو‬ ‫ما‬ ‫كل‬
)

‫األوراق‬

‫التغليف‬ ‫صناديق‬
‫الفارغة‬

‫البالستيك‬ ‫األغلفة‬
‫ية‬

‫األطعمة‬ ‫مخلفات‬

‫الجروح‬ ‫على‬ ‫الغيار‬ ‫نواتج‬
(
‫الشاش‬
–
‫القطن‬
-
‫البالستر‬
-
‫باد‬ ‫استرى‬
-
‫الجبس‬
-
‫الدرنقة‬
–
‫االنبوبة‬
‫الصدريه‬
-
‫الويرات‬
-
‫الغرز‬
)....

‫األسطح‬ ‫وتطهير‬ ‫تنظيف‬ ‫نواتج‬
(
‫القفازات‬ ‫و‬ ‫القطن‬
)

‫المعقمة‬ ‫و‬ ‫التكس‬ ‫القفازات‬
-
‫الرأس‬ ‫غطاء‬
-
‫الماسك‬
-
‫البالستيك‬ ‫االبرون‬
‫المستخدم‬ ‫العمليات‬ ‫فرش‬
(
‫االستخدام‬ ‫احادى‬ ‫النوع‬
)
‫القساطر‬ ‫أنواع‬ ‫جميع‬
(
‫وريدية‬ ‫قسطرة‬
–
‫بوليه‬ ‫قسطرة‬
–
‫رايل‬ ‫قسطرة‬
-
)...........

‫الوريد‬ ‫أجهزة‬
-
‫الدم‬ ‫لنقل‬ ‫وريد‬ ‫جهاز‬
–
‫المحاليل‬ ‫زجاجات‬
-
‫ب‬ ‫تى‬ ‫ال‬ ‫أكياس‬
‫ى‬
‫ان‬
-
‫السكر‬ ‫تحليل‬ ‫شرائط‬

‫العزل‬ ‫غرف‬ ‫مخلفات‬

‫غطاء‬ ‫بدون‬ ‫المستعملة‬ ‫السرنجات‬

‫السنون‬

‫الشكاكات‬

‫المشارط‬

‫الكانيوالت‬

‫الكسر‬ ‫سهلة‬ ‫االمبوالت‬
37

38. Environmental cleaning
and disinfection

39. Management of Environment
• Increase the frequency of routine environmental cleaning including
bathrooms and around the resident’s living space
• Particular attention should be given to cleaning objects that are
frequently touched such as:
Faucets,
Door handles,
Light switches and
Bed side tables
Toilets
Sink areas
39

40. 40
Surface Disinfection? Yes and No!
 Immediate removal of spillage
(blood, urine, etc.) with a
disinfectant/ detergent? Yes
 Routine surface disinfection?
 No for Floor & Minimal Touch
 Yes for High Touch

41. Spinal injection procedure

42. Infection Control Practices for Special Lumbar Puncture
Procedures
 Droplet transmission of oropharyngeal flora of healthcare
providers has been reported in previous outbreaks to be the
cause of bacterial meningitis following myelogram and other
spinal procedures (e.g., lumbar puncture, spinal and epidural
anesthesia, intrathecal chemotherapy). As a result in October
2005, the Healthcare Infection Control Practices Advisory
Committee (HICPAC) concluded that a face mask should be
worn by HCWs placing a catheter or injecting material into the
spinal or epidural space

43. • Use aseptic technique and follow safe injection
practices (e.g., dedicating single-dose vials to
single-patient use)
• At a minimum, wear a facemask (e.g., procedure
or surgical masks) and sterile gloves when
injecting material or inserting a catheter into the
epidural or subdural space (e.g., administration
of intrathecal chemotherapy).

44. Respiratory hygeine

45. Respiratory hygiene/cough etiquette:
 Respiratory hygiene and cough etiquette include covering
the mouth and nose during coughing and sneezing with a
tissue
 offering a surgical mask to the coughing patient,
discarding the mask
 performing hand hygiene
 educating healthcare staff, patients, and visitors.

47. 47