This I do believe is self-explanatory! The single most important thing that you can do to stop the spread of any germs is to wash your hands
The next type of Precaution is Droplet Precautions. Droplet Precautions are intended to prevent infection by large droplets that are released when an infected person sneezes, coughs, or talks. Examples of infectious diseases that are spread this way include: Neisseria meningitidis, Pertussis, and Influenza. It is probable that person-to-person transmission of avian influenza occurs primarily via droplets.
Universal safety Precautions
What are Universal Precautions
Universal precaution are
control guidelines designed to
from exposure to Diseases
spread by Blood and other Body
– Applied universally in caring for all patients
• Hand washing
• Decontamination of equipment and devices
• Use and disposal of needles and sharps safely
• Wearing protective items
• Prompt cleaning up of blood and body fluid spills
• Systems for safe collection of waste and disposal
• Previously known by various names including “universal
• Sstandard precautions are designed to reduce the risk of
transmission of bloodborne and other pathogens from
both recognized and unrecognized sources to a
• They are the basic level of infection control precaution
• Hospital Infection is the result of a combination of factors:
Microbial source + Transmission + Susceptible host =
History of Infection Control Precautions
Infection Control Precautions
Separates facilities, Antisepsis and disinfections ... etc
UNIVERSAL PRECAUTIONS (guidelines for protecting healthcare
worker because the emergence of HIV & other bloodborne
BODY SUBSTANCE ISOLATION ( focused on protecting patients and
health personnel from all moist body fluids not just blood: semen,
vaginal secretions, wound drainage, sputum, saliva etc
STANDARD PRECAUTIONS:Two level approach:
•Standar Precautions which apply to all clients and patients
attending healthcare facilities
•Transmission-based Precautions which apply only to hospitalized
ISOLATION PRECAUTIONS (new pathogens; SARS, Avian Influenzae
Every Procedure increases the
Risk of Infection to HCW
• Understand and become familiar with
• Learn the importance of good hygiene
and hand washing.
• Learn proper hand washing techniques.
• Learn the proper technique for applying
and removing gloves.
Why Universal health
The concept of Universal Health
Precautions emphasizes that all our
patients should be treated as
though they have potential blood
born infections, and can infect the
caring health care workers. ( CDC )
Human materials/Tissues considered
3 Vaginal secretions
5 Synovial fluids
6 Amniotic fluid
7 All other body fluids
Not Infectious unless contaminated with
Blood or Body fluids.
Urine / Vomitus,
Saliva unless blood
Hand washing is the most
important method of disease
Bacteria and bacteria can
be spread via dirty hands
and the are too small to
see with the human eye.
You must wash you hands
properly in order to
• There is no Health precaution like Hand
• Washing with simple toilet soap - reduces the
rate of transmission of common infections
including the HIV.
Indications for Hand Washing
• In prolonged contact with patient.
• Before taking care of Immune supressed,New born
infants, patients in ICU / ICCU, Dialysis Units, Burn’s
• Before and after touching wounds.
• When Microbial contamination of Hands, likely to
occur when in contact with mucous membranes,
body fluids, and other secretions contaminated with
Blood, and serous fluids.
What to be used for hand washing
• In most circumstances Non medicated soaps and
detergents are effective in removing most transient
• In demanding circumstances, in handling potentially
harmful infections, use Ethyl or Isopropyl alcohol.
• Detergent formulations containing Chlorhexidine
Povidone,or Hexachlorophene are effective in
prevention of spread of infections.
Words of Wisdom on Hand
Soap, water and
Common sense are still be
This I do believe !
The single most important thing that you can do to stop
the spread of any germs is to wash your hands
Use of Gloves
Use of a pair of
gloves can protect
if chances of
Blood or Body
Use of Mask, Cap, Eye Wear
• Will certainly protect
us from splashes of
Blood or Body fluids.
• Don't underestimate
the importance of
Use of Cap and
• It equally protects
UP recommends the use of
• Face shields
Uses of Cap and Mask
Stringent use of
Mask and Cap
several Lives in
Use of Foot wear
•Wearing foot wear covering entire
sole protects the entry of Microbes
from the contaminated floors with
Blood and Body fluids.
•Remember many of us have cracks on
Use of Impervious Gown
A simple thin Plastic
apron underneath the
linen is of great help in
soaking our inner
clothes and exposure
to harmful microbes.
Universal Precautions also
• Proper handling and
disposal of needles.
• Taking precautions to
prevent injury from
scalpels, needles, and
Disposal of Needles and Sharps
• All used needles and sharps should be
deposited in thick walled puncture resistant
• Bending, Reshaping, should be prohibited.
• Do not recap the needles to avoid needle stick
• All used Disposable syringes and needles
should be discarded into Bleach solution at
the work station before final disposal.
Dealing with Used Needle
continues to be
Of dealing with
Managing Occupational Exposure to HIV
Post-Exposure Prophylaxis (PEP:
• PEP – Following occupational HIV exposure, shortcourse of ARV drugs can be used to reduce the
likelihood of infection
• Register occupational exposures
• Ensure that HIV counselling, testing,and ARV
drugs are available
• Educate healthcare workers
Post-Exposure Prophylaxis (PEP)
• Immediate steps post- exposure
• Wash exposed wound or skin with soap and water
• For needle or sharp injury, allow to bleed for a few
seconds before washing
• Inform supervisor of type of exposure and the actions
• Assure confidentiality to the HCW
• Ensure support and referral for treatment
Guidelines for PEP
• Ideally, initiate PEP treatment within 2
hours of exposure
• If source patient is HIV negative,
discontinue PEP and retest at 6 weeks,
3 months, and 6 months
• If source patient is HIV positive,
counsel, support, and refer the HCW
for continued treatment
Guidelines for PEP (continued)
– Follow approved PEP regimen( suggested)
• ZDV 200 mg 3 times daily for 4 weeks
• Combivir tablet (300 mg ZDV and 150 mg
lamivudine) twice daily +
• Indinavir 800 mg 3 times daily for 4 weeks
Dealing with Needle stick
• Consider all Needle stick injuries as a serious
health hazard in the era of AIDS
• All events of Needle stick injuries to be
reported to the supervisory staff.
• Wash the injured areas with soap and water.
• Encourage bleeding if any.
• Prophylaxis for prevention of HIV/HBV is top
• Anti retroviral prophylaxis, if necessary should
started within 2 hours, ( if injury is from HIV
positive or high risk group).
Hazards of Needle stick
HIV HBV and HCV viral
infections can spread by Needle
Nursing staff are at greater risk
Several Injuries are preventable
Decontamination of Hospital
• All the linen contaminated with
Blood or Body fluids should be
soaked in 1: 100 bleach solution
for 30 minutes.
• Advised Autoclaving, as the most
ideal procedure for
Spillage of Blood/Body fluids
• A common health hazard in the working
• Never wipe the spillage with working wet
Always cover the spills with paper and
pour 1 % Hypochlorite or Bleaching
powder to decontaminate the spills with
Care of Endoscopes
• Endoscopes are delicate/precious
• Follow the instruction of Manufacturers.
• It is commonly cleaned with 2 %
• Specified time schedules to be followed to
decontaminate for HIV.
• Mycobacterium needs even > 2 hours for
Decontamination of Metal Instruments
• Hold all contaminated instruments with
• Subject all metal instruments to washing
with soap and water.
• Treat all contaminated instruments with
2% Glutaraldehyde. For at least 30
• Many consider sterilizing in Hot air oven
if not sharp instruments.
Anesthetic Tubing's and other
• Since they are in intimate contact with
Human secretion need utmost attention
• Treat all Non disposable as highly
hazardous, if used without safe practices
can infect the next patient undergoing
• Soaking in 2 % Glutaraldehyde is
common practice in Developing world.
Pregnant Health Care Workers
• Not at more risk than other, Health care
• Should adopt Universal Health
Precautions with more dedication,
• If neglected the Unborn is at grave risk of
attaining congenital infections.
• The Laboratory supervisors should
monitor/ guide the HCW’s for adherence
to scientific practices.
Operating on HIV/High risk groups
• It is a concern all should be cared equally.
• HIV infected carries the risk of being neglected
at the time of crisis.
• Law many not change for equality but
motivated health workers should bring in
change of attitude.
• Adherence of Universal Health precaution
bring in safety to all HCW.
• Follow the precautions even in Non HIV
patients as some of our patients are in
window period and more dangerous than
truly positive with Sero testing.
Caution on Operating HIV
Sero Negative Patients
•Universal precaution apply to all our
patients irrespective of Blood tests we
•We handle so many patients in
emergency situation with out any details.
•Education on Universal precautions
participation of you and educating your
subordinates/Juniors will make a lot of
Difference in the work Environment.
Precaution for Invasive
• All HCW’s who participate in invasive
procedures must routinely use appropriate
• All Health care workers who perform/assist
vaginal, and cesarean deliveries should wear
gloves and gowns when handling, the
placenta, and the new born, till blood and
amniotic fluid has been removed from infants.
• Amniotic fluid is rich in HIV/HBV virus, in
Handling Dentistry Patients
Blood, Saliva, Gingival fluid from all
Dental patients should be
considered infective, Dental, workers
should wear surgical mask, gloves
and eye wear
Caring Bleeding Patients
• Primary health care workers who handle the patients
in Emergencies, and Accidents to be trained in basic
principles of Universal Health care precautions.
• Mouth to Mouth resuscitation is life saving in the
Critically injured accident victims. May be neglected
because of fear of HIV infection.
• If the situation warrants, Bleeding from mouth can
be wiped out with clean cloth, or Handkerchief, and
still one can do resuscitation.
Importance of Vaccination in
Hepatitis B Infection.
• We have > 400 Million carriers with Hepatitis
• Every HCW is at risk of Contacting infection.
• Vaccination is safe -Genetically Engineered
vaccination remains the great hope for
prevention, apart from Major component of
Vaccination for HBV infection
• All HCW’s must take at least three doses of
At 0 – 1 – 6 months. without discontinuation of
• All Health care workers many not attain equal
• High risk HCW’s should undergo estimation of
anti HB s ( antibodies ) to know whether they
were well protected.
Problem of HBV vaccines in the
• Who pays for the Vaccine.
• Many who work in unorganized sector, do not
get Institutional support of Vaccine.
• Life, at risk if Infected with HBV
• More Awareness to be brought in by
Managers of the Hospitals, to promote to
vaccinate their Employees.
• Used in addition to Standard Precautions
for Specified Patients
• Designed for the Care of Specified Patients
known or suspected to be infected by
epidemiologically important pathogens
spread by: airborne, droplet, or contact
• For infectious agents with droplet nuclei >
– Meningococcal meningitis
• Precaution Examples:
– Private room
– Mask if within 3’ of patient
• Prevent infection
by large droplets
– Neisseria meningitidis
• For infectious agents with droplet nuclei < 5
• Precaution Examples
– Isolation rooms under negative pressure
– N95 or HEPA respirator use
Patient care equipment
• Handle equipment soiled with blood, body
fluids, secretions, and excretions in a
manner that prevents skin and mucous
membrane exposures, contamination of
clothing, and transfer of pathogens to
other patients or the environment.
• Clean, disinfect, and reprocess reusable
equipment appropriately before use with
• For protection against skin-to-skin contact and physical
transfer of microorganisms to a host from a source
• Precaution Examples:
– Private room
– Hand washing
– Glove changes
Never forget to take Hepatitis B
Vaccine if You are a HCW
Majority of OSHA CDC, and NIOSH
guidelines are incorporated.
• The Programme created by Dr.T.V.Rao MD
for the Medical and Health Care Personal in
the Developing World