Standard Precautions First

Standard Precautions First

The term Standard Precautions speaks for itself. These are basic precautions taken to reduce the possibility of coming in contact with infectious body fluids including blood, secretions, excretions, non-intact skin and mucous membranes. In other words, anything that is warm and wet, except for sweat.

Standard Precautions include hand washing, using alcohol hand sanitizers when there are no visible signs of soiling, and barriers such as gloves, gowns, masks and goggles, depending on the situation. Use Standard Precautions all the time with every patient. Often the term just isn’t understood and is overlooked, instead healthcare workers scramble to determine “What kind of precautions the patient is on.” Barriers are included as part of Standard Precautions, leaving the use of them to be determined by assessing the patient situation. It would make sense to use gloves if there is a possibility of soiling your hands, gowns and goggles if splashing or contact with bodily fluids is anticipated. 

When you think of Standard Precautions, think insurance policy. Why do we use Standard Precautions? Precaution is the key word here. We use precautions in advance of coming upon a situation that might lead to an undesired outcome, one leading to possible transmission of infectious organisms from patient to patient, patient to healthcare worker and what of the visitors? Let us not overlook role of the visitors in the mix.  

We can’t always know who among our patients, employees, physicians, or visitors, may be carrying an infectious or potentially infectious organism. It’s safe to say not only do we not always know, we usually do not know.  So, in order to avoid an unwanted outcome, such as the spread of infectious disease, we use barriers such as gloves, gowns and masks, when indicated. This means we need to rely on our own assessment of a situation when it comes to caring for patients who have not yet been diagnosed with any particular infectious organism. 

Example: A patient has been coughing; do any of us want to inhale droplets sprayed into the air by a coughing or sneezing person? Don’t we usually avoid those situations anyway? So before any tests are completed, before a particular organism is cultured, identified and reported, put a mask on yourself and one on your patient if they are leaving the room.  That’s Standard Precautions.  

Example: A patient has complained of sudden upset stomach and diarrhea. Do any of us want to touch anyone’s feces? Do we want to touch the same places the person with the diarrhea has touched?  So before any tests, cultures and diagnoses are made, put on gloves and even a gown if there is a chance your clothes could become contaminated. That’s Standard Precautions.

Example: A newly admitted patient complains of intense itching, especially bothersome at night. Before you think Scabies, before skin scrapings and identification of mites occurs, put on gloves before touching the patient. That’s Standard Precautions.

Let’s not forget. Patients, just like you and me, touch their bodies, their noses, mouths and their skin. Hopefully we all wash our hands, but we don’t know for sure. We all live in a unique cloud of our own organisms and touch things in the environment over and over again, leaving our own unique brand of micro-organisms behind us. See Microbiome

Fortunately, or unfortunately, we don’t see what is on our hands, our skin or in the environment. When we’re distracted we forget, overlook or postpone doing what we know is the right thing to do; after all, we are very busy. But, if we could actually see the organisms on our hands, our patient’s hands and the environment we might never stop washing, cleaning and sanitizing. At the very least, using Standard Precautions all of the time dilutes the potential number of organisms we transmit to one another. 

To be sure: Every time you enter a patient’s room, sanitize your hands. Every time you care for a patient, and go to another patient, sanitize your hands.  Every time you leave a patient’s room sanitize your hands. That’s Standard Precautions.

 

 

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