Standard precautions are used for all patient care. Transmission-based precautions are used in addition to Standard Precautions for patients with known or suspected infections. Skip directly to site content Skip directly to search.

Español Other Languages. Infection Control Basics. Minus Related Pages. Standard Precautions for All Patient Care. Wash your hands between each client and use fresh gloves for each client where necessary personal items — don't share towels, clothing, razors, toothbrushes, shavers or other personal items.

Food preparation and workplace infection control When preparing food: Wash your hands before and after handling food. Avoid touching your hair, nose or mouth. Keep hot food hot and cold food cold. Use separate storage, utensils and preparation surfaces for cooked and uncooked foods.

Wash all utensils and preparation surfaces thoroughly with hot water and detergent after use. Infection control and workplace cleanliness Infection control procedures relating to cleanliness in the workplace include: regularly washing the floors, bathrooms and surfaces such as tables and bench tops with hot water and detergent periodically washing the walls and ceilings thoroughly washing and drying mops, brushes and cloths after every use — drying mops and cloths is particularly important, since many pathogens rely on moisture to thrive using disinfectants to clean up blood and other spills of bodily fluids when using disinfectants — always wearing gloves, cleaning the surfaces before using the disinfectant, and always following the manufacturer's instructions exactly spot cleaning when necessary.

Dealing with spills of body fluids Examples of body fluids include blood, saliva, urine and faeces. Always: Isolate the area. Wear gloves, a plastic apron and eye protection, such as goggles. Soak up the fluid with disposable paper towels, or cover the spill with a granular chlorine-releasing agent for a minimum of 10 minutes.

Scoop up granules and waste using a piece of cardboard or similar , place in a plastic bag and dispose of appropriately. Mix one part bleach to 10 parts water and apply to the area for 10 minutes. Wash the area with hot water and detergent.

Dry the area. Dispose of paper towelling and gloves appropriately. Wash your hands. Rinse any contaminated clothing in cold running water, soak in bleach solution for half an hour, then wash separately from other clothing or linen with hot water and detergent.

Infection control — disposing of infectious waste To dispose of infectious waste that has been contaminated with blood or other body fluids: Wear heavy duty gloves. Place waste in plastic bags marked 'infectious waste'.

Dispose of waste in accordance with EPA guidance External Link. Workplace infection control — handling contaminated sharps Infection control procedures when handling needles and other sharp contaminated objects include: Never attempt to re-cap or bend used needles.

Handle by the barrel. Infection control — occupational exposure to body fluids If you come in contact with blood or body fluids: Flush the area with running water.

Infection control refers to the policy and procedures implemented to control and minimize the dissemination of infections in hospitals and other healthcare settings with the main purpose of reducing infection rates.

Infection control as a formal entity was established in the early s in the United States. By the late s and s, a small number of hospitals began to recognize healthcare-associated infections HAIs and implemented some of the infection control concepts. This activity reviews the types of infection control methods and their indications and highlights the role of the interprofessional team in following principles of infection control to improve outcomes.

Objectives: Identify the single most effective and least expensive way for providers to prevent the spread of infection. Summarize standard precautions, contact precautions, droplet precautions, and airborne precautions.

Review the types of precautions required for a patient with tuberculosis versus a patient with Clostridium difficile. Outline interprofessional team strategies for ensuring proper infection control measures are being followed to prevent the spread of infection in healthcare institutions. Access free multiple choice questions on this topic.

The primary purpose of infection control programs was to focus on the surveillance for HAIs and in-cooperate the basic understandings of epidemiology to elucidate risk factors for HAIs [1]. However, most of the infection control programs were organized and managed by large academic centers rather than public health agencies which lead to sporadic efficiency and suboptimal outcomes.

It was not until the late 19th and early 20th century when the new era in infection control was started through three pivotal events. This new era in healthcare epidemiology is characterized by consumer demands for more transparency and accountability, increasing scrutiny and regulation, and expectations for rapid reductions in HAIs rates [5].

The role of infection control is to prevent and reduce the risk for hospital-acquired infections. This can be achieved by implementing infection control programs in the forms of surveillance, isolation, outbreak management, environmental hygiene, employee health, education, and infections prevention policies and management.

Infection control program has the main purpose of preventing and stopping the transmission of infections. Specific precautions are needed to prevent infection transmission depending on the microorganism. Multiple of those indications might require more than one precaution to ensure efficient standard and transmission-based precautions.

For example, patients with suspected C. difficile need to be under contract and standard precautions, tuberculosis need to be under airborne, contact, and standard precautions. Healthcare facilities must have the necessary equipment to implement the standard precautions for all patient. The most significant precaution that is effective in preventing infection transmission is hand hygiene.

Gloves can also be used as a standard precaution, new gloves have to be used for each patient and must be disposed of after each patient interaction. Infection control equipment also includes the housekeeping tools where adequate and routine disinfection of surfaces and floors are implemented.

Also, linens have to be handled and transported in a manner which prevents skin and mucous exposure by using the appropriate personal protective equipment. Hospitals need to attain hospital epidemiologists, infection preventionists, and an infection control committee to organize a well-structured and implemented infection control program.

The hospital epidemiologist is required to interface with many of the hospital departments and administrators to discuss their responsibilities, expectations, and available resources. The epidemiologist generally oversees the infection prevention program and in some cases the quality improvement program.

A physician with a subspecialty in infectious disease usually holds the position [6]. A registered nurse with a background in clinical practice, epidemiology, and basic microbiology typically hold the infection preventionist title. Hospitals can have multiple infection preventionists depending on the number of beds available, mix of patients, and the Center for Disease Contol and Prevention CDC recommendations [7].

The last aspect of a functioning infection control program is the infection control committee, which consists of an interprofessional group of clinicians, nurses, administrators, epidemiologist, infection preventionists and other representatives from the laboratory, pharmacy, operating rooms, and central services.

The responsibilities of this committee are to generate, implement, and maintain policies related to infection control [7].

To achieve a successful and functioning infection control program, a hospital can implement the following measures:. Surveillance: The primary aim of surveillance programs is to assess the rate of infections and endemic likelihood. However, surveillance has expanded in the recent years to include a hospital-wide based surveillance as it is becoming a mandatory requirement by the public health authorities in multiple states [8].

Most hospitals have developed sophisticated algorithms in their electronic health systems that could streamline surveillance and identify patients at highest risk for HAIs.

Hence, a hospital-wide surveillance targeting a specific infection could be implemented relatively easily. Public health agencies require that hospitals report some specific infections to strengthen the public health surveillance system [9]. Isolation: The main purpose of isolation is to prevent the transmission of microorganisms from infected patients to others.

Isolation is an expensive and time-consuming process, therefore, should only be utilized if necessary. On the other hand, if isolation is not implemented then we risk the increase in morbidity and mortality, henceforth, increasing overall healthcare cost.

Hospitals that operate based on single-patient per room can implement isolation efficiently, however, significant facilities still have a substantial number of double-patient rooms which is challenging for isolation.

The CDC and the Healthcare Infection Control Practice Advisory Committee have issued a guideline to outline the approaches to enhance isolation. These guidelines are based on standard and transmission-based precautions. The standard precaution refers to the assumption that all patients are possibly colonized or infected with microorganisms, therefore, precautions are applied to all patients, at all times and all departments.

The main elements for standard precautions include hand hygiene before and after patient contact , personal protective equipment for contact with any body fluid, mucous membrane, or nonintact skin , and safe needle practices use one needle per single dose medication per single time, then dispose of it is a safe container [11].

Other countries such as the United Kingdom have also adopted the bare below the elbows initiative that requires all healthcare providers to wear short-sleeved garments with no accessories including rings, bracelets, and wrist watches. As for the transmission-based precautions, a cohort of patients is selected based on their clinical presentations, diagnostic criteria, or confirmatory tests with specific indication of infection or colonization of microorganisms to be isolated.

These precautions are designed to prevent the transmission of disease based on the type of microorganism [12]. Outbreak Investigation and Management: Microorganisms outbreaks can be identified through the surveillance system.

Also, clusters of infections can be reported by the healthcare providers of laboratory staff which should be followed by an initial investigation to assess if this cluster is indeed an outbreak. Usually, clusters of infections involve a common microorganism which can be identified by using the pulsed-field gel electrophoresis or the whole-genome sequencing which provides a more detailed tracking of the microorganism.

Most outbreaks are a result of direct or indirect contact involving multidrug-resistant organism. Infected patients have to be separated, isolated if needed, and implementation of the necessary contact precautions, depending on what the suspected cause of infection is, have to be enforced to control such outbreaks [13].

Education: Healthcare professionals need to be educated and periodically reinforce their knowledge through seminars and workshops to ensure high understanding of how to prevent communicable diseases transmission.

The hospital might develop infection prevention liaison program by appointing a healthcare professional who could reach out and disseminate the infection prevention information to all members of the hospital.

Employee Health: It is essential for the infection control program to work closely with employee health service. Both teams need to address important topics related to the well-being of employees and infection prevention, including management of exposure to bloodborne communicable diseases and other communicable infections.

Generally, all new employees undergo a screening by the employee health service to ensure that they are up-to-date with their vaccinations and have adequate immunity against some of the common communicable infections such as hepatitis B, rubella, mumps, measles, tetanus, pertussis, and varicella.

Moreover, healthcare employees should always be encouraged to take the annual influenza vaccination. Also, periodic test for latent tuberculosis should be performed assess for any new exposure.

Employ health service should develop proactive campaigns and policies to engage employees in their wellbeing and prevent infections. Antimicrobial Stewardship: Antimicrobials are widely used in the inpatient and outpatient settings. Antimicrobial usage widely varies between hospitals, commonly, a high percentage of patients admitted to hospitals are administered with antibiotics.

Increasingly, hospitals are adapting antimicrobial stewardship programs to control antimicrobial resistance, improve outcomes, and reduce healthcare costs. Antimicrobial stewardship should be programmed to monitor antimicrobial susceptibility profiles to anticipate and assess any new antimicrobial resistance patterns.

These trends need to be correlated with the antimicrobial agents used to evaluate susceptibility [14]. In the pre-prescription period, an active program includes prescriptions restrictions and preauthorization, while passive initiative includes education, guidelines, and antimicrobial susceptibility reports.

On the other hand, an active post-prescription program would focus on a real-time feedback provision to physicians regarding antibiotic usage, dose, bioavailability, and susceptibility with automatic conversion of intravenous to oral formulations, while passive post-prescription involves the integration of the electronic medical records to generate alerts for prolonged prescriptions and antibiotic-microorganism mismatch [15].

Policy and Interventions: The main purpose of the infection control program is to develop, implement, and evaluate policies and interventions to minimize the risk for HAIs. Interventions that impact infection control can be categorized into two categories; vertical and horizontal interventions.

The vertical intervention involves the reduction of risk from a single pathogen. For example, the surveillance cultures and subsequent isolation of patients infected with Methicillin-resistant Staphylococcus aureus MRSA.

Whereas, horizontal intervention targets multiple different pathogens that are transmitted in the same mechanism such as the handwashing hygiene, where clinicians are required to wash their hands before and after any patient contact which will prevent the transmission of multiple different pathogens.

Vertical and horizontal interventions can be implemented simultaneously and are not mutually exclusive. However, vertical interventions might be more expensive and would not impact the other drug-resistant pathogens, while horizontal intervention might be a more affordable option with more impactful results if implemented appropriately [16].

Environmental Hygiene: As the inpatient population becomes more susceptible to infections the emphasize on environmental hygiene has increased.