Universal

Precautions
 Universal precautions are infection control
guidelines designed to protect people from
diseases spread by blood and certain body
What are fluids.

“Universal Always assume that all "blood and body fluids"

are infectious for blood-borne diseases such as
HBV (Hepatitis B Virus), HCV (Hepatitis C Virus)
Precautions"? and HIV (Human Immuno-deficiency Virus).

These precautions are written in accordance

with guidelines established by the Center for
Disease Control (CDC) and OSHA. • These apply
to all personnel.
 • Universal precautions are the
standard preventive measures
that are normally taken by
Universal professional and health persons
when they are handling sick
Precautions people with communicable
diseases.
• This is for the purpose of
preventing the spread of a
certain disease through
infection .
Body Fluids
which • Blood
require • Any body fluid with
visible blood
Universal • Wound secretions
Precautions : • Vaginal secretions and
semen
What are Bloodborne Pathogens?

Hepatitis B – HBV -- Extremely contagious.

1.

About 10% of those infected become carriers.

Can live outside the body for up to 2 weeks.
2. Hepatitis C - Very contagious.
Can live outside the body for 3-4 days.
3. HIV – AID - HIV attacks the immune system,
eventually destroying the body’s ability to
fight infection.

Note: There is no vaccine and no cure!!

Body Fluids which
• Urine
DO NOT require
Universal • Feces or stool ( with no visible
blood)
Precautions but
are still a • Saliva (with no visible blood)
potential source • Sputum/mucous (with no visible
of many other blood)
types of infection. • Vomit (with no visible blood)
• Sweat
• Tears
 • Airborne (Legionaires Disease)
How are Germs • Droplets (Cold, Influenza, TB)
Transmitted? • Blood and Body Fluids
Five Modes : (STD’s,HBV,HIV)
• Skin to Skin (Pinkeye,
Ringworm)
• Oral/Fecal (Hepatitis A, Food
Poisoning, e-coli)
AN INFECTIOUS AGENT/ETIOLOGIC AGENT:
• Pathogen/ Microorganisms
• Capable of producing an infectious process

RESERVOIR
.Source
• anything (a person or animal or plant or substance)
in which an infectious agent normally lives and
multiplies
PORTAL OF EXIT/ FROM through sneezing,
coughing, talking; open wound; drainage.

MODE OF TRANSMISSION
• way that the causative agent can be transmitted to
another reservoir or host where it can live by:
- Contact-Direct or indirect
- Airborne-droplet or droplet nuclei
- Vector- insects or animals
- Vehicle- food, water, blood medication
PORTAL OF ENTRY TO SUSCEPTIBLE HOST
• Refers to the method by which the pathogen enters the
body
• It can be through skin, GIT, respiratory tract, genito urinary
tract

SUSCEPTIBLE HOST
• one whose biologic defense mechanisms are weakened in
some way
PRINCIPLES IN THE PREVENTION OF INFECTION
1. Consider every person (patient or staff)
infectious.
2. Wash Hands- the most practical procedure for
cross-contamination(person to person).
3. Wear gloves before touching anything wet-
broken skin, mucous membranes, blood or
other body fluids( secretions and excretions) or
soiled instruments.
 PRINCIPLES IN THE PREVENTION OF INFECTION
4. Use physical barriers(protective goggles, face
masks and apron) if splashes and spills of any
body fluids are anticipated
5. Use safe work practices, such as not recapping or
bending needles, dispose properly.
6. Isolate patient only if secretions(airborne) or
excretions(urine and feces) cannot be contained
7. Decontaminate process for instruments and other
items by sterilizing.
 Types of PPE Used in Healthcare
Settings
• Gloves – protect hands
• Gowns/aprons – protect skin and/or clothing
• Masks and respirators– protect mouth/nose
–Respirators – protect respiratory tract from
airborne infectious agents
• Goggles – protect eyes
• Face shields – protect face, mouth, nose, and eyes
PPE Use in Healthcare Settings
Factors Influencing PPE Selection
1. Type of exposure anticipated
–Splash/spray versus touch
–Category of isolation precautions
2. Durability and appropriateness for the
task
3. Fit
PPE Use in Healthcare Settings
 Sequence* for Donning PPE
• Gown first
• Mask or respirator
• Goggles or face shield
• Gloves
 How to Don a Gown
• Select appropriate type and size
• Opening is in the back
• Secure at neck and waist
• If gown is too small, use two gowns
– Gown #1 ties in front
– Gown #2 ties in back
PPE Use in Healthcare Settings
 How to Don a Mask
• Place over nose, mouth and chin
• Fit flexible nose piece over nose
bridge
• Secure on head with ties or
elastic
• Adjust to fit
PPE Use in Healthcare Settings
 How to Don Eye and Face
Protection
• Position goggles over eyes and
secure to the head using the ear
pieces or headband
• Position face shield over face and
secure on brow with headband
• Adjust to fit comfortably
PPE Use in Healthcare Settings
 How to Don Gloves
• Don gloves last
• Select correct type and size
• Insert hands into gloves
• Extend gloves over isolation
gown cuffs
PPE Use in Healthcare Settings
 How to Safely Use PPE
• Keep gloved hands away from face
• Avoid touching or adjusting other PPE
• Remove gloves if they become torn; perform
hand hygiene before donning new gloves
• Limit surfaces and items touched

PPE Use in Healthcare Settings

 “Contaminated” and “Clean”
Areas of PPE
• Contaminated – outside front
• Areas of PPE that have or are likely to have been in
contact with body sites, materials, or environmental
surfaces where the infectious organism may reside
• Clean – inside, outside back, ties on head and back
• Areas of PPE that are not likely to have been in contact
with the infectious organism

PPE Use in Healthcare Settings

 Sequence for Removing PPE
• Gloves
• Face shield or goggles
• Gown
• Mask or respirator

PPE Use in Healthcare Settings

 Where to Remove PPE
• At doorway, before leaving patient room or
in anteroom*
• Remove respirator outside room, after door
has been closed*

PPE Use in Healthcare Settings

 How to Remove Gloves (1)
• Grasp outside edge near
wrist
• Peel away from hand, turning
glove inside-out
• Hold in opposite gloved hand

PPE Use in Healthcare Settings

 How to Remove Gloves (2)
• Slide ungloved finger
under the wrist of the
remaining glove
• Peel off from inside,
creating a bag for both
gloves
• Discard
PPE Use in Healthcare Settings
 Remove Goggles or Face Shield

• Grasp ear or head

pieces with ungloved
hands
• Lift away from face
• Place in designated
receptacle for
reprocessing or disposal
PPE Use in Healthcare Settings
 Removing Isolation Gown
• Unfasten ties
• Peel gown away from
neck and shoulder
• Turn contaminated
outside toward the inside
• Fold or roll into a bundle
• Discard
PPE Use in Healthcare Settings
 Removing a Mask

• Untie the bottom, then

top, tie
• Remove from face
• Discard

PPE Use in Healthcare Settings

 Removing a Particulate Respirator

• Lift the bottom elastic

over your head first
• Then lift off the top
elastic
• Discard

PPE Use in Healthcare Settings

 Hand Hygiene
• Perform hand hygiene immediately after removing PPE.
– If hands become visibly contaminated during PPE
removal, wash hands before continuing to remove PPE
• Wash hands with soap and water or use an alcohol-based
hand rub

* Ensure that hand hygiene facilities are available at the point

needed, e.g., sink or alcohol-based hand rub

PPE Use in Healthcare Settings

 What Type of PPE Would You Wear?
• Giving a bed bath?
• Drawing blood from a vein?
• Suctioning oral secretions?
• Cleaning an incontinent
• Transporting a patient in a patient with diarrhea?
wheel chair?
• Irrigating a wound?
• Responding to an
emergency where blood is • Taking vital signs?
spurting?

PPE Use in Healthcare Settings

 What Type of PPE Would You Wear?
• Giving a bed bath? • Drawing blood from a vein?
• Generally none • Gloves
• Suctioning oral secretions? • Cleaning an incontinent patient with
• Gloves and mask/goggles or a face diarrhea?
shield – sometimes gown • Gloves w/wo gown
• Transporting a patient in a wheel • Irrigating a wound?
chair? • Gloves, gown, mask/goggles or a
• Generally none required face shield
• Responding to an emergency • Taking vital signs?
where blood is spurting? – Generally none
• Gloves, fluid-resistant gown,
mask/goggles or a face shield
PPE Use in Healthcare Settings
 Use of PPE for Expanded Precautions
• Contact Precautions – Gown and gloves for contact with patient
or environment of care (e.g., medical equipment, environmental
surfaces)
• In some instances these are required for entering patient’s
environment
• Droplet Precautions – Surgical masks within 3 feet of patient
• Airborne Infection Isolation – Particulate respirator*

*Negative pressure isolation room also required

PPE Use in Healthcare Settings

 Handwashing
• The most effective means of preventing disease transmission
• It should be done :
• At the start of the day or when soiled. Before contact
with food.
• After using toilet facilities or assisting with personal
hygiene.
• After coming into contact with any Potential Infectious
Material, *even if gloves were worn.*
• After handling or feeding pets.
• After working or playing outside.
DO HAND WASHING PROPERLY...

Wash hands thoroughly with soap and water

for 5 minutes. Rinse under running water.
Dry hands.
STEPS IN DOING HAND WASHING:
1. Wet hands before applying liquid soap.
2. Rub palm to palm.
3.Right palm over left dorsum and left palm over right
dorsum.
4.Palm to palm with fingers interlaced.
5. Back of fingers to opposing palms with fingers
interlocked.
6. Rotational rubbing of the right thumb clasped in left palm,
and vice versa.
7. Rotational rubbing backwards and forwards with tops
of fingers and thumb of right hand to left, and vice
versa.
8. Rinse hands under running water.
9. Dry hands using paper towels. Dry palms and back of
hands.
 Managing Exposure Incidents

• Immediately wash hands and other skin surfaces that are

contaminated.
• Mucous membranes or eyes must be flushed with clear
water.
• Allowing puncture wounds to bleed for a short period prior
to washing will help to clean the wound from the inside
• All exposure incidents must be reported to your
supervisor or the On-call supervisor as soon as it is safe
to do so.
• This includes :
- Staff to Staff, Individual to Individual, Staff to
Individual and Individual to Staff.
• In addition to an Incident Report, an Exposure Incident
Report must be filled out and given to your supervisor by
the end of your shift.
• All employees who have been identified as having
potential exposure will be offered the HBV vaccine.
• Receive prophylaxis
STANDARD
PRECAUTIONS USE Isolation- refers to measures design to
IN THE CARE OF prevent the spread of infections or
ALL HOSPITALIZED potentially infectious microorganisms to
health personnel's.
PERSONS
REGARDLESS OF Category:
THEIR DIAGNOSIS
OR POSSIBLE 1. Specific Isolation precaution-strict
INFECTION STATUS. isolation, contact isolation, enteric
isolation, drainage/secretions
isolation, blood and body fluid
precaution
2. Disease –specific isolation precaution
–for specific diseases.
 • - use in addition to
Transmission standard precaution, for
-Based clients with known or
Precaution: suspected infections that
are spread in one of three
ways: by airborne, droplet
transmission or contact.
 Prepared by:
Concepcion G. Bautista, MAN

Thank you