Standard Precautions

In response to the HIV epidemic, Universal Precautions were instituted in the mid-1980s. It stipulated that patients with HIV infection can be asymptomatic and unaware that they are contagious; therefore, all blood and body fluids contaminated with blood were to be treated as infectious. The Occupational Safety and Health Administration (OSHA) based its 1991 final rule on Occupational Exposure to Bloodborne Pathogens in Healthcare Settings on the concept of Universal Precautions.2

In 1996, the Centers for Disease Control and Prevention (CDC) expanded Universal Precautions into the concept of Standard Precautions.3 Standard Precautions apply not only to contact with blood and body fluids contaminated with blood, but to contact with all other potentially infectious material, i.e., contact with all body fluids, secretions and excretions, nonintact skin, and mucous membranes regardless of suspected or confirmed presence of an infectious agent.

Standard Precautions apply to the care of all patients in all healthcare settings, regardless of the suspected or confirmed presence of pathogenic organisms.3,4 Periodically, outbreak investigations indicate the need to reinforce existing standards or to implement new precautions.1 Three of these recommendations, i.e., respiratory hygiene/cough etiquettes, sharp safety, and safe injection practices, are now considered standards of care and are considered parts of Standard Precautions, which include:

Education

  • To establish the rationale for policies and practices intended to prevent HAIs.

Immunization

  • To reduce the risk of vaccine-preventable HAIs.

Engineering and work practice controls

  • To eliminate or isolate hazards and promote safer behavior in the work place:
    • Respiratory hygiene/cough etiquette
    • Hand hygiene
    • Personal protective equipment
    • Sharp safety
    • Safe injection practices
    • Sterile instruments and devices
    • Clean and disinfected environmental surfaces

Administrative controls

  • To promote an understanding of policies and practices related to medical conditions, post exposure evaluation and follow-up, and work restrictions.