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Healthcare Safety and Standard Precautions
Competencies 1-2
Competency 1
List regulatory agencies and the
requirements they set for safety standards for healthcare facilities, their employees,
and clients.
• Identify selected safety terminology relevant to healthcare.
• Identify the CDC and list its safety requirement(s) as they pertain to the healthcare
environment.
• Identify OSHA and the Department of Health and list safety regulations as they
pertain to the healthcare environment.
• Identify the Joint Commission and describe its role in regulating safety with the
healthcare environment.
• Identify the OSHA Bloodborne Pathogens Standard and list its requirements.
Terminology and Definitions
Review list
American’s Top 10 Most Dangerous Jobs
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Miscellaneous Agricultural Workers
Driver/Sales Workers and Truck Drivers
Roofers
Electrical Power Line Installers/Repairs
Farmers and Ranchers
Refuse and Recyclable Material Collectors
Structural Iron and Steel Workers
Logging Workers
Aircraft Pilots and Flight Engineers
Fishers and Related Workers
Regulatory Agencies
CDC – Center for Disease Control & Prevention
OSHA – Occupational Safety & Health Administration
MDH - Minnesota Department of Health (Example MN)
TJC – The Joint Commission
CDC – Center for Disease Control
CDC as the lookout for the health of the people of the U.S. and
throughout the world, strives to protect people’s health and safety,
provide reliable health information, and improve health through strong
partnerships.
Established in 1946 to control Malaria outbreaks in post WW2 war
areas.
CDC Operates to:
• Study the causes and distribution of diseases.
• Formulate safety guidelines to help prevent and control the spread of infectious
diseases.
• Identifies Standard Precautions apply to every client in the healthcare environment
• Identifies Transmission-Based Precautions for Airborne, Droplet, Contact
Regulatory Impact of Occupational Safety and
Health Administration (OSHA)
• Permissible Exposure Limits (PEL) is the maximum concentration of chemicals
• Hazard Communication is the “Right to Know” and requires employers to
communicate information about hazardous chemicals in the workplace.
• Bloodborne Pathogens (BBP) is the standard to prevent exposure to healthcare
workers.
• Personal Protective Equipment (PPE) are gloves, masks, eye protections, aprons,
etc.
Minnesota Department of Health (MDH)
• Hazard Communication Rule: Right to Know
• Informs workers when working with hazardous/ infectious materials and provides
for the availability of infection control measures if necessary.
• MDH supervises the compliance of facilities to health regulations.
The Joint Commission (TJC)
Mission Statement:
To continuously improve safety and quality of care provided to the public through the
provision of health care accreditation and related services that support performance
improvement in health care organizations.
Formed in 1951
The Joint Commission Provides Evaluation
and Accreditation for:
• General, psychiatric, children’s & rehabilitation hospitals
• Critical access hospitals
• Medical equipment services, hospice services
• Nursing homes & other long term care facilities
• Behavioral health care organizations
The Joint Commission Role
• Private, non-profit organization whose purpose is to encourage the attainment of high
standards of institutional medical care.
• Establishes guidelines for operation
• Conducts inspections
The Joint Commission Patient Safety
Goals - 2014
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Improve accuracy of patient identification.
Improve effectiveness of communication.
Improve safety of using medications.
Reduce the risk of health care-associated infections.
Reduce the risk of patient harm from falls.
Prevent health care associated pressure ulcers
Reduce safety risks to patients
Pre-procedure verification process
Encourage patients’ active involvement in their own case as a patient safety strategy.
Reduce harm associated with clinical alarm systems
OSHA Bloodborne Pathogens Standard
• occupational exposure
• non-intact skin
• exposure incident
Preventing Accidents
OSHA
Two main standards that effect healthcare workers
1. Blood-borne Pathogen Standard
2. Occupational Exposure to Hazardous Chemicals Standard
Exposure control plan (Control methods)
• Engineering controls
• Work practice controls
• PPE (personal protective equipment)
• HBV vaccine
Competency 2
Explain the current requirements of standard
precautions and the procedures used at a variety of healthcare facilities to support
those standards.
• Explain the purpose of standard precautions and when they are applied.
• List common pathogens.
• Identify PPE (personal protective equipment) and usage.
• List compliance measures for Blood borne Pathogens Standards.
• Identify types of Isolation Precautions and describe why isolation is used in a
healthcare facility.
• Identify concerns and needs of clients in isolation.
Standard Precautions
Purpose is to decrease transmission risk of disease producing microorganisms
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Used on all clients/patients
Used at exposure to body fluids
Used at contact with mucous membranes
HIV or HBV risk
Caregiver/client has non-intact skin
Transmission – Based Precautions
CDC recommends use of Transmission-Based Precautions with patients who are
documented or suspected to be infected with pathogens.
Used for ALL clients
When to use Standard Precautions
• Used if client or caregiver has non-intact or broken skin.
• Used when there is exposure or potential exposure to body fluids such as blood,
urine, stool, saliva, vaginal secretions.
• Contact with mucous membranes that are HIV and HBV risk.
• Remember: perspiration is not a body fluid.
Infection Control
• To prevent the spread of infectious disease
• Infectious disease is any disease caused by the growth of pathogens.
• Pathogens are disease-causing microorganisms (germs) in the body.
• Microorganisms are very small, usually one-celled living plants or animals.
Types of Microbes
Bacteria which are one-celled plants.
• Staph, whooping cough, strep, TB
Fungus which is the largest group of simple plants.
• Athlete’s foot, candida
Viruses which are the smallest of microbes.
• Common cold, herpes simplex, HIV, Hepatitis A, B, C
Drug Resistant Organisms
• MRSA =Methicillin Resistant Staph Aureus
• CMV =Cytomegalovirus
• VRE =Vancomycin Resistant Enterococcus
Types of Transmitted Illnesses
• Food Borne Illnesses
• Sexually Transmitted Diseases (STDs)
• Measles, Mumps, Rubella (MMR)
Standard Precautions Required by
Healthcare Workers
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Handwashing
Personal Protective Equipment (PPE)
Patient Care Equipment
Environment Control
Linen
Occupational Health & Blood-borne Pathogens
Chain of Infection
Conditions for Growth
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Temperature 40 – 110 F
Moisture
Air (if needed)
Darkness
Food source
Body secretions
Uses for Isolation Precautions
• To protect the client
• To protect the public and healthcare worker
3 Types of Transmission-Based
Precautions
Airborne
• Travels short distance through air
• Deposited on host’s conjunctiva, nasal mucosa, or mouth
• Talking, sneezing, coughing
Examples: Chicken Pox, Rubeola
3 Types of Transmission-Based
Precautions
Droplet
• Droplet or dust particles containing infectious agent
• Can be widely dispersed
• Talking, sneezing, whispering, coughing
Examples: Mumps, Influenza
3 Types of Transmission-Based
Precautions
Contact
• Most frequent mode of nosocomial infections
• Direct-contact
• Indirect-contact
Examples: Herpes, Scabies, Wounds
Isolation
Uses:
Protect client/patient, protect healthcare worker & public
Procedures:
Restriction to a room, procedures for disposal of trash/linens, special equipment
Clients needs/feelings:
Evidence of acceptance, additional checks, lonely, unclean, why
Disadvantages of Transmission
Precautions
• Patient needs private room
• Special equipment
• Frequent visits by nurses
• Forced solitude/isolation
Biological Waste Disposal
• Biological waste disposal
• Use of gloves
• Antiseptics
• Disinfectants, Methods of supplies and equipment
• Sterilization Methods
Maintain Workers Own Good Health
• Well balanced diet, rest, exercise, good mental health
• Do not go to work if ill and teach visitors to stay away from facility if ill
Author: Dede Carr, BS, LDA
“This workforce solution was funded by a grant awarded by the U.S. Department of Labor’s Employment and Training Administration.
The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The
Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information,
including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness,
usefulness, adequacy, continued availability, or ownership.”
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