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Routine Precautions To Prevent the Transmission of Infectious Diseases Routine Precautions (also known as Standard Precautions) are designed to reduce the risk of transmission of infectious diseases. Routine and Standard Precautions were formerly known as Universal Precautions. • • • Routine Precautions should be used whenever there is a risk of an exposure to any body fluids that could cause infection if they enter non-intact skin or mucous membranes. Routine Precautions are most often used in acute care, long-term care, ambulatory care, medical clinics, and home care settings but can be used by anyone in a situation where there are body fluids present that may be capable of transmitting infection. Routine Precautions are often used with additional transmission-based precautions such as contact precautions, droplet precautions and air-borne precautions. Body fluids include: Blood, vomit, stool, semen, vaginal fluid, urine, fluids from coughing or sneezing and other secretions and excretions, except sweat, regardless of whether or not they contain visible blood. Non-intact skin and mucous membranes include: Eyes, nose, mouth, open wounds, scrapes, and also severe dry skin and dermatitis. A full description of Routine Practices can be found on the Public Health Agency of Canada website at http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/99vol25/25s4/index.html. Hand Hygiene • Hand hygiene is the single most important measure in preventing the spread of infection. Hand hygiene includes washing with soap and water and the use of alcohol-based hand rubs(ABHR). • Use of alcohol-based hand rubs (70-90% alcohol) is the preferred method of cleaning hands when hands are not visibly soiled. Hand washing with soap and water must be performed when hands are visibly soiled. • Hand hygiene is required after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn. Hand hygiene must be performed immediately after gloves are removed, between patient contacts to avoid transfer of organisms to other persons or environmental surfaces. • It may be necessary to wash hands between procedures on the same person to prevent cross-contamination of different body sites. Gloves • Wear gloves (clean, non-sterile gloves are adequate) when touching blood, body fluids, secretions, excretions, and potentially contaminated items. • Put on clean gloves just before touching any mucous membranes or non-intact skin. • Gloves should be changed between procedures on the same person to prevent cross-contamination. • Remove gloves promptly after use, before touching non-contaminated items and environmental surfaces, and before working with another person and/or moving to another room. • Perform hand hygiene immediately after removing gloves to avoid transfer of organisms to other persons and/or environments. Mask, Eye Protection, Face Shield and Gowns • Wear mask, eye protection, face shield and gowns to protect clothing and mucous membranes such as eyes, nose, and mouth during procedures and care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. Handling Sharps • Handle all sharps as minimally as possible. Do not re-cap needles. Place used needles and other sharps in a specially designed sharps container. ! If you are exposed to blood or body fluids by a needlestick injury, an opening in the skin or by a human bite, immediately report it to occupational health or your manager. Information and up to date advice on human body fluid exposures is available by calling the MiddlesexLondon Health Unit at 519-663-5317 ext. 2330. Cleaning and Disinfection of Equipment and Environmental Surfaces • Handle used care equipment that is soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane contact, contamination of clothing, and transfer of organisms to other persons and environments. • Single-use items should be discarded. Ensure that reusable equipment is not used for the care of another person until it has been properly cleaned and disinfected. A cleaning step is required for all reusable equipment. The level of disinfection required depends on the use of the equipment and the potential risk of infection. • • • Equipment that enters sterile tissues, including the vascular system is referred to as a critical device and must be sterilized after cleaning. Equipment that comes in contact with non-intact skin or mucous membranes but does not penetrate them is referred to as a semi-critical device and requires high level disinfection after cleaning. Equipment that touches only intact skin and not mucous membranes, or does not directly touch the resident is referred to as a non-critical device and requires low level disinfection after cleaning. Examples of equipment and recommended cleaning and disinfecting products are outlined in Appendix A of the Provincial Infectious Diseases Advisory Committee (PIDAC) Best Practices For Cleaning, Disinfection and Sterilization In All Health Care Settings (April 2006) found at http://www.health.gov.on.ca/english/providers/program/infectious/diseases/ic_cds.html Last updated December 19, 2008 Information adapted from: Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee, Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, June 2007 http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Health Care http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/99vol25/25s4/index.html