07 Aug Standard vs. Transmission-Based Precautions: What’s the Difference?
Infection control is of paramount importance in healthcare settings to prevent the spread of infectious diseases. Two key strategies used to minimize the transmission of pathogens are standard precautions and transmission-based precautions. While both approaches aim to protect patients, healthcare workers, and visitors, they are employed in different scenarios. In this article, we will delve into the nuances of standard precautions and transmission-based precautions, exploring their key differences and when each protocol is utilized.
Understanding Standard Precautions
Standard precautions are fundamental infection prevention and control practices that are implemented consistently for all patients in all healthcare settings. These precautions are based on the assumption that all blood, body fluids/substances (except sweat), non-intact skin, and mucous membranes may harbor potentially infectious microorganisms. The primary goal of standard precautions is to minimize and eliminate the risk of transmission of infections.
Key Components of Standard Precautions
Hand Hygiene
Hand hygiene is considered one of the most effective infection control measures. It involves washing hands with soap and water or using an alcohol-based hand rub (ABHR) when hands are not soiled. Hand hygiene should be practiced before and after all patient contact, contact with contaminated surfaces or equipment, as well as before and after performing procedures or exposure to body fluids. Alcohol-based hand sanitizer is preferred in most clinical situations. Soap and water should be used before eating, after using the restroom, or when hands are visibly soiled.
Personal Protective Equipment
Personal protective equipment (PPE), such as gloves, gowns, masks, and eye protection, serves as a barrier between healthcare workers and potentially infectious materials. Gloves should be worn when there is a potential for hand contact with blood, body fluids/substances, mucous membranes, or non-intact skin. Gowns and aprons with sleeves protect the skin and prevent soiling of clothing during procedures that may generate splashes or sprays. Masks and eye protection are worn to safeguard mucous membranes during procedures that may generate splashes or sprays.
Safe Handling and Disposal of Sharps
Sharps, including needles and other sharp objects, should be handled with caution to prevent accidental injuries. Proper disposal of sharps in puncture-resistant containers is essential to minimize the risk of needlestick injuries and subsequent transmission of bloodborne infections.
The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard was created to protect healthcare workers from injuries caused by needles or other types of sharp objects. Safety engineered sharps should be used and healthcare personnel should be trained in their use to prevent injury from improper use or operation.
Aseptic Technique
Aseptic technique refers to the approach used during invasive procedures to prevent the introduction of microorganisms into sterile areas of the body. This includes the use of sterile instruments, appropriate skin disinfection, and maintaining a clean environment.
Environmental Cleaning
Routine cleaning and disinfection of healthcare settings are crucial to reducing the presence of infectious agents on surfaces. Focus should be placed on frequently touched surfaces and equipment in the immediate vicinity of the patient.
Respiratory Hygiene and Cough Etiquette
Promoting respiratory hygiene and cough etiquette among patients, visitors, and healthcare workers can help minimize the spread of respiratory infections. This includes covering the mouth and nose with a tissue or the elbow when coughing or sneezing, promptly disposing of used tissues, and performing hand hygiene afterward.
Waste Management
Proper segregation, handling, and disposal of healthcare waste are essential to prevent the spread of infectious diseases. Different categories of waste, such as sharps, contaminated materials, and general waste, should be managed according to specific guidelines.
Check with your state regulations to determine what is considered regulated medical waste and should be placed in a red bag. Some states follow Federal OSHA standards while other states have an OSHA office for standard development.
Application of Standard Precautions
Standard precautions are applied to all patients, regardless of their diagnosis or presumed infection status. These measures are considered the minimum infection prevention and control practices that must be used consistently for all patients in all situations. By adhering to standard precautions, healthcare workers can provide a baseline level of protection for themselves and their patients.
Introduction to Transmission-Based Precautions
Transmission-based precautions are additional measures implemented alongside standard precautions in situations where standard precautions alone may not be sufficient to prevent the transmission of infectious agents. These precautions are based on the mode of transmission of the specific pathogen involved. By tailoring precautions to the mode of transmission, healthcare facilities can provide a higher level of protection for patients, healthcare workers, and other individuals in the healthcare setting.
Routes of Transmission
Transmission-based precautions are categorized based on the routes of transmission of infectious agents. The three main routes are:
Airborne Transmission
Airborne transmission occurs when infectious agents are disseminated in small particles, known as droplet nuclei or aerosols, and remain suspended in the air for extended periods. Diseases transmitted by the airborne route include pulmonary tuberculosis, chickenpox, and measles. Key measures for airborne precautions include:
- Placing the patient in a negative pressure isolation room, specifically designed to minimize the risk of airborne transmission.
- Requiring healthcare workers to wear fit-tested NIOSH-approved N95 respirators or higher-level respirators for respiratory protection.
- Properly disposing of contaminated personal protective equipment (PPE) and performing hand hygiene after patient contact.
Droplet Transmission
Droplet transmission involves the direct transmission of infectious agents through respiratory droplets generated when an infected individual coughs, sneezes, or talks. Examples of diseases transmitted by droplet transmission include influenza, pertussis (whooping cough), and rubella. Key measures for droplet precautions include:
- Placing the patient in a private room or cohorting patients with the same infection, if single rooms are not available.
- Requiring healthcare workers to wear surgical masks and eye protection when within 6 feet of the patient.
- Educating patients on respiratory hygiene and cough etiquette to minimize the spread of respiratory droplets.
Contact Transmission
Contact transmission can occur through either direct contact or indirect contact. Direct contact transmission involves physical contact between an infected individual and a susceptible person. Indirect contact transmission occurs when a susceptible person comes into contact with contaminated objects or surfaces. Diseases transmitted by contact transmission include methicillin-resistant Staphylococcus aureus (MRSA), scabies, and others. Key measures for contact transmission include:
- Placing the patient in a single-patient room or cohorting patients with the same infection.
- Requiring healthcare workers to wear gloves and gowns when entering the patient’s room.
- Implementing rigorous cleaning and disinfection protocols for the patient’s immediate environment.
- Some pathogens requiring contact precautions also require specific disinfectants such as Clostridioides difficile and Candida auris.
- Integral components of infection prevention in healthcare settings.
Standard precautions and transmission-based precautions are integral components of infection prevention and control in healthcare settings. While standard precautions are the baseline practices used consistently for all patients, transmission-based precautions are additional measures employed when standard precautions alone may not be sufficient to prevent transmission.
By understanding the differences and implementing these precautions appropriately, healthcare personnel can effectively minimize the risk of infection transmission, safeguarding the well-being of patients and healthcare workers alike. To learn more or to get an on-site infection assessment, contact Infection Control Results today.