Standard Precautions: Core Infection Control for Every Patient

Standard precautions are the foundation of infection control in nursing. They apply to every patient, every time, and are essential knowledge for safe practice and for nursing exams.

Definition

• Standard precautions apply to all patients, all the time, regardless of diagnosis or infection status.
• Assume that all blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes may contain infectious agents.

Components of Standard Precautions

• Hand hygiene — before and after patient contact, and after removing gloves.
• Gloves — when touching blood, body fluids, mucous membranes, or non-intact skin.
• Gown — during procedures with splashes or sprays of body fluids.
• Mask and eye protection — during procedures with splashes or sprays.
• Safe injection practices — sterile syringe and needle for each patient.
• Respiratory hygiene — cover cough; mask symptomatic patients.
• Environmental cleaning — clean surfaces between patients.

Hand Hygiene

• Perform hand hygiene before and after every patient contact and after removing gloves.
• Use alcohol-based hand rub for most situations.
• Use soap and water for C. difficile, norovirus, or visibly soiled hands.

Personal Protective Equipment (PPE)

Match PPE to the type of anticipated contact:

• Touching blood or body fluids → gloves
• Potential splash to face → mask and eye protection
• Potential splash to clothing → gown
• Large splash or spray → gloves, gown, mask, and eye protection

Specific PPE Guidance

• Gloves: worn for blood, body fluids, mucous membranes, and non-intact skin. Change between patients.
• Gowns: worn for splash risks. Remove the gown before leaving the patient's room.
• Mask and eye protection: worn for splashes (e.g., wound irrigation, suctioning).

PPE Removal Order

Remove PPE in this order to prevent self-contamination:

1. Gloves
2. Gown
3. Eye protection
4. Mask

Perform hand hygiene after removing all PPE.

Safe Injection Practices

• Use a sterile, single-use syringe and needle for each patient. Never reuse.
• Do not administer medications from a single-dose vial to multiple patients — they lack preservatives.
• Multidose vials may be used for multiple patients only with a new sterile syringe each time.

Respiratory Hygiene and Cough Etiquette

• Place masks on coughing patients as soon as they arrive.
• Separate coughing patients from others by at least 3 feet.
• Instruct patients to cover the mouth and nose with a tissue or elbow when coughing.
• Perform hand hygiene immediately after coughing or sneezing.
• Provide tissues, masks, and alcohol-based hand rub in waiting areas.

Environmental Control

• Clean high-touch surfaces regularly: bed rails, call lights, IV pumps, door handles.
• Clean spills of blood or body fluids immediately with appropriate disinfectant.
• Do not shake soiled linen — it aerosolizes pathogens. Bag linen at the point of use.
• Dispose of sharps in puncture-resistant containers immediately. Do not recap needles.

Standard vs. Transmission-Based Precautions

• Standard precautions apply to all patients, all the time.
• Transmission-based precautions (contact, droplet, airborne) are added for patients with known or suspected infections.
• Always use standard precautions plus any indicated transmission-based precautions.

Common Exam Traps

• Do not skip standard precautions because the patient looks "clean."
• Do not reuse a single-dose vial for multiple patients.
• Do not wear the same gloves for multiple patients.
• Do not forget hand hygiene after removing gloves.
• Do not shake soiled linen — it aerosolizes pathogens.
• Do not recap used needles — dispose of them immediately.
• Do not remove PPE in the wrong order — gloves first, then gown, then eye protection and mask.

Key Takeaways

• Standard precautions apply to all patients, all the time; assume all body fluids may be infectious.
• Remove PPE in order: gloves → gown → eye protection → mask, then perform hand hygiene.
• Use soap and water (not alcohol rub) for C. difficile, norovirus, or visibly soiled hands.
• Never reuse single-dose vials or single-use syringes/needles between patients.
• Do not shake soiled linen and do not recap needles — both spread pathogens.
• Mask coughing patients immediately and keep them at least 3 feet from others.