The document discusses standard work precautions which include promoting hand hygiene, proper needle and sharps disposal, sterilizing equipment, waste disposal policies, post-exposure management, and ensuring compliance among staff in order to reduce the transmission of bloodborne pathogens between patients. It notes that while handwashing is important, a doctor examines many patients without routinely washing his hands due to inconvenience, and provides suggestions for improving hand hygiene compliance such as making sinks more accessible. Universal precautions are important not just for protection but also to prevent discrimination against infected patients.

1. CME
On
Standard Work Precautions
Date: 21.03.2015
DMRCH BARGARH

2. Objective:
Standard Work precautions are designed to
reduce the risk of transmission of blood borne
pathogens (blood and body fluids) and are
applied to ALL patients regardless of their
known or presumed status.

3. Components of the Standard Work
precautions:
1. Promoting hand hygiene and use of PPE.
2. Providing appropriate needle and sharps disposal
methods.
3. Documenting the quality of sterilization for all medical
equipment.
4. Waste disposal policy.
5. Post exposure management.
6. Ensuring compliance and adherence to Standard Work
precautions amongst all levels of staff.

4. Universal work precaution is not only
protection for Health care provider but also an
essential part of strategies to prevent stigma
and discrimination against HIV infected
patients by health care providers.

5. Dr. M works in a surgical OPD. The building is very old
and none of the sinks are located in or near surgical
OPD room .
Dr. M examines > 25 patients during the day,
Dr. M does not routinely wash his hands before
or after examining them.
Dr. M finds washing his hands inconvenient and
his hands don’t look dirty.

6. Is this an appropriate practice?
If Yes ,Why?
If No ,Why?
What are the barriers to appropriate hand
hygiene for Dr. M?
What are some suggestions for how to improve
Dr. M’s compliance?

7. Hand Hygiene
1. Always wash hands before/after removing
gloves, after handling all materials known or
suspected to be contaminated.
2. Good hand washing= 15seconds with running
water, soap & friction.
3. Gloves are not the substitute for Hand
Washing
4. Gloves need to be removed between patients

8. Hand washing recommendations
 Arriving at and before
leaving work
 Before and after patient
contact
 Before and after eating
 After removing gloves
 After using restroom
 After coughing, sneezing,
blowing nose
 Whenever hands are
soiled or contaminated

9. HANDWASHING
FOR PATIENT CARE
 Friction/lather 10-15 seconds;
rinse and dry thoroughly
 “Waterless agent” (alcohol based)-
apply to hands, rub together
Chlorhexidine gluconate - Active
ingredient in hospital approved soap

10. Area commonly missed in hand washing
Effective Hand Washing
SWP & BM Waste Management 8

11. Effective Hand Washing

14. 1. Transmission of health-care related pathogens from one
patient to another via the hands of a health-care staff is a
common, but preventable problem.
2.A common mistake is to use gloves rather than take the time to wash
hands.
3. Always wash and dry your hands after removing gloves.
4.The germs on your hands will grow well in a hot moist environment
(under the gloves) and the amount of germs will increase while you
wear gloves.
5.Gloves often develop tears so germs enter and contaminate the
hands.
6.Used utility gloves should be considered as being heavily
contaminated inside and out, and hands should be washed after
wearing them.

15. “How do you ensure that staff follow Standard Work precautions
in your facility?”
Give staff reminders to complete their Hepatitis B
vaccination schedule.
Regular use of single use disposable injection equipment.
Discard of all used sharps immediately after use.
Document the quality of sterilization for all medical
equipment.
Promote hand hygiene and use of PPE.
Ensure regular supply of protective gear; prevent stock-outs.
Ensure hand washing facilities at easy access points.

16. : “How do you ensure that staff follow Standard
Work precautions in your facility?”
Give reminders to staff on Standard Work Precautions
policies and procedures (this could be done by
posting information and reminders in areas
frequented by staff).
Training on Standard Work precautions should be
provided to ALL levels of staff. In addition all new staff
orientations should include this information.
Disinfect instruments and other contaminated
equipment.

17. Next……..
Post Exposure
Prophylaxis………..