This document outlines universal standard precautions for preventing the transmission of infectious diseases. It discusses the definition of universal precautions, the history of infection control practices, and key aspects of precautions such as proper use of protective equipment, hand hygiene, safe handling of sharps, and waste disposal. The document emphasizes that all human blood and body fluids should be treated as potentially infectious to prevent transmission of bloodborne pathogens like HIV, hepatitis B, and hepatitis C from healthcare workers to patients and vice versa.

1. UNIVERSAL STANDARD
PRECAUTIONS
DR. PANKAJ CHAUDHARY
RESIDENT
G.S.V.M MEDICAL COLLEGE
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2. PRESENTATION OUTLINE
 Total no of Slides: 41
 Definition
 Introduction
 History
 Chain of Infection
 Risk assessment
 Protection Equipment Barrier
 Handwashing
 Selection of protection barrier
 Safe handling of sharps
 Safe disposal of sharps
 Management of spillages
 Waste disposal
 Needle stick injuries
 Post exposure prophylaxis
 Summary
 Source: WHO Universal Precautions, OSH INDIA, NCBI, Infection Control Today, Needle stick
injuries AIIMS.
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3. Definition
“ Universal Precautions is the term applied to
treating all blood , tissues and some body
fluids as potentially infectious .The
appropriate level of Precautions necessary is
determined according to the extent of
possible exposure to blood & body fluid and
not because of the speculation of the
infectious status of the patient”
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4. INTRODUCTION
• Blood and body fluids may contain blood-borne viruses (e g. Hepatitis B
and HIV) or other bacterial and other viral pathogens.
• These can present a risk to other patients and health care workers.
• As it is not always possible to know who is infected with these
pathogens, emphasis on infection control effort should focus primarily on
“Universal Standard Precautions” which prevent the exposure to
blood and body fluids which are presumed to be potentially infective.
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5. • Application for universal standard precautions means that all patients'
body fluids should be treated as infectious, since it is not known who is
infected and carry a virus.
• The purpose of these precautions is to prevent the exposure and
infection of healthcare workers from blood-borne pathogens.
• The rationale for applying the precautions is that the health care worker
may not know who is and is not infected, thereby making it important to
treat all blood and body fluids as infectious.
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6. These precaution apply to patients with:
• HIV
• Hepatitis B & C
• Non-A & Non-B
• Syphilis
• Malaria
• Blood-borne viral & Bacterial infections
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7. HISTORY
1877: INFECTIOUS DISEASE HOSPITAL.
1910: ANTISEPSIS & DISINFECTIONS.
1985: UNIVERSAL PRECAUTIONS.
1987: BODY SUBSTANCE ISOLATION.
1996: STANDARD PRECAUTIONS.
2007: ISOLATION PRECAUTIONS.
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8. CHAIN OF REACTION
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9. • Agent: Micro-organism which causes infection, i.e bacteria, viruses, fungi
and parasites.
• Reservoir: A place where micro organisms live, such as in humans and
animals, in soils, food, plants, air or water.
• Portal of exit: Where the micro organism leaves the reservoir.
• Method of transmission: How the micro-organism travels from
place to place.
• Portal of entry: Where the microorganism enters the next host usually
the same way as it left the old host.
• Susceptible host: A person who may become infected.
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10. RISK ASSESSMENT
• From sharps and hollow needles.
• Splashing of conjunctivae and mucous membranes with
contaminated blood and body fluids.
• Heavy contamination of broken skin.
• Handling of large quantities of blood and body fluids without
protective clothing.
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11. •Use of recycled hollow needles and syringes.
•Contaminated blood transfusion.
•Heavy soiling of the environment.
•Poor ward facilities and cleaning.
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12. Body fluids to be treated under Universal Precautions
• Blood.
• Blood-stained body fluids.
• Semen.
• Vaginal secretions.
• Tissues.
• CSF, Amniotic, Pericardial, Pleural fluids.
• Feces.
• Urine.
• Vomit.
• Sputum.
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13. Universal Precautions do not apply to:
•Tears.
•Nasal secretions.
•Sweat.
•Saliva.
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14. PROTECTION EQUIPMENT BARRIER
• Gloves: Should be worn for direct contact with blood or body fluids and for
direct contact with non-intact skin or mucous membranes.
• Plastic aprons: These should be worn to protect from body fluids.
• Eye protection: Goggles or some sort of eye protection (visor) should
be worn to avoid conjunctival splash contamination. Spectacles are
acceptable.
• Masks: These are recommended to avoid blood or body fluids splashing
into the mouth and nostrils.
• Broken Skin: Cuts and abrasions on the hands and forearms should be
covered with a waterproof dressing.
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18. Handwashing
• Hand washing is considered the simplest and most important action to
prevent infection transmission
• Microbes on human skin can be classified into two groups:
1. Resident flora
2. Transient/contaminated flora
Resident flora : Not easy to eliminate by scrubbing since they are
adapted to living on human hands.
Transient /contaminated flora :Easy to eliminate by scrubbing
with soap or detergent. This kind of microbe can be frequently found on the skin
of health care workers.
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19. There are two types of hand washing
1. Social hand washing:
• Routinely before and after coming into contact.
• When starting work.
• When going off-duty.
• When they become visibly dirty.
• When they are contaminated with body fluids or organic matter.
• After visiting the toilet.
• After removing gloves.
• After a non-sterile procedure.
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20. 2. Aseptic hand-washing:
• This type of hand washing should be used when as aseptic procedure is
about to be performed on a patient (e.g. introducing central venous pressure
lines, peripheral cannula or urinary catheters).
• This requires meticulous cleaning of the hands and the use of a sustained
action disinfectant.
• It is usually accompanied by the wearing of gloves.
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22. Selection of Protective Barriers
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23. Safe Handling of Sharps
• Needles must never be re-sheathed or recapped.
• Must obtain assistance when taking blood or giving injections to
uncooperative or confused patients.
• Never carry sharps by the hand , if transporting always place in an appropriate
container.
• Needles must never be broken or bent prior to disposal.
• Needles must never be passed from hand to hand.
• When performing phlebotomy, cannulation or giving injections must wear
appropriate disposable gloves.
• Never reuse a sharp.
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24. SCOOP METHOD
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25. Safe Disposal of Sharps
• Do not dispose of sharps with other clinical waste.
• Sharps containing bins to be kept in location that precludes injury, bins are
situated at a suitable height i.e. not placed on the floor or above shoulder
height.
• Always dispose of needles as a complete unit into a sharps container never
disassemble prior to disposal.
• Sharps containers should be ¾ full prior to sealing and disposal.
• Never force a sharp into a sharps container.
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26. Management of Spillage
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28. WASTE DISPOSAL
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34. Needle-Stick Injuries
• Occupational Exposure to potential blood-borne infections (HIV, HBV and HCV)
that occurs during performance of job duties.
• “Exposure” which at risk of blood-borne infection is defined as:
1. Percutaneous injury (e.g. needle-stick or cut with a sharp instrument).
2. Contact with the mucous membranes of the eye or mouth.
3. Contact with non-intact skin (particularly when the exposed skin is chapped,
abraded, or afflicted with dermatitis).
4. Contact with intact skin when the duration of contact is prolonged (e.g. several
minutes or more) with blood or other potentially infectious body fluids.
Consider all Needle stick injuries as a serious health hazard
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35. Protocol
• Determine the status of the exposure and the HIV status of the exposure
source.
Immediate measures
For skin — if the skin is broken after a needle-stick or sharp instrument:
• Immediately wash the wound and surrounding skin with water and soap, and
rinse.
• Do not scrub.
• Do not use antiseptics or skin washes (bleach, chlorine, alcohol, betadine).
After a splash of blood or body fluids on unbroken skin:
• Wash the area immediately.
• Do not use antiseptics.
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36. For the eye:
• Irrigate exposed eye immediately with water or normal saline.
• Sit in a chair, tilt head back and ask a colleague to gently pour water or normal saline over
the eye.
• If wearing contact lens, leave them in place while irrigating, as they form a barrier over the
eye and will help protect it.
• Once the eye is cleaned, remove the contact lens and clean them in the normal manner.
• This will make them safe to wear again
• Do not use soap or disinfectant on the eye.
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37. For mouth:
• Spit fluid out immediately
• Rinse the mouth thoroughly, using water or saline and spit again.
• Repeat this process several times
• Do not use soap or disinfectant in the mouth
• Consult the designated physician of the institution for management
of the exposure immediately.
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38. Post-Exposure Prophylaxis (PEP)
• Ideally, initiate PEP treatment within 2 hours of
exposure not recommended after 72 hours.
• If source patient is HIV negative, discontinue PEP
and retest at 6 weeks, 3 months, and 6 months.
• If source patient is HIV positive, counsel, support,
and refer for continued treatment.
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39. •Follow approved PEP regimen(suggested) –
Examples
•ZDV 200 mg 3 times daily for 4 weeks
•Combivir tablet (300 mg ZDV and 150 mg lamivudine)
twice daily
•Indinavir 800 mg 3 times daily for 4 weeks.
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40. • Universal Standard Precautions are designed for the care of all persons, patients,
health care personnel regardless of whether or not they are infected.
• Treat all human blood, body fluids and other potentially infectious materials as if
they are infectious
• There are 3 major Blood-borne pathogens: Hepatitis B, Hepatitis C and HIV.
• The most common mode of transmission of pathogens is the hands.
• Wear proper Protection Equipment Barrier in exposure situation.
• Safe handling and disposal of Sharp.
• Standard Precautions breaks the chain of infection thus minimizing transmission of
infection within the Healthcare environment.
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41. THANK YOU
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