The two core steps of any effective infection control method, as recommended by the Center for Disease Control and Prevention (CDC) in healthcare settings, are:
- Standard Precautions
- Transmission-Based Precautions
Let's break down each of these steps:
Standard Precautions
Standard Precautions are the foundational level of infection control. They should be applied to all patients, regardless of suspected or confirmed infection status, in any healthcare setting. These precautions are designed to reduce the risk of transmission from both recognized and unrecognized sources of infection.
Key components of Standard Precautions include:
- Hand Hygiene: This is the most important measure. Wash hands with soap and water, or use an alcohol-based hand rub, frequently and thoroughly.
- Use of Personal Protective Equipment (PPE): This includes gloves, gowns, masks, and eye protection, depending on the anticipated exposure.
- Respiratory Hygiene/Cough Etiquette: Covering coughs and sneezes with a tissue, followed by hand hygiene.
- Safe Injection Practices: Using aseptic technique for all injections and avoiding reuse of syringes or needles.
- Safe Handling of Potentially Contaminated Equipment or Surfaces: Cleaning and disinfecting environmental surfaces and reusable patient care equipment.
- Waste Management: Safely handling and disposing of contaminated waste.
- Linen Handling: Handling used linen carefully to prevent contamination.
Transmission-Based Precautions
Transmission-Based Precautions are used in addition to Standard Precautions when a patient is known or suspected to be infected or colonized with pathogens that can be transmitted by airborne, droplet, or contact routes. These precautions are tailored to the specific pathogen and its mode of transmission.
There are three main types of Transmission-Based Precautions:
- Contact Precautions: Used for infections spread by direct or indirect contact. This often includes wearing gloves and gowns for all interactions with the patient and their environment. Examples include Clostridium difficile (C. diff), Methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE).
- Droplet Precautions: Used for infections spread through respiratory droplets produced during coughing, sneezing, or talking. This includes wearing a mask when within close proximity to the patient. Examples include influenza, pertussis, and rhinovirus.
- Airborne Precautions: Used for infections spread through the air over long distances. This includes placing the patient in an airborne infection isolation room (AIIR) and wearing an N95 respirator. Examples include tuberculosis, measles, and varicella (chickenpox).
In summary, effective infection control relies on the consistent application of Standard Precautions for all patients, supplemented by Transmission-Based Precautions when indicated by the specific infectious agent and its mode of transmission. These measures, when implemented diligently, significantly reduce the risk of healthcare-associated infections.
