When it comes down to controlling the spread of pathogens in a healthcare setting, it is the combined effort of all individuals (patients, visitors and healthcare workers) correctly performing the essential infection control practices that can make a difference for the better (World Health Organisation 2007).
Standard Precautions
The primary level of defence is standard precautions, whereby healthcare workers are responsible for implementing infection control measures across everyday work practices. Based on the Infection Prevention and Control Policy (NSW Government, Department of Health 2017), standard precautions are necessary for all patient interactions and patient care activities, including the handling of all body substances, secretions, excretions, non-intact skin, and mucosal membranes.
Furthermore, standard precautions should be applied using the following practices (World Health Organisation 2007; NSW Government, Department of Health 2017):
- implementing hand hygiene, such as hand wash and hand sanitiser
- wearing personal protective apparel, such as masks and gowns
- performing aseptic technique
- safe conduct and disposal of sharps and waste
- routine cleaning of environment
- maintenance of patient-care equipment and;
- respiratory symptom controls
Transmission-Based Precautions
Comparatively, transmission-based precautions provide an additional level of protection for healthcare workers, who cannot effectively reduce infectious agents with only standard precautions. As highlighted in the Australian Guidelines for the Prevention and Control of Infection in Healthcare (National Health and Medical Research Council 2010), infectious agents can be transmitted through contact (indirect or direct), droplet or airborne routes.
By reviewing the route of transmission for each patient case and the associated precautions, healthcare workers can effectively treat their patient whilst staying protected. Comparatively, when a patient presents with a condition that involves multiple routes of transmission, healthcare workers must apply more than one transmission-based precaution category (Victoria State Government 2018).
Choosing the Right Personal Protective Equipment
For different patient situations, having access to and wearing the right personal protective equipment (PPE) can be the determining factor of your safety and the safety of the patient that you are responsible for. When choosing the right level of PPE protection, it is important for healthcare workers to consider how best they can protect themselves and teach their patients to do the same (refer to Table 1).
| HOW TO STAY AHEAD OF INFECTION | KEY CONSIDERATIONS |
| Protect Yourself |
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| Stay Informed |
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| Keep Your Patients Educated |
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| Ask Your Patients To Help |
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Adapted from the findings of the National Health and Medical Research Council (2010) and Victoria State Government (2018), the following tables outline how airborne, contact and droplet precautions should be applied by all individuals within a healthcare setting (click each tab for more information).
| Airborne Precautions |  |
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| Contact Precautions |  |
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| Droplet Precautions |  |
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| Airborne Precautions |
|
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| Contact Precautions |
|
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| Droplet Precautions |
|
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| Airborne Precautions |
|
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| Contact Precautions |
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| Droplet Precautions |
|
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Real World Scenarios
1. Dental Surgical Procedures
When performing gum surgery, a dental surgeon must wear sterile gloves, a surgical gown, surgical face mask to prevent exposure to blood and saliva from the patient, and make sure to utilise sterile equipment.
2. Lumbar Puncture Procedure
For maximum safety, all surgical staff are required to wear synthetic gloves, such as polyisoprene, a surgical gown and surgical face mask.
3. Gastroenteritis
If a patient presents symptoms of gastroenteritis, a healthcare worker must wear disposable gloves, a disposable gown and single-use face mask when touching the patient to prevent the spread of the patient’s bodily fluids (National Health and Medical Research Council 2013).
4. Methicillin-resistant Staphylococcus aureus (MRSA)
When caring for MRSA-infected patients a healthcare worker must wear personal protective equipment that covers their hands and body during personal care activities, and when handling their linen to prevent the spread of infection via direct and indirect contact (National Health and Medical Research Council 2013).
References
- National Health and Medical Research Council (NHMRC) 2010, Australian Guidelines for the Prevention and Control of Infection in Healthcare, viewed 24 May 2019, <https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-prevention-and-control-infection-healthcare-2010>
- National Health and Medical Research Council (NHMRC) 2013, Prevention and control of infection in residential and community aged care, viewed 24 May 2019, <https://www.nhmrc.gov.au/about-us/publications/prevention-and-control-infection-aged-care>
- NSW Government, Department of Health 2007, Infection Prevention and Control Policy, viewed 24 May 2019, <https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2017_013.pdf>
- Victoria State Government 2018, Infection control – standard and transmission-based precautions, viewed 27 May 2019, <https://www2.health.vic.gov.au/public-health/infectious-diseases/infection-control-guidelines/standard-additional-precautions>
- World Health Organisation 2007, Standard precautions in healthcare, WHO, Geneva, viewed 24 May 2019, <https://www.who.int/csr/resources/publications/EPR_AM2_E7.pdf>
