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Attitude And Practice Of Standard Precautions Among Healthcare Workers
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1.3 SOLUTIONS TO THE PROBLEM
Solutions of this problem include the following (WHO, 2012):
Determination of the local factors of the HAI burden.
Encouragement of the reporting and surveillance system.
Improvement of education and training of nurses in applying safety precaution.
4.Implementation
and application of standard precaution which is simple and low-cost but
helpful in controlling spread of HAI as it saves money and saves life.
1.4 UNIVERSAL PRECAUTIONS (UP):
In
1983, CDC disseminated a document called (Guidelines for Isolation
Precautions in Hospitals). This document included a section about
precautions that must be taken when dealing with blood and body fluid of
suspected patient infected by blood-borne pathogen (CDC, 2001).In 1985,
in response to HIV /AIDS epidemic(CDC, 2007), CDC developed precautions
to be applied to all patients irrespective of their blood-borne
infection status. They were called universal precautions. These
precautions are defined as †a set of precautions devised to prevent,
and minimize accidental transmission of all known blood-borne pathogens
including HIV, hepatitis B virus, and hepatitis C virus to/from health
care personnel when providing first aid or other health care servicesâ€
(Vaz et al., 2010). These universal precautions can also be defined as
an “approach to infection control to treat all human blood and certain
human body fluids as if they were known to be infectious for HIV,HBV and
other blood borne pathogens†(NIOSH,2016). These precautions apply to
blood, body fluid containing visible blood, semen, cerebrospinal,
synovial, pleural, peritoneal and amniotic fluid but don’t apply to
feces, nasal secretion, sputum, sweat, tears, urine and vomits unless
blood appears (Vaz et al., 2010).
1.5 BODY SUBSTANCES ISOLATION (BSI):
BSI
appeared in 1987. This precaution supposed that all moist substances
except sweat (execrations and secretions) were infectious (not just
blood in UP) (Vaz et al., 2012). It depended mainly on using gloves, and
it was advised to use clean gloves before dealing with or touching
mucous membranes or contact with body fluids or moist substances, but
after removing gloves there would be no need for hand washing if there
was recommended(CDC, 2007; Vaz et al., 2010). UP and BSI were presented
nearly in the same period.Some hospitals adapted UP while others adapted
BSI. This problem and other problems required additional precautions to
prevent transmission of diseases that are transmitted via airborne and
droplet routes. However, there was no agreement on the washing of hands
after using gloves. The existence of such problems led to emergence of
another system of precautions called Standard Precautions (SP) (Vaz et
al., 2012).
1.6 STANDARD PRECAUTIONS (SP)
The main principles of
Universal Precautions and Body Substance Isolation practice were mixed
by CDC in a new precaution system called Standard Precautions (SP) which
now has replaced the “Universal Precautionsâ€. Standard precautions are
defined as “group of infection prevention practices that apply to all
patients, regardless of suspected or confirmed diagnosis or presumed
infection status†(CDC, 2012). These precautions are the basic level of
infection control precautions which are to be used, as a level of
precautions (CDC, 2012; WHO, 2013). The fact is that “standard
precautions†are recommended when delivering the care to all
patients,regardless of their presumed infection status. It is also
recommended that when handling equipment and devices that are
contaminated or suspected of contamination, and in situations of contact
risk with blood, body fluids, secretions and excretions except sweat,
without considering the presence or absence of visible blood and skin
with solution of continuity and mucous tissues. They included
precautions against agents that are transmitted by the following routes
of transmission: air-borne, droplet and contact routes (CDC, 2007; Vaz
et al., 2013).
The aims of standard precautions are the following:
prevention and/ or reduction of transmission of HAI, and, at the same
time, protection of nurses from sharp injuries. These aims can be
achieved by the application of SP measures which consist of the
following elements: hand hygiene, personal protective equipment (gloves,
gown, gaggle, facemasks, head protection, foot protection and wearing
face shields) and prevention of sharp injuries (CDC, 2015; WHO, 2012).
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