The Centers for Disease Control (CDC) and the Occupational Safety and Health Administration (OSHA) are the regulating bodies of infection control, prevention, and awareness.
Precautions are preventative steps needed to be taken by healthcare team members and staff at healthcare facilities to prevent the spread of infections. There are universal standard precautions are the minimum infection prevention steps defined by the CDC as:
In addition to universal standard precautions, the Center for Disease Control (CDC) defines additional types of proper personal protective equipment (PPE) required for each kind of precaution. Signs defining the precaution category should be easily visible and placed on each patient's room explaining the PPE needed and the type of isolation in effect.
The main types of transmission-based precautions defined by the CDC result from direct or indirect patient contact, bloodborne products, droplet, and airborne. Each kind of transmission-based precaution is dependent on the type of infection or pathogen the patient or source has, as outlined as follows:
1. Contact precautions:
2. Bloodborne precautions:
3. Droplet precautions:
4. Airborne precautions:
Whenever interacting with any patient in a health-care facility, health-care team members and visitors need to adhere to and comply with PPE and infection control signs. It is also essential to wash hands thoroughly with soap and water before and when leaving a patient's room to ensure the safety of the patient and oneself.
Despite efforts made by the CDC, OSHA, and internal policies by health-care organizations, infection control, and safety rules frequently get broken. An observational study analyzing adherence to contact precautions showed 27.9% of nurses and nursing assistants adhered to proper personal protective equipment (PPE) in comparison to 100% of infectious disease physicians and 85.7% of house-keeping staff. Being on the front lines of patient interactions, physicians, nurses, and nursing assistants are the foundation of infection control and should be aware of PPE and utilize them as expected. Prevention of infections in health-care systems is critical in overall disease control and morbidity and mortality.
Health-care workers should be aware of bloodborne pathogens and consider safer practices and procedures when handling objects potentially contaminated with blood or bodily fluids to prevent injuries and possible spread of infections. Studies have shown that awareness of technique and safety precautions can lead to decreased bloodborne infection transmission.
A retrospective cohort study also found that patients in isolation rooms requiring PPE received less attention and care from health care staff. The study determined that isolation precautions lead to poorer outcomes, more extended hospitalizations, and increased readmissions to health-care facilities. These factors together also contribute to increased health-care costs and time and increased morbidity and mortality of treatable infectious organisms.
Infection control through the use of personal protective equipment (PPE) and alert signs designed by the CDC, OSHA, and individual internal policies in health-care facilities is critical for proper patient care and prevention of prolonged hospitalizations and decreasing health-care costs. While awareness of precautions is appreciated, adherence to following the precautions appears to be lacking. All health-care team members and visitors to health-care facilities must abide by those policies to encourage safe practices and reduce the spread of infections.
Health-care team members, including physicians, nurses, and nursing assistants, should pay close attention to proper PPE use and isolation precautions for personal safety and safety of the patients. It is also crucial for team members to enforce isolation precautions on visitors and other members not complying with standard protocols to reduce infection transmission within the workplace.
In the retrospective cohort study by Tran K. and Bell C. et al., patients on isolation precautions on average had a 17% increase in hospital stays and a 23% increase in health-care cost due to lack of attention by health-care staff. Health-care members must provide consistently high-quality care and attention to any patient, regardless of social or health status. [Level 3] Team-members in any health-care organization should be aware of the length of stay increase as well as the lack of quality care in isolation precaution patient populations.
Nursing and other health-care team members should make every effort to consistently provide high-quality care and help enforce CDC, OSHA, and internal organization infection control rules and guidelines. When care is compromised, or there is a risk of infection transmission, it should be brought to the attention of supervisors and managed, so that patient care takes precedence.
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