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A policy of universal precautions is mandatory in all healthcare facilities and establishes procedures to cover aspects of training, monitoring, and reporting exposures.
According to the Centers for Disease Control and Prevention (CDC), universal precautions apply to all patients, regardless of their infectious status.
In this article, we explore the role of universal precautions in patient safety and infection prevention, compare them to standard and isolation precautions, review examples of how they are applied to everyday healthcare practices, and finish it off with a series of commonly asked questions and answers.
Role in infection prevention
Universal precautions in healthcare form the basis upon which all infection prevention practice depends. Without universal precautions, hospital-acquired infections (HAIs) would occur much more frequently and would be far more hazardous.
Hospital-acquired infections (HAIs) prevention
For infection control and prevention, universal precautions are implemented on a recurring basis.
Minor transgressions can create viral or bacterial epidemics, some of which are lethal. Adhering to regular Universal precautions dramatically reduces these occurrences and ensures patient safety.
Examples of universal precautions in nursing
Some examples of applying universal precautions in nursing include the following:
- Wearing gloves for inserting an IV or working with specimens
- Wearing masks and eye protectors when splashing can happen
- Throwing away used needles in puncture-proof containers
Universal precautions are applied in multicultural healthcare settings, acute, ambulatory, emergency, outpatient, and home health settings.
They should be applied wherever there may be potential exposure to blood.
Universal vs standard and isolation precautions
What is the difference between universal, standard, and isolation precautions?
Similarities and differences
Universal precautions focus mainly on blood and specific body fluids.
Standard precautions expand universal precautions to apply to all body fluids (except sweat), non-intact skin, and mucous membranes.
Isolation precautions focus on suspected infections.
Universal precautions
What is the origin, focus, and target for universal precautions?
- Origin: 1980s in response to bloodborne pathogens
- Focus: Blood and some fluids
- Target: All patients
Standard precautions
What is the origin, focus, and target for standard precautions?
- Origin: 1996 in response to more universal hazards
- Focus: All fluids (except sweat)
- Target: All patients
Isolation precautions
Contrary to universal and standard precautions, isolation precautions (e.g., airborne or contact isolation) are not applicable to all patients. They are implemented for known or suspected infections.
Compliance with legal and regulatory requirements
Compliance with the Occupational Safety and Health Administration’s (OSHA) universal precautions is mandatory within the United States. Noncompliance can result in fines, litigation, and public health consequences.
Current guidelines
The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and other regulatory healthcare agencies regularly update guidelines, clarify definitions, and establish personal protective equipment (PPE) and exposure control criteria.
Universal precautions for bloodborne pathogens
How do universal precautions apply when there are bloodborne pathogens?
Regulations
Universal bloodborne pathogen precautions are regulated by OSHA in the United States.
Bloodborne pathogens
Some examples of bloodborne pathogens include:
- HIV (Human Immunodeficiency Virus)
- HBV (Hepatitis B Virus)
- HCV (Hepatitis C Virus)
These viruses pose a serious risk of harm to healthcare workers through needlesticks, splashes, or direct contact.
OSHA universal precautions requirements
What are the requirements dictated by OSHA when it comes to universal precautions?
- Provide PPE (gowns, gloves, masks).
- Provide safe sharps disposal systems.
- Train staff in bloodborne pathogen standards.
- Have exposure control and post-exposure evaluation procedures.
Key elements of universal precautions
Proper use of universal precautions avoids infection among healthcare workers and patients. The following are the key elements:
- Wear disposable gloves.
- Put on gloves for any risk of exposure to potential infectious material or blood.
- Change gloves from patient to patient and on contact with contaminated surfaces.
- Wash hands effectively after contact with blood, body fluids, or soiled items—even when using gloves.
- Wear protective clothing and equipment.
- Wear gowns when clothing is to be exposed to the risk of splash from any body fluid or blood.
- Wear masks or face shields when splashes or sprays might occur to protect the eyes.
- Report sharps injury and exposure immediately.
- Participate in periodic training and updates.
Guidelines & checklists for universal precautions
Using a universal precautions checklist encourages uniformity and adherence. Every healthcare worker needs to be methodical and consistent.
- Treat all body fluids as infectious.
- Wear appropriate PPE for anticipated exposure.
- Practice good hand hygiene prior to and after patient contact.
- Handle, transport, and dispose of sharps safely.
- Decontaminate and clean work surfaces after use.
- Clean and treat soiled clothing and linens properly.
Step-by-step procedures
Some step-by-step procedures include the following:
- Risk assessment: Before each procedure, assess the risk for fluid or blood exposure.
- Select PPE: Utilize gloves, masks, eyewear, or gowns based on need.
- Hand hygiene: Before putting on and after PPE removal, and after touching.
- Safe sharps handling: Get rid of sharp devices instantly.
- Surfaces and equipment decontamination: Disinfect equipment and used surfaces.
Universal precautions training
What kind of training do healthcare workers require for universal precautions?
- Onboarding and continuing training: All staff members must be trained in universal precautions upon employment and periodically as needed. Training includes safe work practices, use of PPE, and what to do in case of exposure.
- Continuing education and compliance: Repeating courses at regular intervals ensures compliance with universal precautions and educates staff on updated guidelines.
Challenges facing universal precautions
Some challenges can arise when facing universal precautions in the workplace:
- Problems with compliance: Staff take shortcuts in the name of speed, forgetfulness, or finding them inconvenient and open themselves up to infection risks. Sufficient staffing can help to reduce the pressure for speed.
- Resource limitations: Inadequate PPE availability, suboptimal training, or excessive distance from hand hygiene stations can discourage adoption.
- Myths and Barriers: Universal myths (e.g., "Universal precautions can only be used with some patients") lower compliance. Education and accountability resolve such issues.
Solutions and recommendations
What can be done to overcome these challenges?
- Manager commitment: Policies must be enforced, and adequate resources must be made available by managers.
- Regular audits: Track PPE use, hand hygiene, and disposal of sharps.
- Feedback: Offer feedback on noncompliance and near-miss incidents.
Best practices and universal precautions compliance tips
Let’s review some tips that help with compliance when it comes to universal precautions.
Time-saving strategies for busy nurses and staff
- Place PPE and hand hygiene stations throughout the facility.
- Make reminders for universal precautions a standard daily procedure.
- Enforce habits with checklists.
- Notify leadership of depletion or breakage of supplies immediately.
Sharps handling and disposal
Remember to:
- Do not recap used needles by hand.
- Get rid of sharp devices and objects promptly in puncture-proof containers to prevent hand stick injury.
Environmental cleaning
When cleaning after a procedure:
- Disinfect and clean with solutions
- Throw away trash in biohazard waste containers
Leadership's role
Leaders in healthcare facilities must always:
- Lead by example at all times.
- Provide frequent refresher training.
- Reward employees for excellent compliance.
Frequently asked questions (FAQs)
Below are some frequently asked questions.
What is the best definition of universal precautions?
Universal precautions are the infection control measures that require healthcare workers to treat all blood and specified bodily fluids as potentially infectious, ensuring consistent use of PPE and other protective strategies and habits.
Who regulates universal precautions for bloodborne pathogens?
OSHA (Occupational Safety and Health Administration) regulates universal precautions for exposure to bloodborne pathogens in the USA.
Are universal precautions still required?
Yes. While guidelines have been broadened (now standard precautions), general principles of universal precautions are still necessary in healthcare.
How are universal and standard precautions different?
Universal precautions are designed to prevent transmission of bloodborne disease from blood and other specified body fluids.
Standard precautions broaden to cover all body fluids (except sweat) and direct and indirect contact exposures.
Why are universal precautions important for nurses and facilities?
Universal precautions are the cornerstone of infection control by nurses and healthcare providers.
Guidelines save lives, reduce risk, and are legislated for by regulatory authorities. Everyone, rank and file or brass, must attack universal precautions as firm and fast rules that never change.
Adhering to universal precautions is not optional—it is something that all health workers need to do for themselves and the safety of the patients they are treating.
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