What Are Standard-Based Precautions? 

Hand hygiene is considered one of the most important infection control measures for reducing the spread of infection. Hand hygiene is a general term that refers to any action of hand cleansing, such as handwashing or hand rubbing (CDC, 2017).

Microorganisms are either present on hands most of the time (resident flora) or acquired during healthcare activities (transient flora) The aim of hand hygiene is to reduce the number of microorganisms on your hands, particularly transient flora which may present the greater risk for infection transmission (ACIPC, 2020).

Handwashing: Hands should be washed with soap and water when visibly soiled and after using the toilet.

Hand rubbing: Hand rubbing with an alcohol-based hand rub (ABHR) is the preferred method for hand cleansing in the healthcare setting when hands are not visibly soiled. ABHRs are more effective against most bacteria and many viruses than either medicated or non-medicated soaps.

The 5 Moments for hand hygiene was developed by the World Health Organisation (WHO).

The 5 moments are:

• before touching a client
• before performing a procedure
• after a procedure or exposure to body fluids/substances
• after touching a client
• after touching the environment around a client.

Visit our hand washing and hand sanitiser guide and 5 moments of hand wash page for downloadable posters.

PPE protects the healthcare worker from exposure to blood and body fluids/substances. PPE that complies with relevant Australian Standards should be readily available and accessible in all health services.

• Wear appropriate PPE when you anticipate contact with blood and/or body fluids.
• PPE includes gloves, fluid resistant gowns and/or aprons, eye protection, face shields and surgical masks.
• PPE must be changed between patients and/or when soiled.

Gloves

• The use of gloves should not be considered an alternative to performing hand hygiene. Hand hygiene is required before putting on gloves and immediately after removal.
• Wear gloves (single-use non-sterile) when there is the potential for contact with blood, body fluids/substances, mucous membranes, or non-intact skin.
• Sterile gloves are only required for certain invasive procedures, otherwise non-sterile gloves may be used if an aseptic non-touch technique is used.
• Change gloves between tasks and procedures on the same patient. Gloves should be removed immediately after a procedure and hand hygiene performed to avoid contaminating the environment, other
• patients or other sites on the same patient.
• Gloves used for healthcare activities are to be single use only. ABHR should not be used on gloves to decontaminate them, nor should gloves be washed with soap and water and continued to be used.

Gowns and aprons

• Wear an apron or gown to protect skin and prevent soiling of clothing during procedures and patient care activities that are likely to generate sprays of blood, body fluids, secretions or excretions.
• Select a gown or apron that is appropriate for the activity and the amount of fluid likely to be encountered.
• Remove the used gown as promptly as possible and roll it up carefully and discard appropriately. See how to don and doff PPE in Healthcare settings

Masks, eye protection, face shields

• Wear a mask and eye protection, or a face shield to protect mucous membranes of the eyes, nose and mouth during procedures, patient-care activities and cleaning procedures that are likely to generate splashes or sprays of blood, body fluids, secretions and excretions.
• Remove the mask by holding the ties only and dispose of the mask into a waste bin.
• Perform hand hygiene immediately after removal.

PPE protects the healthcare worker from exposure to blood and body fluids/substances. PPE that complies with relevant Australian Standards should be readily available and accessible in all health services.

Safe handling of needles and other sharp devices are components of standard precautions that are implemented to prevent health care worker exposure to blood borne pathogens.  Breaches in safe injection, infusion and medication vial handling practices have resulted in transmission of HIV and viral hepatitis and in some cases caused outbreaks of disease. Standard precautions, particularly aseptic technique, form the basis of safe injection practices.

• The safety devices on needles and other sharps should be activated immediately after use.
• Used needles should be discarded immediately after use and not recapped, bent, cut, removed from the syringe or tube holder, or otherwise manipulated.
• Any used needles, lancets, or other contaminated sharps should be placed in a leak-proof, puncture-resistant sharps container that is labelled with a biohazard label.
• Do not overfill sharps containers. Discard after 2/3 full or when contents are at the full line indicated on the containers.
• Used sharps containers may be taken to a collection facility such as an area pharmacy, hospital, or clinic that provides this service.

• Reusable equipment used in the assessment and delivery of patient care must be reprocessed between patients according to the intended use and following manufacturers recommendations, national and international standards.
• Client care areas, common waiting areas, and other areas where clients may have potentially contaminated surfaces or objects that are frequently touched by staff and clients (doorknobs, sinks, toilets, other surfaces and items in close proximity to clients) should be cleaned routinely with TGA registered disinfectants, following the manufacturers’ instructions for amount, dilution, and contact time.
• Most disinfectants are not effective in the presence of dirt and organic matter; therefore cleaning must occur first before disinfection (using a 2 step process). Wet a cloth with the disinfectant, wipe away dirt and organic material, then with a clean cloth apply the disinfectant to the item and allow to air dry for the time specified by the product manufacturer.

Respiratory hygiene and cough etiquette are terms used to describe infection prevention measures to decrease the transmission of respiratory illness (e.g., influenza and cold viruses, COVID-19). A respiratory infection is spread when a person who is infected with a virus coughs or sneezes.  Elements of respiratory hygiene and cough etiquette that the CDC recommends include:

• Covering the nose/mouth with a tissue when coughing or sneezing or into the elbow to contain respiratory droplets.
• Using tissues to contain respiratory secretions and discarding in the nearest waste receptacle after use.
• Performing hand hygiene immediately after contact with respiratory secretions and contaminated objects/materials.
• In healthcare facilities, patients with symptoms of respiratory infections should sit as far away from others as possible. If available, healthcare facilities may place these patients in a separate area while waiting for care.

• Spacing seating in waiting areas at least 1 metre apart to minimize close contact among persons with each other.
• Supplies such as tissues, waste baskets, alcohol-based hand sanitisers, and surgical masks should be provided in waiting and other common areas in local public health agencies. Place cough etiquette signs  where the general public can see them.
• Keep contaminated hands away from the mucous membranes of the mouth, eyes, and nose.
• Those who are immobile will need a receptacle (e.g. plastic bag) readily at hand for the immediate disposal of used tissues and will need to be offered hand hygiene facilities. Healthcare workers with viral respiratory tract infections should remain at home until their symptoms have resolved.

Aseptic means the absence of germs, such as bacteria, viruses, and other microorganisms that can cause disease. Healthcare professionals use aseptic technique to protect patients from infection. Aseptic techniques range from simple practices, such as using alcohol to sterilize the skin, to full surgical asepsis, which involves the use of sterile gowns, gloves, and masks. Healthcare professionals use aseptic technique practices in hospitals, surgery rooms, outpatient care clinics, and other healthcare settings. Sterile single-use equipment or instruments must be used according to the manufacturer’s instructions and in such a way that the sterility of the item is maintained. Asepsis can be explained in different levels.

As there is currently no national definition of clinical waste in Australia, healthcare facilities, including community healthcare settings, need to conform to relevant state or territory legislation and regulations on the management of clinical and related wastes. Healthcare facilities should also refer to Standard AS/NZS 3816: 2018 and the Waste Management Association of Australia’s industry code of practice (reference).

When handling waste:

• apply standard precautions to protect against exposure to blood and body substances during handling of waste; wash hands following procedure
• segregation should occur at the point of generation
• waste should be contained in the appropriate receptacle (identified by colour and label) and disposed of according to the facility waste management plan
• healthcare workers should be trained in the correct procedures for waste handling. Regardless of where waste is generated (e.g. from isolation rooms/patients versus routine patient-care areas), the principles of determining whether it is to be treated as clinical or general waste remain the same

When handling linen:

Healthcare facilities must have documented polices on the collection, transport, and storage of linen. Healthcare facilities that process or launder linen must have documented operating policies consistent with Standard AS/NZS 4146: 2000. All used linen should be handled with care to avoid dispersal of microorganisms into the environment and to avoid contact with staff clothing.

The following principles apply for linen used for all patients:

• Appropriate personal protective equipment is worn during handling of soiled linen to prevent exposure of skin and mucous membrane to blood and body substances.
• Used linen is ‘bagged’ at the location of use into an appropriate laundry receptacle.
• Used linen must not be rinsed or sorted in patient-care areas or washed in domestic washing machines.
• Linen soiled with body substances should be placed into leak-proof laundry bags for safe transport.
• Hand hygiene is performed following the handling of used linen.
• Clean linen must be stored in a clean and dry place that prevents contamination by aerosols, dust, moisture, and vermin, and is separate from used linen.