Infection prevention and control precautions help prevent the spread of infection in NSW Health facilities and protect patients, staff and visitors. They include standard precautions for all patient care, and additional transmission-based precautions when a specific pathogen is known or suspected.
Standard precautions
Standard precautions are the minimum infection prevention measures for all patient care, regardless of the patient’s infection status. They include:
- hand hygiene
- personal protective equipment (PPE) selection based on anticipated exposure
- respiratory hygiene and cough etiquette
- aseptic technique
- safe handling of sharps
- reprocessing of reusable equipment
- environmental cleaning
- waste disposal.
For detailed guidance on each element, refer to Chapter 5 of the Infection Prevention and Control Practice Handbook.
Selecting PPE
When selecting PPE, consider:
- Type of exposure: the anticipated activity (touch, splashes, or large volumes of blood or body substances) and the category of precautions the patient is on
- Durability and fit: choose a gown or apron based on whether fluid resistance or fluid proof protection is needed.
- Individual fit: PPE must fit the user. Employers must ensure PPE is available in sizes appropriate for their workforce.
Transmission-based precautions
Apply transmission-based precautions in addition to standard precautions when standard precautions alone will not prevent the spread of a known or suspected pathogen. The type of precaution depends on how the infection spreads.
There are four categories:
- Contact precautions reduce the risk of transmission through direct or indirect contact. Consider these for patients colonised or infected with a multi-resistant organism (MRO) where there is significant patient or environmental contact.
- Droplet precautions reduce the risk from large respiratory particles produced during coughing, sneezing or talking.
- Airborne precautions reduce the risk from small particles (aerosols) that remain suspended in the air and can travel longer distances, particularly in poorly ventilated indoor settings.
- Combined precautions apply when a microorganism spreads through more than one route. Use the relevant precaution types together with standard precautions.
Applying transmission-based precautions
When applying any type of transmission-based precaution:
- place the patient in an appropriate room (single room where available)
- select the right PPE for the precaution type
- perform hand hygiene before and after patient contact
- use disposable or dedicated patient care equipment where practical
- clean and disinfect shared equipment between use
- limit patient transport and movement where possible
- change gloves between tasks on the same patient and between patients.
For detailed guidance on each precaution type, including patient placement and de-isolation, refer to Chapter 6 of the Infection Prevention and Control Practice Handbook.