Standard Precautions (SICP)

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What are standard precautions (SICP)?

  • Effective hand hygiene 
  • Appropriate use of personal protective equipment (PPE)
  • Safe handling and disposal of sharps 
  • Food hygiene 
  • Environment cleaning including decontamination of equipment 
  • Appropriate management of laundry
  • Staff hygiene
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why is Hand hygiene important?

Hand hygiene is important as it is one of the processes that we can use to destory micro-organisms and break the chain of infection early and reduce the spread of communicable diseases (e.g. Influenza) and infections caused via the faecal/oral route such as norovirus.

As staff move from patient to patient or have contact with the patients environment, their hands can pick up micro-organisms which, if not removed through hand hygiene can be passed to the next patient or deposited elsewhere. Our hands always have micro-organisms present on them, it is impossible to physically remove or destory them all, although we can significantly reduce their numbers.Micro-organisms present on hands are predominantly bacteria, but occasionally may include spores (from fungi or bacteria) or viruses if hands are in contact with a contaminated surface, body area or fluid.

The bacteria on our hands are divided into 2 categories- resident and transient bacteria.

  • Resident bacteria flora- are those that live on our hands permanently, and play a protective role by helping to prevent non-resident bacteria form establishing colonies on the skin
  • Transient bacteria- are the most frequently associated with the spread of infection in healthcare.The transient bacteria become loosely attatched to the outer skin layers and can be easily transfered.
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Hand washing techniques

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The world health organisation (WHO) recommends: 5

  • Before you touch, enter the patients environment (this is really important for patients with low immunity)
  • Before clean or Aseptic technique 
  • After dealing with body fluid- urine, blood, faeces, vomit, sputum
  • After you touch the patient like if you shake hands or perform vital sign check
  • After touching the patients environment, for example: if you fluff a pillow, cover the patient with their own blanket, pass them something

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How do we clean our hands?

Soap and water

  • Use when hands are physically dirty
  • Use for infections like C-Diff and Covid-19
  • Moisturise to reduce the erosion that constant hand washing can cause

Alcohol rub

  • Use in between soap and water hand washes

The aim of hand washing is to remove transient organisms (bacteria, virus, fungi and spores) from the surface of the hands using mechanical friction as a result of the application, rubbing and removal of soap and water during the process of washing. Hand drying using paper towels also physically removes organisms from the hands. This contacts with the application of hand sanitizers, which chemically destroy or inactivate bacteria present on the surface of hands. The use on hand sanitizers is not promoted for patients suspected or known to have viral gastroenterities or a gastrointestinal infection.

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Types of PPE

  • Disposable gloves
  • Disposable aprons
  • Disposable gowns
  • Disposable masks- depending on the infection your patient has
  • Disposable eye protection
  • Visor/ face shield
  • Disposable surgical cap

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Why we use personal protective equipment (PPE)

  • We use PPE during certain points of care with patients. The overuse of gloves can have a dertimental effect on healthcare workers skin on their hands.
  • The use of PPE prevent the spread of organisms by providing a physical barrier- stops us for acting as a reservoir
  • Wash hands before and after use
  • PPE are single use items
  • Safely remove PPE without contaminating self
  • Disposal of PPE via clinical waste route
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Donning and Doffing of PPE

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Safe use and disposal of sharps

The main risk posed by needle-stick injury to workers is exposure of the worker to blood-borne viruses (BBV). The main viruses concerned are:

  • Hepatitis B (HBV)
  • Hepatitis C (HCV)
  • Human immunodeficiency virus (HIV)
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Inoculation injuries- unsafe disposal of sharps

Inoculation injuries are when the healthcare worker is exposed to blood borne viruses in such a way to make them at risk of infection. This could include:

  • Needle stick injuries
  • Bites (human or animal)
  • Scratches
  • Splashes to broken skin
  • Splashes to mucous membranes (eyes, mouth)
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Good practice of safe sharps

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If the exposure occurs then immediate action neede

  • Wash with soap and water and rise under the tap (2 mins). If you have 'splash' injury to eye - rinse your eye with water in a way that allows the water to drain away from your face (for example a bag of saline and a giving set- follow local trust policy)
  • Encourage to bleed freely
  • Apply waterproof dressing
  • Report the incident to manager
  • Contact Occupational health or Accident and Emergency for review (see local policy)
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Safe handling and disposal of waste

  • Waste disposal in healthcare is subject to strict regulation
  • There are identified streams for waste depending on its hazard status. Hazards can be unused medicines or waste from clinical care
  • The management of healthcare waste is an essential part of ensuring that care activities do not pose a risk or potential risk of infection and are appropriately managed. Waste is potentially hazardous and if not disposed of correctly can result in injury or infection.
  • All staff are responsible for the safe management and disposal of waste and should understand how waste should be segregated and stored prior to collection or disposal. This is driven by the need to reduce environmental impact, comply with waste regulations and other national guidance such as The Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance.
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Laundry

  • Know how to segregate the linen
  • You may have red washable bags for isolation areas and infectious linen
  • White or Grey bags for dirty non soiled linen like routine bed changes, and then there will be another coloured bag or a plain linen bag that is used for linen that is soiled heavily.
  • Always refer to the policy for the truct/area you are working in
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