9.1 Standard Precautions
Karen Piette, MHS, CMA and Kristen Hosey
Due to the nature of their profession, healthcare workers can be exposed to blood through needlestick injuries, other sharps injuries, mucous membrane contact, and skin exposure (Occupational Safety and Health Administration, 2023). They are at increased risk of bloodborne pathogen exposure due to their close work with patients. Standard precautions are important practices that should be used for all patient care, at all times. According to the Centers for Disease Control (CDC, 2019d), standard precautions include handwashing and the use of personal protective equipment (PPE) to protect healthcare providers from infection and prevent the spread of infection from patient to patient. The proper use of standard precautions prevents the spread of bloodborne pathogens. Bloodborne pathogens are microorganisms, such as viruses and bacteria, that are carried in blood and cause diseases such as Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV).
Hand hygiene is an important aspect of standard precautions and includes both the proper use of hand sanitizer and effective handwashing at appropriate times during patient care. It is the most widely known form of standard precautions, yet, on average, healthcare providers clean their hands less than half of the times they should (CDC, 2019b). The CDC offers many resources to help healthcare providers understand the importance of hand hygiene in healthcare settings. Remember, healthcare workers encounter more sick people than employees in any other work settings do. Therefore, understanding and practicing good hand hygiene is essential for both their own safety and the safety of the patients they serve.
In the healthcare field, it is vital to utilize Personal Protective Equipment (PPE) in order to minimize exposure to bloodborne pathogens and injury. PPE act as a barrier to infectious materials by blocking the transmission of contaminants from bodily fluids, blood, and respiratory secretions (U.S. Food and Drug Administration, 2020). Healthcare workers are exposed to bodily fluids, medical equipment, and sharp instruments. PPE consists of equipment worn by workers to minimize exposure to hazards that cause workplace injuries or illnesses. PPE that can be worn in the healthcare setting include gowns, masks or respirators, goggles, face shields and gloves. PPE should also be donned (put on) and doffed (taken off) in a specific order to prevent contamination.
Respiratory hygiene and cough etiquette are important standard precautions to prevent the spread of respiratory infections. Covering the mouth and nose with a tissue when coughing or sneezing, followed by appropriate hand hygiene, may stop the spread of infection through respiratory droplets. Healthcare facilities should ensure the availability of materials to support these practices.
Sharps safety and needlestick prevention are also important standard precautions in healthcare settings. Sharps are devices, such as needles, that can penetrate the skin, causing injury and spreading bloodborne pathogens. Needlestick exposures to bloodborne pathogens are a serious problem, resulting in approximately 385,000 cases a year (CDC, 2019c). Sharps should be immediately disposed of in a sharps container after use. Sharps injuries are primarily associated with the transmission of diseases such as hepatitis B and C, HIV, and at least 20 other pathogens (CDC, 2019c).
The Occupational Safety and Health Administration (OSHA, n.d.) requires healthcare employers to have an exposure control plan to eliminate the hazards of occupational exposure to bloodborne pathogens, as outlined in OSHA’s bloodborne pathogens standard. Healthcare workers must complete bloodborne pathogen training, which provides an overview of exposure risks and the appropriate use of PPE.
Attributions
- Figure 5.3: Medical personnel don PPE before entering a COVID-19-positive, non-critical patient’s room. (50199060167).jpg by Petty Officer 3rd Class Jacob L Greenberg/U.S. Navy in the Public Domain
American Academy of Professional Coders. (2023). CPT® codes lookup. Codify by AAPC. https://www.aapc.com/codes/cpt-codes-range/
Cavaness, K., Picchioni, A., & Fleshman, J. W. (2020). Linking emotional intelligence to successful health care leadership: The Big Five model of personality. Clinics in Colon and Rectal Surgery, 33(4), 195–203. https://doi.org/10.1055/s-0040-1709435
Centers for Disease Control and Prevention. (2022a). Blood sugar and diabetes. https://www.cdc.gov/diabetes/managing/manage-blood-sugar.html
Centers for Disease Control and Prevention. (2022b). Chronic diseases in America. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
Centers for Medicare & Medicaid Services. (2024a). Get started with Medicare. https://www.medicare.gov/basics/get-started-with-medicare
Centers for Medicare & Medicaid Services. (2024b). Medicaid. https://www.medicaid.gov/medicaid/index.html
Commonwealth Fund. (2022, September 29). The state of U.S. health insurance in 2022. https://www.commonwealthfund.org/publications/issue-briefs/2022/sep/state-us-health-insurance- 2022-biennial-survey
Harvard University. (2014). Health and Human Rights Resource Guide (5th Ed.). https://www.hhrguide.org/
NEJM Catalyst. (2017). What is patient-centered care? https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0559#tab-contributors
Olejarczyk, J., & Young, M. (2022). Patient rights and ethics. National Institutes of Health. https://www.ncbi.nlm.nih.gov/books/NBK538279/
Oxford English Dictionary. (2023). Socialized medicine. In Oxford English Dictionary. https://www.oed.com/search/dictionary/?scope=Entries&q=socialized%20medicine
Quality and Safety Education for Nurses Institute. (2022). QSEN competencies. QSEN.org. https://www.qsen.org/competencies-pre-licensure-ksas
Population Health Forum. (2019). Why do people in these countries live longer than we do in the United States? University of Washington. https://depts.washington.edu/eqhlth/index.htm
Rice, T., Rosenau, P., Unruh, L. Y., & Barnes, A. J. (2020). United States: Health system review. Health Systems in Transition, 22(4), 1–441. https://pubmed.ncbi.nlm.nih.gov/33527901/
Tolbert, J., Orgera, K., & Damico, A. (2023). Key facts about the uninsured population. Kaiser Family Foundation. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/
USAFacts. (2022). US population by year, race, age, ethnicity, & more. USAFacts.org. https://usafacts.org/data/topics/people-society/population-and-demographics/our-changing-population
U.S. Department of Health and Human Services. (2023). Poverty guidelines. Office of the Assistant Secretary for Planning and Evaluation. https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
Washington State Board of Nursing. (2024). Nurse license fees. https://nursing.wa.gov/licensing/nurse-license-fees
Professional communication is an important part of becoming a nurse and being a nursing student. You are entering a "profession" which means there are certain expectations in terms of your professional conduct specifically in terms of how you communicate.
Professional communication involves a level of formality and is an important component of your post-secondary nursing education. It is different than the informal communication that you may engage in with your friends and family. It also applies to your verbal and written communication including emails.
The principles of professional communication include being truthful, accurate, clear, and both concise and comprehensive. For example, you should say or write something in a succinct and short way while also including all relevant information. You should also have a professional tone that is conveyed through appropriate greetings, complete sentences, and grammar. In order to be professional, you need to know your audience; both the content and form of your message should be tailored to your audience.
Here are some tips to follow in terms of professional communication:
- Introduce yourself fully by name, role/institution and pronouns, such as: "I am Mateo Reyes, a year one nursing student from Toronto Metropolitan University. My pronouns are they/them."
- Address the person you are speaking to formally. Also, do not assume the gender or pronouns of the person you are speaking to. For example, you should avoid using terms such as “miss,” “ma’am,” “sir,” “mister,” “ms,” etc., until you know how the recipient wants to be addressed. If you are uncertain, introduce yourself fully and ask how the recipient would like to be addressed and what pronouns they use.
- Clearly articulate your message (what you are trying to say).
- Speak in full sentences.
- Be honest.
- Be polite. Your communication is a reflection of YOU and your professionalism.
- Consider reciprocity (mutual influence). For example, a person may answer your question after you have emailed (or contacted them in some other way) with a question. If so, it is important to respond back to them so that they know that you have received their reply. It may be something like "Thank-you so much Professor Shevchenko. That helps me understand the topic better."
Because a lot of communication occurs electronically, it is important to consider how to construct an email. Here are some tips:
- Use a professional email address. At most universities, your email communication with a professor should originate from your university email.
- Begin with a clear description in the subject line. For example, students should include the course code in the subjective line and a brief description identifying the reason for the email (e.g., “NSE 54: question regarding week 3 quiz”).
- Use a professional email greeting and salutation to address your professor, or the salutation preferred by the professor.
- Appropriate: “Dear Professor Dodge” or “Hello, Dr. Chen.”
- Inappropriate: “Hey teacher", "Hi", or "Yo."
- Introduce yourself so that the email recipient knows who you are. Remember, professors teach several courses and course sections. Thus, you might say “I am Minta Li. I am a student in your Wednesday section of NSE 678.” Additionally, you may need to consider including your student number in an email when you introduce yourself. This is particularly when inquiring about course issues, grades, or program status in order to clearly identify yourself as student names can be similar.
- Refer to any attachments in the email text.
- Avoid point form, slang, and abbreviations.
- Include a signature block at the end of your email identifying your full name, role, institution, and contact information. You should NOT include your student number or a personal cell phone number in the signature block because it is considered part of your private information at the university. This private information can be used in the body of the email when communicating with certain individuals who may require this information such as your professor or a student affairs coordinator.
- Proofread your email for accuracy, grammar, and spelling - important to have your program name spelled correctly.
- Avoid humour and excessive use of exclamation points and all caps. These can easily be misinterpreted.
Signature Block Example
Sharod Hadi, nursing student year one, pronouns: he/him
Toronto Metropolitan, Centennial, George Brown Collaborative Nursing Degree Program, Toronto, Ontario
Professional/institutional email address (insert your own email)
Points of Consideration
Addressing and referring to your instructor
Students are often uncertain how to address their instructors. It is okay to ask your instructors how they would like to be addressed. Until you know how, you should refer to them as "Professor X" (insert their surname) or "Dr. X" (insert their surname).
Although some instructors may invite you to use their first name, it is part of professional communication etiquette to use "Professor X" or "Dr. X" (including both their first and last name) when referring to them to others. In addition to ensuring professional communication, this helps to provide clarity if your instructors share a first or last name with another instructor.
Example: Dr. Huang is your course instructor, and they have encouraged you to reach out to another professor to discuss potential research opportunities. Although Dr. Huang has given you permission to call her Lisa in the classroom, you should always refer to them as Dr. Lisa Huang in communication with others. Thus, when initiating communication with the instructor that Dr. Huang has referred you to, you may consider a beginning such as: "Dear Dr. Hameed. I am a student in the undergraduate year one nursing communication course with Dr. Lisa Huang. Dr. Huang has encouraged me to reach out to you about potential research opportunities because of my interest in critical feminism."
.jpg){kind=link}