Infection control precautions keep everyone safe. In a care setting, whether this is a hospital, a doctor’s surgery or a care home, controlling infection is especially important as those in the environment may be more susceptible to serious illness if they become infected.
There are a set of standard infection control precautions in place that are used as best practices for care settings to ensure that the spread of infection is reduced or eradicated, to keep both the staff who work there and the patients safe. In this article, we explain how many infection control standard precautions there are, what each of them involves and how to follow them to stay safe from infection.
The Standard Infection Control Precautions, also known as SICPs, are a set of control measures designed to reduce and prevent the spread of infection. They originated from the very first advances made in infection control and are now a standardised set of guidelines used across the world.
SICPs are commonly used in care settings as a way to keep patients and staff members safe. After completing a risk assessment, they are applied to situations where contamination from infectious substances may be likely and used to decide what precautionary measures need to be taken.
In many cases, it is impossible to know who may be infected with any contagious pathogen, so standard precautions for infection control are followed at all times to ensure high levels of hygiene and slim chances of infection transmission.
There are ten official standard infection control precautions used in social care and medical settings. Below, we’ll go into each of them in more detail.
The first of the standard infection control precautions is patient placement and assessment. This should be done as soon as a new patient arrives in a care setting in order to prevent infection from entering the environment from outside sources.
New patients should be assessed for infection risk based on the symptoms they are exhibiting. Tests may need to be run to confirm the origin of this infection, and the patient should be kept in isolation until the results are confirmed.
If a patient already in a care environment starts to exhibit symptoms of infection, they should be moved and isolated until the cause of this is determined and treated.
One of the most important of all the principles of infection prevention and control is hand hygiene. Our hands can quickly spread infectious pathogens over a very large area, so maintaining good hand hygiene is essential to preventing and reducing this risk.
Instructions from the World Health Organisation state that hands should be washed:
You should also wash your hands before handling medication or food, after any cleaning or disinfection procedures, after handling waste, after using the toilet and before donning or removing PPE.
Before washing your hands, all skin below the forearms must be exposed, all jewellery needs to be removed, fingernails should be short to ensure they can be cleaned underneath, and any cuts or abrasions should be covered with a waterproof dressing.
Hands should be washed for a minimum of twenty seconds using soap and water. Alcohol-Based Hand Rubs (ABHRs) may be used if hands are visibly clean, and antiseptic wipes may be used if there are doors that need to be opened before a hand washing sink can be reached.
For staff undertaking surgical or some invasive procedures, a more thorough hand hygiene process is necessary. Official instructions for this process can be found here.
Coughing and sneezing can quickly result in a lot of infectious pathogens spreading through the air, which is why standard precautions are required to manage this hazard.
If sneezing, coughing, wiping or blowing your nose, you should cover the lower half of your face with a tissue. This should then be disposed of immediately.
If a tissue isn’t available, coughing or sneezing into your arm or elbow is the next best thing.
After coughing, sneezing or blowing your nose, hands should be thoroughly washed using water and soap. Alcohol-based hand gel is also suitable if a sink isn’t available, but soap and water should be used at the earliest possible opportunity after this.
If a member of staff is showing symptoms of respiratory illness, they should be encouraged to wear a surgical face mask if they are able to do so and it is considered clinically safe.
Personal protective equipment, or PPE, is additional clothing or equipment worn to protect the wearer from contamination with infectious agents. This may include surgical face masks, gloves, aprons and other items that cover the body.
All PPE should be stored in an easily accessible place close to the point of use and be disposed of immediately in a safe way.
PPE should be worn after a risk assessment is completed to determine what is needed to reduce the risk of infection transmission. When blood or bodily fluid contact is likely, non-sterile gloves and aprons must be worn, with additional gowns, face and eye protection if splashing of these fluids is likely to occur.
Aprons should be worn when contamination of the uniform is likely. They are single-use and must be changed between patients or changed if they become damaged during use.
Gloves must be worn when exposure to the following is likely:
They are also single-use and must be changed after use or the completion of a task. They should not be worn as a substitute for washing your hands.
Masks, visors or eye protection must be worn during Aerosol Generating Procedures or if it is likely that bodily fluids will splash into the face or eyes. They should also always be worn by scrubbed members of the surgical team for all surgical procedures and must not be touched when on your face.
Finally, surgical gowns are a type of PPE that must also be worn by scrubbed members of the operating theatre surgical team or for certain catheter procedures and spinal, epidural and caudal procedures.
As part of the principles of infection control, PPE needs to be removed in a specific order to prevent cross-contamination. This starts with gloves, then an apron or gown, and then eye and face protection (if worn).
Care equipment refers to any single-use medical equipment, surgical instruments, equipment that can be used repeatedly on the same patient, or other equipment like trolleys, commodes or mobility aids. This needs to be cleaned after contamination from any potentially infectious substance or disposed of if it is single-use.
Decontamination procedures for multi-use equipment need to be followed, ensuring that equipment remains safe for use and has been properly cleaned and dried before being used again.
The management of the care environment is a key aspect of infection control standard precautions. This refers to the entire area or building where care or medical work is taking place.
Environmental cleanliness and maintenance are part of keeping the care environment safe. This begins by ensuring that the space is visibly clean and doesn't have non-essential items in it which may impact effective cleaning.
All care environments must be routinely cleaned in line with official specifications. If any potentially hazardous substances are spilt in a care environment, these must be cleaned up immediately using appropriate equipment and products to ensure the environment remains sterile.
In a care setting, linen refers to any fabric used as bedding or the clothes that patients wear whilst they are there. This can easily be contaminated with infectious substances and therefore is an important aspect of the standard precautions for infection control.
Washed linen must be stored in a clean and enclosed space, ideally a cupboard or a private room. If this is not possible, a covered trolley or a trolley with doors can be used, but clean linen should never be left on open trolleys unless it is about to be used.
Dry linen that has been used on uninfected patients should be disposed of in a laundry receptacle. Used linen may be stored in laundry bags before being washed, which should only be kept ⅔ full and always tied and labelled before transporting them elsewhere.
Soiled linen is the term used to describe any linen that is contaminated with blood or bodily fluids or which has been used by a patient thought to be infectious. This must be placed in a water-soluble inner bag and a plastic outer bag before being securely closed and placed in a laundry receptacle.
Any linen awaiting cleaning must be stored in a secure area that is not accessible by the public. Staff should always wear relevant PPE when handling used or soiled linen and always wash their hands with soap and water afterwards.
Personal laundry should ideally be given to a patient’s carer or relative to be safely washed at home, following guidance given by the care setting. If a patient’s personal laundry needs to be washed in the care setting, it must be done separately from any other patient’s personal laundry.
The safe management of spilt infectious substances mainly focuses on blood and bodily fluids. As part of standard infection control precautions, any spillages must be cleared and decontaminated by staff that have been trained in the official procedures to do this.
Waste from care settings has the potential to be an infectious hazard. Therefore, it must be disposed of following the appropriate instructions depending on the nature of the waste.
There are specific guidelines for different substances, but in general infectious waste must be disposed of immediately and as close to the point of use as possible, away from the patient, into the correctly coloured waste bag and in a bag that has been sealed following correct instructions. This waste must be disposed of in an appropriate container, which needs to be kept secure.
Finally, the last of the ten standard precautions for infection control focuses on ‘sharps’ waste, which refers to any used medical equipment that has the potential to puncture or cut the skin. This presents an extremely high infection risk, so needs to be disposed of very carefully.
The Health and Safety (Sharp Instruments in Healthcare) Regulations (2013) contain all of the official instructions for how sharps need to be handled and disposed of in a care setting. Staff are responsible for the sharps waste they generate and must dispose of and label this waste in the correct boxes, store these waste containers in a safe place and always dispose of these containers after 3 months.
SICP is the acronym that stands for standard infection control precautions. It’s used instead of the full term to save time when referred to in medical environments and is also often used in official documentation.
Standard infection control precautions are a widely recognised list of actions that help to prevent the spread of infection, and therefore they appear in a range of different documentation. In England, the 10 different standard precautions for infection control are described in the National Hand Hygiene and Personal Protective Equipment Policy, which is available to view here.
Standard precautions prevent the spread of infection because they ensure that everyone working in a setting where infectious pathogens may be present is following the same set of health and safety guidelines. This ensures that high levels of hygiene are being upheld and transmission is kept to a minimum no matter where you are, preventing infection or ensuring that it doesn’t spread very far.
If you work in a care environment then understanding the 10 principles of infection control is an essential part of maintaining high health and safety standards and keeping yourself and your patients safe. These procedures have been developed after plenty of research into the best ways to prevent the spread of infection, so adhering to them and learning them is a key part of ensuring that infection control standards are met.
If you work in a care setting and would like to learn more about infection control, our online course ‘An Introduction to Infection Prevention and Control’ contains even more useful information. We also offer training courses in ‘Statutory & Mandatory Training: Infection Prevention & Control (Clinical)’ and ‘Statutory & Mandatory Training: Infection Prevention & Control (Non-Clinical)’.