Precautions: standard and transmission-based

Standard precautions

Standard precautions are the work practices required to achieve a basic level of infection prevention and control. The World Health Organization’s Standard precautions in health care  are the minimum infection prevention and control practices that health care workers must use  at all times for all patients in all situations. This helps to protect health care workers from infection and prevents infection from spreading between patients.  

Standard precautions apply to all patients regardless of their diagnosis or presumed infection status. Health care workers must use standard precautions when handling: 

• blood (including dried blood) 
• all other body fluids and substances (except sweat), whether or not they contain visible blood 
• non-intact skin 
• mucous membranes. 

Standard precautions consist of the following practices: 

• hand hygiene before and after all patient contact 
• the use of personal protective equipment, which may include gloves, impermeable gowns, plastic aprons, masks, face shields and eye protection 
• the safe use and disposal of sharps 
• the use of aseptic technique for all invasive procedures, including appropriate use of skin disinfectants 
• reprocessing of reusable instruments and equipment 
• routine environmental cleaning 
• waste management 
• respiratory hygiene and cough etiquette 
• appropriate handling of linen. 

Transmission-based precautions

Transmission-based precautions are the second tier of basic infection prevention and control. Health care workers must use them when using standard precautions alone is not sufficient to prevent the spread of an infectious agent.

Transmission-based precautions vary depending on the mode of transmission of the infectious agent. The principal routes of transmission are through direct or indirect contact, via infectious aerosols – either large droplets or smaller airborne particles – or vector-borne.

Refer to the Centers for Disease Control and Prevention resources on transmission-based precautions.

Ministry of Health guidelines for specific diseases and conditions requiring transmission-based precautions

• Infection Prevention & Control and Management of Carbapenemase-producing Enterobacteriaceae (CPE)  
• Guidelines for the Control of Methicillin-resistant Staphylococcus Aureus in New Zealand 
• Guidelines for the Control of Multidrug-resistant Organisms in New Zealand 
• Guidelines for the Management of Norovirus Outbreaks in Hospitals and Elderly Care Institutions 
• Measures for the Prevention and Control of Clostridium difficile Infection: Guidance to the health sector