TABLE 1
HISTORY OF PRECAUTIONS Year Document Issued Description
1970 Isolation Technique in Hospitals CDC published- Guide for Hospitals
1975 |
Manual revised |
Introduced seven isolation precaution categories with color-coded cards : Strict , Respiratory , Protective , Enteric , Wound and Skin , Discharge , and Blood : No user decision-making required . Simplicity a strength ; over isolation prescribed for some infections |
1983 CDC Guidelines for Hosp . Isolation replaced previous manual
Provided two systems for isolation : category-specific and disease-specific - Protective Isolation eliminated ; Blood Precautions expanded to include Body Fluids - Categories included Strict , Contact , Respiratory , AFB , Enteric , Drainage / Secretion , Blood and Body Fluids . Emphasized decision-making by users
1985-1988 |
Universal Precautions |
Developed in response to HIV / AIDS epidemic . Dictated application of Blood and Body Fluid precautions to all patients , regardless of infection status . Did not apply to feces , nasal secretions , sputum , sweat , tears , urine , or vomitus unless contaminated by visible blood . - Added personal protective equipment to protect health care workers from mucous membrane exposures . Handwashing recommended immediately after glove removal . Added specific recommendations for handling needles and other sharp devices ; concept became integral to OSHA ’ s 1991 rule on occupational exposure to bloodborne pathogens in healthcare settings |
1987 |
Body Substance Isolation |
BSI focused on the isolation of all moist and potentially infectious body substances from all patients , regardless of their presumed infection status , primarily through the use of gloves . The airborne route of transmission was introduced and nurses would determine use of masks . Shared some features with Universal Precautions . Weak on infections transmitted by large droplets or by contact with dry surfaces . Did not emphasize need for special ventilation to contain airborne infections . Handwashing after glove removal not specified in the absence of visible soiling |
Early 1990 ’ s |
Standard Precautions |
As a result of confusion related to UP and BSI , isolation practices were overhauled and an “ enhanced ” set of precautions called standard precautions , were designed to reduce the risk of transmission of bloodborne and other pathogens in hospitals . In conjunction with standard precautions , transmission-based precautions were introduced to reduce the risk of airborne , droplet , and contact transmission in hospitals . |
1991 OSHA Bloodborne Pathogen Rule Focus on protecting healthcare workers
1996 Guideline for Isolation Precautions in Hospitals
2007 Guideline for Isolation Precautions : Preventing Transmission of Infectious Agents in Healthcare Settings ( 2007 )
2012 & updated in 2016
“ Guide to Infection Prevention for Outpatient Settings : Minimum Expectations For Safe Care ”
Prepared by the Healthcare Infection Control Practices Advisory Committee ( HICPAC ). Melded major features of Universal Precautions and Body Substance Isolation into Standard Precautions to be used with all patients at all times . Included three transmission-based precaution categories : airborne , droplet , and contact . Listed clinical syndromes that should dictate use of empiric isolation until an etiological diagnosis is established
Updates and expands the 1996 Guideline for Isolation Precautions in Hospitals . Reasons for updates : Transition of healthcare delivery from hospitals toother healthcare settings ; Nosocomial infections became healthcare-associated infections ( HAIs ); emergence of new pathogens ; Standard Precautions expanded to include respiratory hygiene / cough etiquette and safe injection practices ; Increased focus on environmental controls and protective environment ; administrative involvement in development and support of Infection control programs ; Increased HAIs and MDROs
It includes a comprehensive list of practices including hand hygiene , PPE , injection safety ( if applicable ), respiratory hygiene / cough etiquette , point-of-care testing ( if applicable ) and environmental cleaning . In addition , device reprocessing is also addressed as many outpatient facilities including surgery centers , are providing services that include the need to reprocess reusable patient care items .
2019 |
Enhanced Barrier Precautions |
“ Require gown and glove use for certain residents during specific high-contact |
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resident care activities that have been found to increase risk for MDRO transmission ,” |
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according to the CDC . |
2020-2021 Temporary revisions based on COVID -19 Extended use of PPE , use of facemasks and gowns which were in poor supply
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