Universal precautions: yes you should actually care.

You hear it constantly. Universal precautions. In fact, you probably hear it so often that you tune out the term. I don’t blame you, I am sure management has beat it into the ground. There is a reason. You have the potential to kill a patient. NO, I am not being melodramatic! What is on your hands actually has the potential to kill your patient. Besides that, you have no idea what the hell your patient has until you test them for it. How many times have you admitted a patient and come back the next day to see them on contact precautions for MRSA? Far more times than you can count I’m sure. You are doing this for them, and you.

So what exactly are universal precautions? Well, according to OSHA it’s the approach to “treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens.” In simple terms, treat ’em like they have something until you know they don’t. Trust me, it’s safer this way.

You know what to do.

  • Treat all bodily fluids as if they are infectious.
  • Gloves on before you touch your patient.
  • Eye shield if you are going to be messing around with the gross body fluids your patient decides to involuntarily share with you.
  • Hand sanitizer going in and out of the room REGARDLESS of whether you have touched the patient or not.
  • Put on that hot ass plastic contact gown when you are going inside a contact room.
  • If you have to share equipment between patients, wipe that shit off before going to the next person.

Let’s imagine you have a fresh transplant patient that is, of course, immunosuppressed. You hear a call bell, and being the fabulous nurse you are, you go and help this other patient that is dying of thirst and needs ice before the world ends. You walk in with the ice, and before you leave you make sure to give him his call-bell that has dropped on the floor. You didn’t feel the need to wear gloves because you were just getting him ice for the 30th fucking time tonight. You don’t hit the hand sanitizer because there wasn’t one beside his room. You go check on your transplant patient. You’re just going in to get a temp and turn them, that’s it. Once again, you skip out on the gloves because it’s just a quick turn. No big deal, right? Then a day later the VRE swab that was sent on ice man when he was admitted comes back positive. Great. You and your coworkers were alllll up in there. Except it gets worse. Your transplant patient is getting sicker, WBC’s are climbing, patient is feverish, now hypotensive. Cultures are drawn and guess who has gotten themselves a VRE infection too? Yay for easily spread bacteria! Despite the best efforts of your team, the transplant patient doesn’t make it. Was it you?

Dramatic, yes. However, shit like this happens. In my current unit we recently had an outbreak of CRE that could be traced back to, among other things, inadequate hand washing from staff. Not something we were proud of. It was totally unnecessary.

Don’t be that person. Don’t be the one that gets another patient sick, or even take something “special” home to the family. You know how to prevent this, keep up the good work.

 

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