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1.2 Standard & Additional Precautions

In 1996, the National Health and Medical Research Council (NHMRC)/Australian National Council on AIDS (ANCA) Infection Control Working Party adopted the terms, 'standard precautions' and, 'additional precautions', to define appropriate work practices, based on modes of transmission of infectious agents.

These precautions are based on the principle that all blood and body substances are potentially infectious. This principle is applied universally to all patients, regardless of their infectious status or perceived risk. High-level protection to patients, HCWs and others should be provided by this two-tiered approach.

Standard Precautions

These are work practices required for the basic level of infection control, and are recommended for the treatment and care of all patients. They include:

hygienic practices, particularly washing and drying hands before and after patient contact
use of protective barriers when necessary, which may include gloves, gowns, plastic aprons, masks, eye shields or goggles
appropriate handling and disposal of sharps and other contaminated or clinical waste
appropriate reprocessing of reusable equipment and instruments
use of aseptic technique
use of environmental controls

The implementation of standard precautions benefits patients as well as Health Care Workers (HCW). Their use minimises the risk of cross-infection from HCW to patient, from patient to HCW, and from patient to patient, even in high-risk situations. They are recommended for the care and treatment of all patients, regardless of their perceived infectious status.

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Additional Precautions

Additional precautions are implemented when standard precautions may be insufficient to prevent transmission of infection.

Additional precautions are recommended for specific patients known, or suspected to be, infected or colonised with disease agents that cause infections in health care settings that cannot be contained by standard precautions alone and can cause infection by the following means:

transmission of respiratory secretions, including:
- airborne transmission (e.g. Mycobacterium tuberculosis, chickenpox)
- droplet transmission (e.g. measles virus, rubella, pertussis, influenza)
contact transmission by contact with patients who may be disseminators of infectious agents of special concern, for example, from:
- open or discharging purulent wounds or skin ulcers infected with Methicillin resistant Staphylococcus aureus (MRSA )
- faecal contamination from carriers of vancomycin-resistant enterococci (VRE)
other disease-specific means of transmission, where standard precautions are not sufficient such as Creutzfeldt-Jakob disease (CJD) and related transmissible spongiform encephalopathies (TSE ).

Additional precautions should be tailored to the particular infectious agent involved and its mode of transmission.

For more information about Standard and Additional Precautions and other Infection Control issues see:

Department of Health and Ageing. Infection control guidelines for the prevention of transmission of infectious diseases in the health care setting. 2004.and your own state and facility's Infection Control policies, guidelines and manuals.

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Last Updated: 10 April 2008
Last Reviewed: 10 April 2009