Prevent Transmission of HIV in Hospitals: Adopt Universal Precautions

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Dr Versha Prasad, Dr Praveen Katiyar


Obligation of establishments to provide safe working environment. —Every establishment, engaged in the healthcare services and every such other establishment where there is a significant risk of occupational exposure to HIV, shall, for the purpose of ensuring safe working environment, —(i) provide, in accordance with the guidelines, —(a) Universal Precautions to all persons working in such establishment who may be occupationally exposed to HIV; and (b) training for the use of such Universal Precautions; (c) Post Exposure Prophylaxis to all persons working in such establishment who may be occupationally exposed to HIV or AIDS; and (ii) inform and educate all persons working in the establishment of the availability of Universal Precautions and Post Exposure Prophylaxis. Health Care Personnel and Exposure The definitions of HCP and occupational exposures are unchanged from those used in 2001 and 2005. (5, 6) The term HCP refers to all paid and unpaid persons working in healthcare settings who have the potential for exposure to infectious materials including body substances (e.g., blood, tissue, and specific body fluids), contaminated medical supplies and equipment, or contaminated environmental surfaces. HCP might include, but are not limited to, emergency medical service personnel, dental personnel, laboratory personnel, autopsy personnel, nurses, nursing assistants, physicians, technicians, therapists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care but potentially exposed to blood and body fluids (e.g., clerical, dietary, housekeeping, security, maintenance, and volunteer personnel). Recommendations for the Management of HCP Potentially Exposed to HIV Exposure prevention remains the primary strategy for reducing occupational blood borne pathogen infections. However, when occupational exposures do occur, PEP remains an important element of exposure management. HIV PEP The recommendations provided in this report apply to situations in which a healthcare provider has been exposed to a source person who either has, or there is a reasonable suspicion of, HIV infection. For Prevention and control A two-tiered approach to precautions is used to interrupt the mode of transmission of infectious agents.  Standard precautions: these refer to work practices that are applied to all patients receiving care in health facilities, regardless of their diagnosis or presumed infectious status so as to minimize the risk of transmission of infectious agents in all situations. Standard precautions minimize the likelihood of transmission of infectious agents between HCWs and patients, and from patient to patient. Transmission-based precautions: Transmission-based precautions are precautions required to be taken based on the route of transmission of organisms like contact precautions, airborne precautions, etc. If successfully implemented, standard and transmission-based precautions prevent any infection from being transmitted.


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