26.1.1  Why are universal precautions needed?

Universal precautions were developed because it is not possible to identify all patients with blood-borne diseases caused by microorganisms. With many of the patients you are looking after, there is no risk of HIV transmission. So, it is not appropriate to routinely test every health worker or patient for HIV. However, increased risks are faced by healthcare workers when providing care to HIV-positive patients, or those infected with other blood-borne agents such as the hepatitis virus. It was in response to such concerns that UPs were developed — the term ‘universal’ reflects the fact that they are intended to refer to contact with all patients, not just those known to have blood-borne infections.

UPs are designed to provide for the safe handling of infectious material, including amniotic fluid, cerebrospinal fluid, pleural fluid, abdominal fluid, serum, semen, vaginal fluids, blood and blood-tainted body fluids. As part of this process, barriers to infection were developed, such as gloves, gowns, masks and eye goggles to protect health workers from splashes or sprinkles of infectious materials. The procedures summarised below are designed to keep all healthcare workers safe, and to protect the public against infectious waste material that could pose a risk to them. Safety involves not just patient contact, but the management of the environment in which the patient is situated. Note that, with universal precautions, everyone is considered infectious, since it is impossible to tell ahead of time who is infected and who is not.