CLINICAL GUIDELINES - UNIVERSAL PRECAUTIONS FOR THE PREVENTION OF HIVAND HBV INFECTION IN HEALTH-CARE SETTINGS

Objective. To outline the principles guiding the deliberate actions th at should be taken in health care settings to prevent the spread of pa thogens, especially HIV and hepatitis B virus (HBV), to patients and h ealth care workers (HCWs). Outcomes. Universal precautions should be i mplemented in all health care settings. Evidence. Based on similar int ernational recommendations. Values. An adaptation of an existing guide line, it was sent to 87 organisations for comment. The comments receiv ed were included where possible in this guideline. It is the right of HCWs and patients to be protected from nosocomial HIV and HBV infectio n. Benefits, harms and costs. The prevention of costly HIV and HBV inf ection by simple, rational precautions in the health care setting. The cost to the health care system has not been measured. The cost to ind ividual patients or HCWs who acquire either infection is inestimable. Recommendations. The guideline recommends that the four basic elements of universal precautions be implemented appropriately in all health c are settings: (i) body fluids should be handled with the same precauti ons as blood; (ii) avoidance of sharps (sharp objects); (iii) avoidanc e of skin or mucous membrane contamination; (iv) cleaning/disinfecting /sterilising. Validation. The draft guideline was subjected to extensi ve external review by specialist, generalist and health professional g roups. These included HIV activist groups. There were no major dispute s about the content. The most important amendment to the draft guideli ne is the inclusion of HBV and other related pathogens together with t he HIV. Development and funding. The Medical Association of South Afri ca Committee for Science and Education. Endorsements. The MASA and twe nty national health care organisations and three provincial health aut horities (see list at end of document).