Standard or Universal?

My mother is a second career nurse;  she graduated from the Nell Hodgson Woodruff School of Nursing at Emory University in 1983.  I followed her in 1990.  We even shared some of the same professors.  She worked as a medical-surgical nurse until her retirement and  is currently enjoying her third career as an orchard keeper.  I practiced oncology nursing for five years.  After an extended sabbatical to care for my young children, I’m completing both the RN Refresher course and my MLIS.

This week I’ve been studying infection control precautions.  In the 20 plus years since I was last in nursing school there has been a vocabulary shift from “universal” to “standard” precautions.    I remember when “universal precautions” were inconsistently applied to patients who were HIV+.  Doors were labelled “blood & body fluid isolation” and staff members would gown, glove, & mask before entering.  My mother, who also had a master’s degree in microbiology, reviewed the available research and refused to discriminate against her patients this way.  She wore PPE as necessary to prevent exposure to body fluids from all of her patients.

Universal precautions focus was on protecting the health care provider from blood-borne pathogens, implying a linear relationship between blood exposure and infection.  With the shift to standard precautions, an epidemiological model is used to study the complex relationships between host, environment, and agent.  This linguistic change reflects the evolution of clinical practice.

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