What are standard infection control precautions?
Standard infection control precautions, often shortened to SICPs, are the everyday practices that stop infections spreading in health and care settings. They apply to all patients at all times, because anyone can carry an infection without symptoms.
In England, the National Infection Prevention and Control Manual (NIPCM), published by NHS England, sets out expected practice for NHS settings and is recommended for other care settings. It is based on the Scottish manual, which uses the same ten SICPs. Registered providers must also meet the Health and Social Care Act 2008 Code of Practice on the prevention and control of infections, which the Care Quality Commission uses when assessing services.
Transmission-based precautions, such as isolation for norovirus or tuberculosis, are added on top of SICPs when an infection is known or suspected. They never replace them.
What are the 10 SICPs?
| SICP | What it means in practice |
|---|---|
| 1. Patient placement and assessment for infection risk | Assess every patient on arrival and during their stay; isolate promptly if they have diarrhoea, vomiting, fever, rash or respiratory symptoms, following local policy |
| 2. Hand hygiene | Right method, at the right moments, with bare below the elbows |
| 3. Respiratory and cough hygiene | Tissues, catch it, bin it, clean hands; offer a mask to symptomatic patients where safe and tolerated |
| 4. Personal protective equipment | Choose PPE based on the task and likely exposure |
| 5. Safe management of care equipment | Clean shared equipment between patients and when soiled; never reuse single-use items |
| 6. Safe management of the care environment | Keep the environment clean, uncluttered and in good repair |
| 7. Safe management of linen | Do not shake linen; bag at the bedside; infectious linen in a water-soluble bag |
| 8. Blood and body fluid spillages | Deal with spills promptly using the correct spill kit and products |
| 9. Safe disposal of waste, including sharps | Segregate at source into the right stream; do not overfill bags or sharps bins |
| 10. Occupational safety, including sharps | Prevent exposures, report every sharps injury or splash, and get advice urgently |
When should you clean your hands? The five moments
The World Health Organization's five moments for hand hygiene are used throughout the NHS. They are built around the patient zone: the patient and their immediate surroundings.
- Before touching a patient: For example before taking a pulse or helping someone move. This protects the patient.
- Before a clean or aseptic procedure: For example before handling a cannula, preparing an injection or dressing a wound.
- After body fluid exposure risk: For example after taking blood, emptying a catheter bag or removing gloves.
- After touching a patient: For example after an examination or personal care.
- After touching the patient's surroundings: Even if you did not touch the patient, for example after moving the bedside table or touching the bed rail.
Hand gel or soap and water?
Alcohol-based hand rub is the routine choice when hands are visibly clean. It is fast, effective and kinder to skin. Use soap and water instead when hands are visibly dirty or may be contaminated with blood or body fluids, and when caring for patients with vomiting or diarrhoea or suspected or known gastrointestinal infection such as norovirus or C. difficile, because alcohol rub does not reliably kill spores.
- Commonly missed areas are thumbs, fingertips and the backs of the hands.
- Rub until completely dry before putting on gloves.
- Look after your skin with the emollient provided; see occupational health if you develop dermatitis.
- Bare below the elbows in clinical areas: short sleeves, no wrist watch or bracelets, a plain band ring only, short nails with no varnish or extensions. Follow local uniform policy, including adjustments for religious and cultural needs.
Which PPE do you need, and when?
Choose PPE by assessing the task: how likely you are to be exposed to blood, body fluids, secretions or excretions, and how the infection, if known, spreads.
| Item | Use it when |
|---|---|
| Disposable gloves | Contact with blood, body fluids, mucous membranes or broken skin is expected. Change between patients and between tasks. |
| Disposable apron | Your uniform may be contaminated during close contact, such as personal care. Change between patients. |
| Fluid-resistant gown | Extensive splashing is likely, or transmission-based precautions require it. |
| Fluid-resistant surgical mask | Splashing or spraying to the nose and mouth is expected, or for droplet precautions. |
| Eye or face protection | Splashing or spraying of blood or body fluids towards the eyes is expected. |
| FFP3 respirator | Airborne precautions and aerosol-generating procedures where current guidance requires. You must be fit-tested for that model and do a fit check each time. |
A healthcare assistant wears the same pair of gloves to help one patient to the toilet, adjust another patient's pillow and then take a third patient's blood pressure, cleaning her gloved hands with gel between patients.
She removes her gloves and apron after helping the first patient, cleans her hands with soap and water because the patient has diarrhoea, and uses hand rub before and after touching each of the other patients. Gloves are only worn again when contact with body fluids is expected.
What should you do after a needlestick or splash injury?
Sharps injuries and splashes can transmit blood-borne viruses, including hepatitis B, hepatitis C and HIV. The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 require employers to use safer sharps where reasonably practicable and to provide sharps containers close to where sharps are used. Never recap needles, and dispose of sharps yourself, at the point of use, straight after use.
- Encourage bleeding: Gently encourage the wound to bleed, ideally under running water. Do not suck or scrub it.
- Wash: Wash with soap and running water. For splashes to the eyes, nose or mouth, rinse thoroughly with water, removing contact lenses first.
- Cover: Dry the wound and cover it with a waterproof dressing.
- Report and get advice urgently: Tell your manager and contact occupational health straight away, or the emergency department out of hours. If post-exposure prophylaxis is needed, it works best when started as soon as possible.
- Source patient: Another clinician, not you, should assess the source patient's risk and seek consent for testing according to local policy.
- Record: Complete an incident report so the cause can be reviewed.
Staff who may be exposed to blood should be offered hepatitis B vaccination and a check of their response by occupational health. Keep your own immunisations up to date.
Equipment, linen, spills and waste: getting the basics right
- Clean reusable equipment, such as blood pressure cuffs, stethoscopes and commodes, between every patient and whenever soiled, using the products and method your policy specifies. Many wards use a 'clean' label system.
- Handle used linen with minimal movement, bag it at the bedside and never put it on the floor. Infectious or soiled linen goes in a water-soluble bag inside the correct outer bag.
- Deal with blood and body fluid spills promptly using the right spill kit and products, wearing appropriate PPE.
- Segregate waste at source into the correct colour-coded stream. Do not overfill bags. Close sharps bins at the fill line and lock them temporarily when not in use.
- Review invasive devices such as cannulas and catheters every day, and remove them as soon as they are no longer needed.
On a care of older people ward, Grace, a staff nurse, notices that two patients in the same bay developed sudden vomiting and diarrhoea overnight, and a healthcare assistant who worked there yesterday has called in sick with the same symptoms. Neither patient had these symptoms on admission. Grace recognises a possible outbreak. She isolates the patients where possible, starts contact precautions with gloves and aprons and soap and water hand hygiene, informs the nurse in charge and the infection prevention and control team, sends stool samples, starts a symptom chart and requests enhanced cleaning. Staff with symptoms are advised to stay off work until they have been symptom-free for at least 48 hours, in line with occupational health policy. Visitors are told what is happening and why.
Common IPC mistakes and how to avoid them
| Mistake | Why it matters | Better practice |
|---|---|---|
| Forgetting moment 5 | Bed rails and tables carry organisms to the next patient | Clean hands after touching the patient's surroundings |
| Using hand gel for C. difficile | Alcohol does not reliably kill spores | Soap and water for diarrhoea and suspected GI infection |
| Wearing PPE in corridors | Spreads contamination beyond the patient zone | Remove PPE in the correct order before leaving the area |
| Overfilled sharps bins | Increases the risk of needlestick injury | Close at the fill line and replace |
| Keeping a cannula 'just in case' | Every day in place raises infection risk | Review daily and remove when not needed |
| Waiting for a lab result before isolating | Allows spread in the meantime | Start precautions as soon as infection is suspected |
Recommendations for specific organisms change over time. Always check the current NIPCM and your local IPC policy, and ask your IPC team for advice about a particular case. Scotland, Wales and Northern Ireland have their own national guidance.
Developing your infection prevention practice
Infection prevention is part of every clinical role, not just the IPC team's. Reflecting on a near miss, an audit result or an outbreak you were involved in makes useful CPD evidence.
Our Infection Prevention and Control course covers the chain of infection, the ten SICPs, hand hygiene, PPE, transmission-based precautions, sharps injuries and outbreak recognition, with worked examples and a reflective exercise. It supports, but does not replace, your employer's mandatory IPC training.
Frequently asked questions
What are the 10 standard infection control precautions?
The NIPCM lists: patient placement and assessment for infection risk; hand hygiene; respiratory and cough hygiene; personal protective equipment; safe management of care equipment; safe management of the care environment; safe management of linen; safe management of blood and body fluid spillages; safe disposal of waste including sharps; and occupational safety, including prevention and management of exposures such as sharps injuries.
What is the difference between SICPs and transmission-based precautions?
SICPs are used for every patient, every time, whether or not infection is known. Transmission-based precautions are added on top when a patient has, or is suspected to have, an infection that spreads by contact, droplets or the airborne route. Examples include single rooms, specific PPE such as FFP3 respirators, and dedicated equipment.
When should I use soap and water instead of alcohol gel?
Use soap and water when hands are visibly dirty or may be contaminated with blood or body fluids, and when caring for patients with vomiting or diarrhoea or suspected or known gastrointestinal infection such as norovirus or C. difficile. In other situations, alcohol-based hand rub is the routine choice when hands are visibly clean.
What are the five moments for hand hygiene?
Before touching a patient; before a clean or aseptic procedure; after body fluid exposure risk; after touching a patient; and after touching a patient's surroundings. The five moments come from the World Health Organization and are used across the NHS to show exactly when hand hygiene is needed during care.
What should I do immediately after a needlestick injury?
Encourage the wound to bleed gently under running water without sucking or scrubbing, wash it with soap and water, and cover it with a waterproof dressing. Then report it straight away to your manager and occupational health, or the emergency department out of hours, because post-exposure treatment may be needed quickly. Complete an incident report.
Can I wear a watch or rings on a ward?
Most NHS organisations require staff in clinical areas to be bare below the elbows, which usually means no wrist watches or bracelets and no rings other than a plain band, with short nails and no varnish or extensions. This allows effective hand hygiene. Check your local uniform policy, which may include adjustments for religious or cultural reasons.
Do I need an FFP3 mask for every infectious patient?
No. FFP3 respirators are used for airborne precautions and certain aerosol-generating procedures where current guidance requires them. Many infections need only standard precautions or droplet precautions with a fluid-resistant surgical mask. If you use an FFP3, you must have been fit-tested for that model. Check the NIPCM and local policy.
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Sources and further reading
- National infection prevention and control manual for England. NHS England.
- National Infection Prevention and Control Manual. NHS National Services Scotland.
- Health and Social Care Act 2008: code of practice on the prevention and control of infections. Department of Health and Social Care.
- The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013. Health and Safety Executive.
- WHO guidelines on hand hygiene in health care: five moments. World Health Organization.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.
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