Infection Control Dr: Shereen Elshayp

The general objective of these guidelines is to provide administrators and

health care workers with the tools to enable them to implement the infection

control programme effectively in order to protect themselves and others

from the transmission of infections.

  • The specific objectives of these guidelines are to provide directions and information in relation to:
  • Facilities, equipment, and procedures necessary to implement standard precautions for control of infections
  • Cleaning, disinfecting and reprocessing of reusable equipment

Standard Precautions

Chain of infection

The chain of infection represents the transmission of microorganisms and subsequent infection within a health care setting, with each link in the chain representing a factor related to the spread of microorganisms.

Transmission occurs when the agent in the reservoir exits the reservoir through a portal of exit, travels via a mode of transmission and gains entry through a portal of entry to a susceptible host.

The strategies that will decrease exposure risk and prevent the transmission of microorganisms.are based on:

  1. client/patient/resident infection status (including colonization)

2.characteristics of the client/patient/resident

3.type of care activities to be performed

4.resources available for control

5.HCP’s immune status

Risks are assessed for

  • Contamination of skin or clothing by microorganisms in the client/patient/resident environment
  • Exposure to blood, body fluids, secretions, excretions, tissues exposure to non intact skin
  • exposure to mucous membranes

Rationale for Standard Precautions

Standard Precautions are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is delivered. These practices are designed to both protect healthcare personnel (HCPs) and prevent HCPs from spreading infections among patients.

Hand Hygiene

The practice of good hand hygiene, either by use of alcohol based hand rubs or handwashing with soap and water, is critical to reduce the risk of transmission of infections.

The use of soap and water is recommended when hands are visibly soiled (e.g.blood, body fluids), or after caring for patients with known or suspected infectious diarrhea (e.g. Clostridium difficile, norovirus). Otherwise, the preferred method of hand decontamination is with an alcohol based hand rub as recommended by the CDC and the World Health Organization (WHO) because of its enhanced activity against a broad spectrum of epidemiologically important pathogens. Additionally, it increases compliance with recommended hand hygiene practices as it requires less time in cleaning the hands (20-30 seconds versus 2 mins).

Safe injection practices

A sharps injury prevention program must be in place in all health care settings.This should include follow up for exposure to blood borne pathogens.

Precautions are to be taken to prevent injuries when handling needles, scalpels and other sharp instruments, devices during procedures, cleaning process and disposal:

  • Do not recap used needle.
  • Dispose used needles and syringes as one unit.
  • Do not remove, bend, manipulate or break a used needle by hand.
  • Discard all sharps into an appropriate puncture resistant sharp disposal container.
  • Contaminated instruments should be placed in a puncture resistant container when transporting to the reprocessing area.
  • Treat all specimens as potentially infectious.Place them in appropriate containers and into a biohazard specimen bag to prevent potential spillage and transmission of pathogens.
  • In event of blood or body fluid spills:Pour chlorine based disinfectant (e.g. NaDCC granules or solution) over blood or body fluid spills. It should achieve 10,000ppm chlorine.
  • Wear gloves and use paper towels to clean up blood and body fluids spills .Dispose them into a biohazard bag and mop the area with institution recommended disinfectant
Personal Protective Equipment

This refers to wearable equipment that is intended to protect HCPs from exposure to or contact with infectious agents. These include gloves, gowns,facemasks, respirators, goggles and face shields. The selection of PPE is based on the nature of the patient interaction and potential for exposure to blood, body fluids or infectious agents.

Personal protective equipment includes:

  • gloves
  • protective eye wear (goggles);
  • mask;
  • apron;
  • gown;
  • boots/shoe covers; and cap/hair cover
  • Wear gloves (clean, non-sterile) when touching blood, body fluids, secretions, excretions or mucous membranes.
  • Change gloves between contacts with different patients.
  • Remove gloves immediately after use and before attending to another patient.
  • Wash hands immediately after removing gloves.
  • Use a plain soap, antimicrobial agent or waterless antiseptic agent.
  • Disposable gloves should not be reused but should be disposed of according to the health care facility protocol.

Gown

Wear a gown (clean, non-sterile) to protect the skin and prevent soiling of clothing during procedures that are likely to generate splashes of blood,body fluids secretions or excretions. Impermeable gowns are preferable.Remove a soiled or wet gown as soon as possible.A plastic apron may be worn on top of the gown to protect exposure toblood, body fluids, secretions and excretions.Launder gowns and aprons appropriately if they are reusable, accordingto the hospital guidelines.Do not reuse disposable gowns and aprons. They should be disposed of according to the health care facility protocol.

Caps and boots/shoe covers

Shoe covers

Wear caps and boots/shoe covers where there is a likelihood the patient’s blood, body fluids, secretions or excretions may splash, spill or leak onto the hair or shoes.

Launder caps and shoe covers appropriately if they are reusable, accordingto the hospital guidelines.

Do not reuse disposable caps/shoe covers. They should be discarded according to the health care facility protocol.

Clean and disinfect reusable boots.

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