Download Standard Precautions - Training and Assessment Materials Australia

INFECTION CONTROL
HLTIN301C
Comply with infection control policies and procedures
What are Infectious Diseases?
• disorders caused by organisms
–
–
–
–
Bacteria
Viruses
Fungi
Parasites
• Can be passed (transmitted) by
–
–
–
–
Person to person
bites from insects or animals
ingesting contaminated food or water
Needles (sharps) or other exposures in the environment.
• Signs and symptoms vary, but often include fever and
chills
Duty of Care
• If you do not adhere to infection control policy
and procedure you have the potential to harm
patient/clients, staff and customers
• Who is responsible?
– Employers
– Persons in control of a workplace
– Self-employed persons
– Employees
– Manufacturers, Importers and Suppliers
Duty of Care
• Take all reasonably practicable steps to
protect the health, safety and welfare at
work of the employer’s employees and
third parties
• Provide and maintain
– A safe work environment
– Safe systems of work
Duty of Care
• Use equipment in accordance with
instruction, consistent with its safe and
proper use
• Not create or increase risk to another
person
• Cooperate to extent necessary to enable
one to fulfil duty
Workplace Health & Safety (WHS)
Legislation
• depends on State and Territory Legislation and
requirements
• common law duties to meet the general duty of
care requirements
• requirements for the maintenance and
confidentiality of records of occupational injury
and disease
• provision of information, induction and training
• regulations and approved codes of practice
relating to hazards present in work area
• health and safety representatives and health
and safety committees
• prompt resolution of health and safety issues
Standard Precautions
• Aseptic technique
– Procedure used to prevent the spread of
infection
– Goal is to make the environment free of
harmful micro-organisms
– Practices usually set by each healthcare
setting (e.g., clinics, surgery rooms, etc.)
Standard Precautions
• Minimising contamination
– Protecting materials, equipment and instruments
from contamination until required for use
– Ensuring instruments used for invasive procedures
are sterile at time of use
– Cleaning all environmental surfaces
Standard Precautions
• Techniques to minimise contamination
–
–
–
–
Personal hygiene practices
Personal protective equipment
Routine environmental cleaning
Transmission-based precautions
• Contact precautions
• Droplet precautions
• Airborne precautions
– Good reference: Clinical educators guide for the
prevention and control of infection in healthcare
(NHMRC, 2010)
• Surface cleaning and management of blood and
body fluid spills
Standard Precautions
• Personal hygiene practices especially washing
and drying hands (eg. before and after client
contact)
– Hand hygiene must be performed before and after
every episode of patient contact. This includes:
•
•
•
•
•
before touching a patient;
before a procedure;
after a procedure or body substance exposure risk;
after touching a patient; and
after touching a patient’s surroundings.
– Hand hygiene must also be performed after the
removal of gloves.
Standard Precautions
• Use of personal protective equipment
– Specialised clothing or equipment worn for
protection against infectious materials
• Gloves (most common) that comply with current
Australian/New Zealand standards
– Be aware of guidelines for latex allergic clients and staff
• Aprons and gowns that comply with Australian/New
Zealand standards
• Face shields
• Protective eyewear e.g., goggles, glasses
• Masks and respirators
• Footwear to protect from dropped sharps and other
contaminated items
Standard Precautions
• Cleaning Procedures
– Damp dusting benches, equipment and shelving
– Maintaining the interior of drawers and cupboards
in a clean and tidy state
– Cleaning floors daily using a mop and water and
detergent
– Storing cleaning equipment clean and dry
– Managing the removal of a small blood or body
fluid spill
Standard Precautions
Sharps
• 70% of needlestick / sharps injuries are
preventable.
– The main reasons recapping needles, manipulation of
needles, or incorrect disposal of needles.
• Safe handling of sharps
– Assemble all equipment required for the procedure to
be performed.
– Minimise distractions
– Use equipment strictly according to protocols and
only for the purpose for which it was designed.
– Choose the safest equipment available. T
– Practice with new equipment so it can be used safely.
Standard Precautions
Sharps
• Safe disposal of sharps and other clinical waste
– Any used syringe could be contaminated and should be disposed
– using a yellow receptacle.
– Ensure sufficient sharps’ containers or suitable yellow biohazard bins
are available in all areas where syringes are likely to be used or
disposed of.
– Ensure that sharps containers are puncture resistant, moisture-proof,
shatterproof, capable of being sealed and able to withstand heavy
handling.
– Containers must conform to Australian Standard (AS) 4031 Nonreusable containers for the collection of sharp medical items used in
health care areas.
• Appropriate reprocessing and storage of reusable instruments
– Reusable sharps must be placed immediately after use in a punctureresistant sharps container specially kept for that purpose
– When more than one reusable sharp is carried in a container special
care is required during placement and removal of sharps
Standard Precautions
General Waste
• Discard general waster via a small bin
lined with plastic, mounted on the wall or
on a bench
• The usual waste paper bin under the desk
can be used for waste not contaminated
by blood or body fluids.
Standard Precautions
MRSA
• Methicillin-resistant Staphylococcus aureus
(MRSA) Infections
– bacteria that is resistant to many antibiotics
• In the community, most MRSA infections are
skin infections. I
• In medical facilities, MRSA causes lifethreatening bloodstream infections, pneumonia
and surgical site infections.
– The Centers for Disease Control and
Prevention (USA) has fantastic resources at
preventing MRSA infections
• http://www.cdc.gov/mrsa/
Additional Precautions
• Special ventilation requirements
• Dedicated equipment (eg. to each client or
as appropriate to work function)
• Use of a special facility
Clean Zone
• Storage areas for materials, medicaments,
equipment
• Sterile storage areas
• Administration areas
Contaminated Zone
• Area used for items that have become
contaminated during use
• Receiving area for contaminated
instruments in the instrument reprocessing
centre
Waste
• Clinical waste
– discarded sharps;
– laboratory and associated waste directly involved in specimen
processing;
– human tissues (but excluding hair, teeth, urine and faeces);
– materials or solutions containing free flowing or expressible
blood and animal tissues or carcasses used in research
• Related waste
– includes cytotoxic waste, pharmaceutical waste, chemical
waste and radioactive waste
• General waste
– includes all waste materials that do not fall into the clinical or
related waste categories.
Disposal of Waste Requirements
• Disposal in accordance with:
 Environment Protection (Waste Management) Policy
 Environment Protection (Waste Management)
Regulations
 Australian and New Zealand standards
 Organisation policies and procedures
Clean zone
• Storage areas for materials, medicaments,
equipment
• Sterile storage areas
• Administration areas
Contaminated Zone
• Area used for items that have become
contaminated during use
• Receiving area for contaminated
instruments in the instrument reprocessing
centre
Waste
• Clinical waste
– discarded sharps;
– laboratory and associated waste directly involved in specimen
processing;
– human tissues (but excluding hair, teeth, urine and faeces);
– materials or solutions containing free flowing or expressible
blood and animal tissues or carcasses used in research
• Related waste
– includes cytotoxic waste, pharmaceutical waste, chemical
waste and radioactive waste
• General waste
– includes all waste materials that do not fall into the clinical or
related waste categories.
Disposal of Waste Requirements
• Disposal in accordance with:
 Environment Protection (Waste Management) Policy
 Environment Protection (Waste Management)
Regulations
 Australian and New Zealand standards
 Organisation policies and procedures
Infection Risks
• Contact with waste materials
• Inhalation of aerosols
• Contact with blood and other body
substances
• Personal contact with infectious materials,
substances and/or clients
• Stock including food which has passed
'use-by' dates
• Animals, insects and vermin
Procedures for Risk Control
• Eliminating a hazardous process
• Using personal protective equipment
appropriately
• Changing a system of work to reduce a hazard.
• Isolating the hazard
• Using protective devices to decrease exposure
• Using safe handling techniques
• Following infection control policies and
procedures
• Procedures to minimise the risk of exposure to
blood and body fluids
Protocols for care following
exposure to blood / body fluids
• Immediate care following:
– A sharps injury
– A splash of blood or other body fluids
– Post exposure care
– Record keeping and notification
– Legal requirements for the notification of all
work related occurrences of injury, disease or
illness
Hand Hygiene Procedures
(refer to Hand Hygiene Australia http://www.hha.org.au)
• Routine handwash
• Surgical handwash
• Use of antiseptic wipes and alcohol
based preparations in specific situations
where waterless hand hygiene is
acceptable
Routine Hand Wash
• When needed
– Before eating and/or smoking.
– After going to the toilet.
– Before significant contact with patients (eg physical
examination, emptying a drainage reservoir such as a
catheter bag).
– Before injection or venepuncture.
– Before and after routine use of gloves.
– After handling any instruments or equipment soiled
with blood or body substances.
Reference:
http://toolboxes.flexiblelearning.net.au/demosites/series7/702/content/lr_hygiene/006_routine_wash.html
Routine Hand Wash
• Washing technique
– Remove jewellery.
– Method 1 - Essential if hands are soiled
• Wet hands thoroughly and lather vigorously using neutral pH liquid
handwash.
• Rinse under running water.
• Do not touch taps with clean hands - if elbow or foot controls are not
available, use paper towel to turn taps off.
– Method 2 - Permissible only if hands are not soiled
• Apply sufficient alcohol rub or gel into the palm of the hand to enable
rubbing for 10 - 15 seconds.
• Rub this over all surfaces of both hands for 10 - 15 seconds.
• Drying
– Pat dry using paper towel, clean cloth towel, or a fresh portion of a roller
towel.
Reference:
http://toolboxes.flexiblelearning.net.au/demosites/series7/702/content/lr_hygiene/006_routine_wash.html
Surgical Hand Wash
• A five minute scrub which includes cleaning of the fingernails is
to be undertaken as the first scrub of the day
• Subsequent scrubs of three minutes duration (which omit the
fingernails) are undertaken between cases
• Hands are kept higher than the elbows at all times to allow water
to run in one direction only – from clean to dirty (hands to
elbows)
• The bristles of the nail brush are used to clean the fingernails
only
• Arms are washed in a circular motion, from the hands to the
elbows without returning to the hands
• The antimicrobial soap used for the first scrub of the day should
continue to be used for subsequent scrubs
Reference:
http://www.health.qld.gov.au/qhpolicy/docs/gdl/qh-gdl-321-1-1.pdf
Hand Care
• Use suitable water-based hand creams
that are registered on the Australian
Register of Therapeutic Goods
• Use warm water for handwashing
• Dry hands thoroughly after handwashing
• Wear heavy-duty utility gloves when
handling irritant chemicals