Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

Infection control in a health care organisation is the prevention of the spread of microorganisms from patient to patient, patient to staff and staff member to patient.

All heath care organisations should have a nominated person or team to ensure that there are infection control policies and procedures in place. Every employee whom has contact with patients or items used in the care of patients is obligated to adhere to the infection control policies and procedure of that organisation.

In many health care facilities of the country sick people are treated or cared for in claustrophobic spaces. Resulting in many microorganisms becoming present. Patients will come into contact with numerous members of the staff who can potentially spread the microorganisms and infections between the patients. The large quantities of waste contaminated with blood and body substances which is handled and processed within the health care setting increases the risk of infection.

There are some legislations involved with infection control to help make infection control work, these legislations are; Health Practitioners (Professional Standards) Act 1999, Workplace Health and Safety Act 1989, Quarantine Act 1908, Nursing Act 1992, Health Service Act 1992 and Health Rights Commission Act 1992.

Majority of infections in health care organisations are caused by microorganisms which in a large part can be spread on hands of people, microorganisms are unable to procreate on clean, dry, inanimate surfaces. Although the environment may occasionally be the source of an outbreak, the function of cleaning in health care organisations is to remove soil, minimise the overall amount of microbes and prevent them from spreading to patients and staff.

Patients being treated in hospitals generally have compromised immune system and virulent diseases, it is very important that all health care organisations are kept sanitary through the practice of sterilization.

Sterilization involves a process that completely destroys all forms of microbial life, including bacteria, viruses and spores. For this to be effective sterilization must forego meticulous cleaning that are mechanical and or manual processes that removes all foreign material from objects before going through the sterilization process. Lack of such protocol measures or failure to follow the rules regarding to protocol by staff may cause nosocomial infections in patients.

To maximize and maintain asepsis an aseptic technique is required, the goal of aseptic technique is to protect the patient from any infections and to help stop the spread of pathogens. Nurses maintain the proximate care environment, as they provide care for a

Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

diverse range of patients and the risk of contamination from pathogenic microorganisms is increased.

The practice of medical asepsis and standard precautions are to provide the nurse with techniques for destroying or containing pathogens and to help prevent any contamination to other people and the transmission on inanimate objects.

Medical asepsis helps to contain any infectious organisms and to maintain an environment free from contamination. The techniques used to maintain medical asepsis include hand washing, gowning and wearing facial masks when needed, as well as separating clean from contaminated or potentially contaminated materials and providing information to patients about basic hygienic practices.

The nurse needs to utilise the appropriate hand washing techniques and so too the patient, as this remains the most important factor in preventing the spread of microorganisms.

Common example of medical asepsis involves the steps taken by the nurse to ensure that only clean linen is applied to each patient’s bed. The hands of the nurse are to be washed before handling the clean linen, the unused linen cannot be returned once it has entered the patients room and it cannot be used for another patient’s bed either. This linen is considered to be soiled linen and it must be placed in the soiled linen bin.

Surgical asepsis is the holistic absence of pathogens in the surgical field; basic principles, procedures and surgical conscience are essential components of surgical asepsis. It is to be noted that the floor, walls and other items within the operating room are not sterile; anything brought into the sterile field must be sterilized and packaged to maintain that sterile field.

A few examples of surgical asepsis processes could include; non-sterile hats and masks worn by all staff in the operating room to help prevent any hair or respiratory secretions from contaminating the sterile field, all potential contaminates to the surgical site are to be removed from the patient such as hair follicles near and around the field and thorough washing of the skin with surgical soup. All care is taken, not to contaminate the sterile field with non-sterile items.

Techniques of asepsis can refer to the activities of preparing, creating and maintaining a sterile field. A nurse needs to ensure that the equipment that is going to be used in the sterile field is in fact sterile. Most items that are needed to perform a task within a sterile field often do not contain indicators; instead they are clearly marked “sterile” on the package.

Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

There are three major indicators that the nurse may use to help identify whether the item is sterile or not, the three indicators are (1) glass pellet (2) chemical (3) biologic or spore strip indicators.

A glass pallet indicator is a small glass tube containing a temperature sensitive pallet that changes colour when it is expose to a certain temperature for a specific amount of time. Chemical indicators are made out of paper that is covered with a chemical dye, the dye changes colour when sterilization has occurred. Spore strips are specifically prepared strips containing a known population of bacteria placed in the centre of the package, after being exposed to the sterilization process these strips are sent to the lab, this ascertains whether or not the sterilization was successful.

Work practices that are required for healthcare workers to abide by when coming into contact with patients are the standard infection control precautions; standard precautions combine the major features of universal precautions and body substance isolation. Standard precautions are work practices that are necessary for basic level of infection control, standard precautions are made up of a set of principles designed to minimise exposure to and the transmission of microorganisms. Every patient is a potential infection risk, it is necessary that the applications of standard precautions are applied to all patients.

Standard precautions may be comprised of:

Hand washing. Use of personal protective equipment. Aseptic practices. Appropriate reprocessing of instruments and equipment following use. Safe handling and disposal of potential infectious material and Environmental control.

Body substance isolation protects against the bacterial organisms that may exist in the body substances, this applies in all patient encounters regardless of the diagnosis. The application of gloves for contact with moist body surfaces and areas of non-intact skin, wearing of a facial mask when in contact of an infectious droplet secretions, these measures help prevent the contamination of both the health care worker and the patient.

When patients are suspected to be infected or have a highly transmissible pathogen that can cause an infection, when standard precautions are not enough in preventing an infection additional precautions are needed. When the additional precautions are needed, it is used in addition to the standard precautions.

Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

The implemented precautions are based on the disease transmission and the specific situation. There are three main categories of transmission that require the attention of the standard and additional infection control precautions;

o Airborne transmission.o Droplet transmission.o Contact transmission.

Patients requiring airborne precautions are to be managed, to reduce the risk of transmission of infectious agents. Airborne precautions are measures used to prevent airborne transmission of specific infectious disease by airborne route.

Open Pulmonary Tuberculosis is a disease that is categorized as an airborne infection, tuberculosis (TB) is a bacterial infection caused by a germ called Mycobacterium tuberculosis. The bacterium mainly attacks the lungs, however it can also do damage to other parts of the body such as the joints, bladder, spine, and the brain.

Tuberculosis spreads through the air when a person infected with the bacterium by breathing, coughing, sneezing or talking. Tuberculosis infection to the lesion or significant tuberculin reaction takes around four to twelve weeks.

Patients with the known or suspected of having open pulmonary tuberculosis are to be managed to minimise the risk of transmission of the bacterium. All staff members are to observe, maintain airborne and standard precautions throughout the patients care, staff needs to provide to patients with explanation outlining the reasons for their isolation.

Airborne precautions may include;

o Patient reassigned or assigned a single room with unshared ensuite, preferably if availably in a monitored negative pressure room with 6 – 12 air exchanges per hour.

o Have the area sealed as best as possible this can be as simply keeping the door closed at all times.

o Medical records are to be kept outside of the quarantined area.o Staff are to don personal protective equipment in accordance to the

“81008/ALL: Airborne Precautions” policy.o All reusable equipment is to be decontaminated and sterilized.

Airborne precautions are to be maintained during all patient transfers, patient care in ambulatory care settings and linen management, waste management and environment

Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

decontamination. Staff is to abide by the principles of airborne precautions that are set out in the Queensland Health Infection Control Guidelines. (Refer to page 25)

When discussing infections and diseases associated with droplet transmission, one common bacterial infection arises; the whooping cough. The whooping cough is caused by the Bordetella pertussis, a gram negative bacterial pathogen; this pathogen is highly contagious that has an attack rate of 50 – 100 %.

The primary means of transmission is by droplet or by direct contact with respiratory secretions; pertussis has the incubation period of 6 to 20 days, all age groups are susceptible to the disease but it is more severe in infants and non-vaccinated children.

Patients with the known or suspected of having pertussis are to be managed to minimize the risk of transmission of the bacterium. Droplet precautions are measures used to prevent the transmission of specific infectious disease spread through close respiratory or mucous membrane contact with the respiratory secretions.

Droplets are generated from the source person who is infected with pertussis during coughing, sneezing, and talking. Close proximity is required for the transmission to occur though the droplets do not stay suspended in the air.

In addition to the standard precautions (refer to policy 81003/ALL: Standard Precautions), all staff are to abide by the principles of droplet precautions.

Droplet precautions may include:

o Dedicated linen and waste receptacles are to be placed inside isolation room as per the policy 49200/ALL: Environmental Management Plan.

o Staff are to don personal protective equipment in accordance to the “81008/ALL: Standard precautions” policy.

o The patient is to don a surgical mask for all movement outside the isolation room.

o When the patient is discharged, the room must be thoroughly cleaned with neutral detergent solution and water and allowed to dry naturally. As set out in policy 82600/ALL: Environmental Decontamination.

Droplet precautions are to be maintained during all patient transfers, patient care in ambulatory care settings and linen management, waste management and environment decontamination.

Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

Staff is to abide by the principles of Droplet precautions that are set out in the Queensland Health Infection Control Guidelines. (Refer to page 24).

Patients requiring contact precautions are to be managed, to reduce the risk of transmission of infectious agents; all staff is required to comply with standard precautions to reduce the transmission risk of conditions spread though the contact route or indirect contact.

An infection and disease that is most often occurring through contact transmission is syphilis, syphilis is a sexually transmitted infection that can only be spread via direct contact with a syphilis sore during vaginal, anal, or oral sex. Syphilis is a bacterial infection caused by a bacterium called Treponema pallidum and has an incubation period of 9 to 90 days averaging out to three (3) weeks.

Patients known to be infected with syphilis require contact precautions and the implementation of strategies outlined in Department of Health and Ageing Infection Control Guidelines Section 2.3 Additional Precautions; In addition to the standard precautions (refer to policy 81003/ALL: Standard Precautions), all staff are to abide by the principles of contact precautions.

Contact precautions may include:

o Staff are to don personal protective equipment in accordance to the “81008/ALL: Standard precautions” policy.

o When the patient is discharged, the room must be thoroughly cleaned with neutral detergent solution and water and allowed to dry naturally. As set out in policy 82600/ALL: Environmental Decontamination

o All reusable equipment is to be decontaminated and sterilized.o Dedicated linen and waste receptacles are to be placed inside

isolation room as per the policy 49200/ALL: Environmental Management Plan.

o Remove gloves and gown and wash hands after client contact.

Contact precautions are to be maintained during all patient transfers, patient care in ambulatory care settings and linen management, waste management and environment decontamination.

Staff is to abide by the principles of Contact precautions that are set out in the Queensland Health Infection Control Guidelines. (Refer to page 26).

The decontamination of blood and body fluids requires immediate attention by staff to reduce the risk of infection to staff, patients and visitors. The prompt action by staff in

Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

decontaminating blood and bodily fluids will reduce the risk of infection to staff, patients and visitors.

Standards for decontaminating blood and bodily fluids as outlined in “81300/ALL: Decontamination – Blood and body Fluid Spills” include:

o Incidents are to be reported in accordance with policy 91100/ALL: Clinical Incidents – Reporting and Management.

o Blood and body spills require immediate attention by staff.o Standard precautions are to utilized as outlined in 81003/ALL:

Standard Precautions policy.

If there has been blood spilled on the floor, the spillage must be disinfected and the area cleaned as soon as possible. All appropriate personal protective clothing must be worn by staff (disposable gloves and apron, face protection if there is a risk of splashing) before beginning any disinfection. The affected area is to be appropriately cordoned off and a chlorine – releasing disinfect is to be used such as Actichlor.

Where there has been a spillage of urine, faeces, vomit or bodily secretions, it is essential that all of the organic material is removed prior to the area of spillage being disinfected. All appropriate personal protective clothing must be worn by staff (disposable gloves and apron, face protection if there is a risk of splashing) before attempting to deal with the spillage.

When the residual waste is removed the area should be cleaned thoroughly using warm water and heavy cleaner solution (1,000 ppm dilution). The domestic service staff should be notified the area of spillage has been dealt with.

Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

Periodical:

Mangram, Alicia, Teresa Horan, Michele Pearson, Leah Christine Silver, and William Jarvis. "Guideline for Prevention of Surgical Site Infection, 1999." Infection Control and Hospital Epidemiology 20 (April 1999): 247–78.

Books:

White, L. (Ed.). (2005). Foundation of Basic Nursing (2nd Ed). New York: Thomson.

Hegner, B.R., Acello, B., & Caldwell, E. (2004). Nursing Assistant: A Nursing Process Approach. New York: Thomson.

Heymann D, (2004). Control of communicable diseases manual, (18th Ed.). American Public Health Association.

K. Holmes, P. Mardh, P. Sparling et al (1999). Sexually Transmitted Diseases, 3rd Edition. New York: McGraw-Hill.

Internet:

Osman, Cathy. "Asepsis and Aseptic Practices in the Operating Room." Infection Control Today July 2000 cited March 2010. <http://www.infectioncontroltoday.com/articles/071best.html

Standard and additional precautions. (n.d.). Retrieved March 03 2010 from http://som.flinders.edu.au/students/HAI_Stand_Add.htm

ROYAL COLLEGE OF NURSING. (2004). Working well initiative: Good practice in infection control [on-line]. London: RCN. Retrieved March 03 2010 from www.rcn.org.uk/publications/pdf/goodpracticeinfectioncontrol.pdf

Tuberculosis. (n.d.). Retrieved March 03 2010 from http://www.nlm.nih.gov/medlineplus/tuberculosis.html

Kelly J Wilson Assessment 1 HLTIN301A4140880602 Infection Control Policies and Procedures.

Tuberculosis. (n.d.). Retrieved March 03 2010 from http://familydoctor.org/online/famdocen/home/common/infections/common/bacterial/120.html

Territory Government of Northern Territory, Australia, Department of Health and Families: Contact Precautions. Retrieved March from http://remotehealthatlas.nt.gov.au/contact_precautions.pdf

Australian Government (n.d.). Queensland Health: Syphilis. Retrieved March from http://access.health.qld.gov.au/hid/InfectionsandParasites/SexuallyTransmittedDiseases/syphilis_fs.pdf

Australian Government (n.d.). Queensland Health: Disinfection and Sterilization Infection Control Guidelines. Retrieved March from http://www.health.qld.gov.au/chrisp/sterilising/large_document.pdf

Australian Government (n.d.). Queensland Health: Infection Control Guidelines. Retrieved March from http://www.health.qld.gov.au/chrisp/ic_guidelines/contents.asp

Australian Government, State Government Victoria. (n.d.). Department of Health: Cleaning Standards. Retrieved March from http://www.health.vic.gov.au/cleaningstandards

Australian Government, State Government Victoria. (n.d.). Department of Health: Blue book - Guidelines for the control of infectious diseases. Retrieved March from http://www.health.vic.gov.au/ideas/bluebook

Aseptic Technique - procedure, blood, removal, time, infection, types, risk, Definition, Purpose, Description http://www.surgeryencyclopedia.com/A-Ce/Aseptic-Technique.html#ixzz0iVN2A6RO