Alma Moiselle Lastimosa BSN 4-C Submitted to: Mrs.

Antonietta
Obiedo

INFECTION CONTROL POLICIES

Hospital Infection items and environmental surfaces, and

The following guidelines were before going to another patient.
developed to prevent the transmission • Wash hands/perform hand hygiene
of infection during patient care for all immediately after removing gloves.
patients, regardless of known or Mask, Eye Protection, Face Shield
unknown infectious status. • Wear a mask and eye protection or a
Hand Washing/Hand Hygiene face shield to protect mucous
• Wash hands/perform hand hygiene membranes of the eyes, nose, and
after touching blood, body fluids, mouth during procedures and patient
secretions, excretions, and care activities that are likely to
contaminated items, whether or not generate splashes or sprays of blood,
gloves are worn. body fluids, secretions, or excretions.
• Wash hands/perform hand hygiene Gown
immediately after gloves are removed, • Wear a clean, nonsterile gown to
between patient contacts, and when protect skin and prevent soiling of
otherwise indicated to avoid transfer of clothing during procedures and patient
microorganisms to other patients or care activities that are likely to
environments. generate splashes or sprays of blood,
• Wash hands/perform hand hygiene body fluids, secretions, or excretions.
between tasks and procedures on the • Select a gown that is appropriate for
same patient to prevent cross- the activity and amount of fluid likely
contamination of different body sites. to be encountered.
• Use a plain (nonantimicrobial) soap • Remove a soiled gown as promptly
or alcohol-based hand rub for routine as possible and wash hands/perform
hand washing. hand hygiene to prevent the transfer of
• Use an antimicrobial agent or microorganisms
waterless antiseptic agent for specific to other patients or environments.
circumstances (control of outbreaks or
hyperendemic infections). (See Contact Patient Care Equipment
Precautions.) • Handle used patient care equipment
Gloves soiled with blood, body fluids,
• Wear clean, nonsterile gloves when secretions, and excretions in a manner
touching blood, body fluids, secretions, that prevents skin and mucous
excretions, and contaminated items. membrane exposures, contamination
• Put on clean gloves just before of clothing, and transfer of
touching mucous membranes and microorganisms to other patients and
nonintact skin. environments.
• Change gloves between tasks and • Ensure that reusable equipment is
procedures on the same patient after not used for the care of another patient
contact with materials that may until it has been cleaned and
contain a high concentration of reprocessed appropriately.
microorganisms. • Ensure that single-use items are
• Remove gloves promptly after use, discarded properly.
before touching noncontaminated Environmental Control
• Ensure that the hospital has
adequate procedures for the routine
care, cleaning, and disinfection of
environmental surfaces, beds, bed
rails, bedside equipment, and other
frequently touched surfaces.
• Ensure that procedures are being
followed.
Linen
• Handle, transport, and process used
linen soiled with blood, body fluids,
secretions, and excretions in a manner
that prevents skin and mucous
membrane exposures and
contamination of clothing and that
avoids transfer of microorganisms to
other patients and environments.
Occupational Health and
Bloodborne Pathogens
• Take care to prevent injuries when
using needles, scalpels, and other
sharp instruments or devices:
When handling sharp instruments after
procedures
When cleaning used instruments
When disposing of used needles
• Never recap used needles or
otherwise manipulate them by using
both hands or use any technique that
involves directing the point of the
needle toward any part of the body.
• Use either a one-handed scoop
technique or a mechanical device
designed for holding the needle
sheath.
• Do not remove used needles from
disposable syringes by hand and do
not bend, break, otherwise manipulate
used needles by hand.
• Place used disposable syringes and
needles, scalpel blades, and other
sharp items in appropriate puncture-
resistant containers as close as
practical to the area in which the items
were used.
• Place reusable syringes and needles
in a puncture-resistant container for
transport to the reprocessing area.
• Use mouthpieces, resuscitation bags,
or other ventilation devices as an
alternative to mouth-to-mouth
resuscitation methods in areas where
the need for resuscitation is
predictable.
Patient Placement
• Place a patient who contaminates the
environment or who does not or cannot
be expected to assist in maintaining
appropriate hygiene or environmental
control in a private room.
• If a private room is not available,
consult with infection control
professionals regarding patient
placement or other alternatives.
Urinary infection
Majority of nosocomial infections are
related to infection of the urinary tract.
Precautions are made in order to
minimize or eliminate the occurrences
of this kind of infection.
• Proper handwashing is a
universal precaution in inhibiting
the spread of pathogens.
• An indwelling catheter can lead
to infection. Bacterial
colonization (bacteriuria) occurs
within 2 weeks in half of
catheterized patients and within
4 to 6 weeks in almost all
patients after insertion of a
catheter—even if
recommendations for infection
control and catheter care are
followed carefully.
• Urinary catheters must be
hanged below the waist level of
the patient. The back-flow of
urine from the uro-bag can cause
the spread of microorganisms
and its access to the urinary
tract.
• Aseptic technique should always
be observed in catheter
insertions or any procedures.
• Proper disposal of diapers,
catheters, and uro-bags should
be observed.
Wound Infection
• Wound drainage tubes are
usually inserted during surgery
to prevent the collection of fluid
subcutaneously. The drainage
tubes are connected to portable
suction device (eg, Jackson-
Pratt), and the container is
emptied periodically. Between
80 and 120 mL of
serosanguineous secretions may
drain over the first 24 hours.
• Excessive drainage may be
indicative of a chyle fistula or
hemorrhage.
• If dressings are present, they
may need to be reinforced from
time to time.
• Dressings are observed for
evidence of hemorrhage and
constriction, which impairs
respiration and perfusion of the
graft.
• The graft is assessed for color
and temperature, and for the
presence of a pulse if applicable,
to determine viability. The graft
should be pale pink and warm to
the touch.
• The surgical incisions are also
assessed for infection, which is
reported immediately.
Prophylactic antibiotics may be
prescribed.
Respiratory infection
• Antimicrobial therapy is
prescribed for respiratory
infections to prevent
complications such as
pneumonia, sinusitis, and otitis
media.
• If a URI occurs, the patient is
encouraged to take deep breaths
and cough frequently to ensure
adequate gas exchange and
prevent atelectasis.
• The patient is instructed to seek
medical attention because
allergy symptoms along with a
URI may compromise adequate
lung function.
• Vaccinating as much of the
healthcare workforce as possible.
• Identifying and isolating patients
with known or suspected
respiratory infection.
• Implementing respiratory
hygiene/cough etiquette
programs.
• Placing facemasks on patients,
when tolerated, at facility access
points (e.g., emergency rooms)
or when patients are outside
their rooms (e.g. diagnostic
testing).
• Placing facemasks on patients
during transport; when tolerated;
limiting transport to that which is
medically necessary; and
minimizing delays and waiting
times during transport.
• Wearing appropriate gloves,
gowns, facemasks, respirators,
eye protection, and other PPE
Intravascular infection
• In general, administration sets
include the area from the spike of
tubing entering the fluid container
to the hub of the vascular device.
However, a short extension tube
may be connected to the vascular
device and may be considered a
portion of the device to facilitate
aseptic technique when changing
administrations sets. Replace
extension tubing when the vascular
device is replaced.
• Replace IV tubing used for
continuous infusions, including
piggyback tubing and stopcocks, no
more frequently than at 72 hour
intervals, unless clinically indicated.
• Replace IV tubing for
intermittent infusions within 24
hours of the start of the infusion.
• Replace tubing used to
administer blood, blood products, or
lipid emulsions within 24 hours of
initiating the infusion.
• The hang time of IV fluids,
including non-lipid- containing
parenteral nutrition fluids is limited
to 24 hours from the start of the
infusion.
• Complete infusions of lipid-
containing parenteral nutrition fluids
(e.g., 3-in-1 solutions) within 24
hours of hanging the fluid.
• When lipid emulsions are given
alone, complete the infusion within
12 hours of hanging the lipid
emulsion.
• When lipid-based (e.g., propofol)
or liposomal-based (e.g., liposomal
amphotericin) medications are
used, the hang time should not
exceed the manufacturer’s
recommendation as such use has
led to nosocomial blood stream
infections given the facility of
bacteria to grow in lipid media.
• Clean injection ports with 70%
alcohol or povidone-iodine before
accessing the system.
• Admix all parenteral fluids in the
pharmacy in a laminar-flow hood
using aseptic technique.
• Check all containers of
parenteral fluid for visible turbidity,
leaks, cracks, particulate matter,
and the manufacturer’s expiration
date before use.
• Do not use filters routinely for
infection control purposes.
• All personnel who insert and
maintain intravascular devices
should be trained appropriately with
careful supervision while learning
such techniques. Yale-New Haven
Hospital does not utilize “IV teams”
or central line insertion teams at
this time though the medical
literature indicates that the use of
such teams can result in a lower
rate of catheter-related infections.
Enteric Infection
Enteric precautions are comprised of
four elements:
1. HANDWASHING
· Wash hands with antibacterial
agent or use alcohol-based
handrub after removing gloves.
· Do not touch potentially
contaminated surfaces or items
before leaving the room.
2. DISPOSAL OF EXCRETA
-in the home, the patient should
use flush toilet. If bedpans are to
be used, the attendant should
dispose the excreta quickly.
3. DISINFECTION
- toilets, flush handles, toilet
seats must be disinfected
frequently.
4. EDUCATION
- Everyone must be taught on
proper infection control.
Blood and Bloody fluid
infection
• Gather all equipment required to
deal with a spillage including
personal protective equipment and
spillage kits. Appropriate solutions
must be used for the safe and
effective management of spillages.
• All items used during a spillage
must be disposed of or
decontaminated appropriately
• Hand hygiene should be
performed before and after
management of spillages
 • Laboratories may require their
own more specific spillage policies,
with more detail pertaining to the
infectious agents they encounter.
• Control of Substances Hazardous
to Health (COSHH) sheets and
Materia Safety Data Sheets should
be referred to, to ensure safe
management of spillages, e.g.
disinfectants being used in
accordance with manufacturer’s
instructions for storage, contact
times and expiry dates.
• In community settings where
waste is not categorised as
healthcare waste, waste that is
generated during the management
of spillages should be disposed of
safely, e.g. by wrapping it in paper
or plastic before putting it into the
domestic waste. However, if waste
is categorised as healthcare waste
then special uplifts should be
arranged.
Sources:
Sexually transmitted
infection
The incidence of sexually transmitted
diseases (STDs) is increasing in men
and women. STDs are most common in
young, sexually active people, with the
incidence higher in men than women
(U.S. Surgeon General, 2001). STDs
affect people from all walks of life—
from all social, educational, economic,
and racial backgrounds.
• Treatment of STDs must be
targeted at the patient as well as
his or her sexual partners and
sometimes the unborn child.
• thorough history that includes a
sexual history is crucial to
identify patients at risk and to
direct care and teaching.
Partners of men with STDs must
also be examined, treated, and
counseled to prevent reinfection
and complications in both
partners and to limit the spread
of the disease.
• Sexual abstinence during
treatment and recovery is
advised to prevent the
transmission of STDs (CDC,
2002)
• Using latex condoms for at least
6 months after completion of
treatment is recommended to
decrease transmission of HPV
infections as well as other STDs.
• Because patients with one STD
may also have another STD, it is
important to examine and test
for other STDs.
• Use of spermicides with
nonoxynol 9 (“N-9”) is
discouraged as they do not
protect against HIV infection and
may increase the risk for
transmission of the virus.
• Centers for Disease Control and
Prevention (2002). HIV/AIDS
Surveillance Report, 13(2), 1–
44.
• Centers for Disease Control and
Prevention. Hospital Infection
Control
• Guideline for isolation
precautions in hospitals.
Infection Control and Hospital
Epidemiology, 17, 53–80
• Guideline for hand hygiene in
health-care settings. Morbidity
and Mortality Weekly Report,
51(RR-16), 1–45.
• Practices Advisory Committee
(1997). Part I. Evolution of
IsolationPractices
• Smeltzer and Bare. Medical-
Surgical Nursing.c2006.LWW
• http://www.cdc.gov/hcidod/hip/i
solat/isopart1.htm