chironda best practices for ipac in physicians offices
TRANSCRIPT
Best Practices for Infection
Prevention & Control (IPAC) in
Clinical Offices – A Review of the
Guidance Documents Barley Chironda RPN CIC
Manager of Infection, Prevention & Control and Medical Device Reprocessing Department, SJHC
AGENDA
• Importance of Adhering to Best Practice Recommendations
• Best Practices for IPAC in Clinical Office Practice
• Staff Education and Safety
• Risk Assessments
• Resources and Supports
Reasons to follow Practice
• Legal and Best Practice Guidelines
• Increasing provision of care in the Physicians office
• Vulnerable patient populations visiting offices
• Ongoing outbreaks and patient notification events.
Key Document Highlights
• Administrative Measures
• Facility Recommendations
• Reception Area
• Environmental Cleaning
• Examination Room
• Staff
• Medication Administration
Administrative Measures for Clinical Office
• Dedicate Resources to Infection Prevention
• Develop and maintain IPAC and occupational health programs
• Assure sufficient and appropriate supplies necessary for adherence to Routine Precautions
Facility Recommendations
• There are waste receptacles available in each room
• There is a waiting area for patients that need to be segregated for acute infection
• Gloves are available and used appropriately
• Masks are available and used appropriately
• There is a functional separation of clean storage and dirty utility areas
Reception Area
• Reception staff are protected from patients by a barrier • There is infection control signage at the entrance of the
office/clinic • A telephone screening tool has been provided and is
being used appropriately • There is infection control signage at the reception desk • There are alcohol-based hand rub and masks available at
reception, with signage for appropriate use • There are tissue boxes available • Toys are properly cleaned
Environmental Cleaning
• There are procedures for cleaning the office setting. If cleaning is contracted out, the cleaning contractor has procedures for cleaning the office setting
• Approved and appropriate disinfectant products are available for patient surfaces, equipment and instruments
• Clinic/examination areas and high touch surfaces are cleaned and disinfected daily. Areas in direct contact with the patient are cleaned between patients.
Environmental Cleaning cont..
• Other office areas are cleaned at least weekly
• Medical equipment used on multiple patients is cleaned between patients
• There is a procedure for cleaning up spills of body fluids
• Waste is segregated and managed according to provincial regulations and local bylaws
Examination Rooms
• There are hand washing sinks with liquid soap available in each clinic area
• Alcohol-based hand rub is available in each examination room
• Puncture-resistant sharps containers are provided in each exam room or clinic area
• Sharps are discarded directly into sharps containers
• Sharps containers are not overfilled past the fill line
Examination Rooms continued
• PPE is available and is worn when necessary and appropriately
• Supplies are not stored under, or on counters adjacent to, hand washing sinks
• If patients with active pulmonary tuberculosis are routinely seen, an appropriately ventilated examination room is available
Staff
• There are written IPAC policies and procedures • Staff are aware of the location of IPAC policies
and procedures • Staff follow IPAC policies and procedures • Staff are immunized appropriately • If patients with active pulmonary tuberculosis
are routinely seen, N95 respirators are available and used appropriately and staff receive annual TB skin testing
• Staff who wear N95 respirators are fit-tested
Medications and Vials
• Single dose vials are not reused. Leftover contents are not combined or pooled.
• A sterile syringe and needle/cannula is used when entering a vial.
• All needles and syringes are single patient use only.
• Multidose vials are not used wherever possible
Vaccines
• There are policies and procedures for handling and storage of vaccines.
• There is a thermometer in the refrigerator. • Temperatures of refrigerators used to store vaccines
are checked twice daily and recorded. • Vaccines are: kept refrigerated at a temperature
between 2°C and 8°C kept frozen at a temperature of -15 °C protected from light if required
• If refrigerator temperatures are less than 2°C or greater than 8°C, report immediately to the public health unit for assessment of vaccine potency.
Resources
• Public Health Ontario Checklists
• Toronto Public Health
• Hospital Infection Control Team
• Regional Infection Control Networks (RICN)
References
• Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Infection Prevention and Control for Clinical Office Practice. 1 st Revision. Toronto, ON: Queen’s Printer for Ontario; April 2015. https://www.publichealthontario.ca/en/eRepository/IPAC_Clinical_Office_Practice_2013.pdf