routine practices

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Routine Practices. What Is It?. A set of infection control precautions & practices used for all patient care regardless of their presumed infection status or diagnosis. What's Its Purpose?. - PowerPoint PPT Presentation


  • A set of infection control precautions & practices used for all patient care regardless of their presumed infection status or diagnosis

  • To prevent the transmission of organisms from contact with blood, body fluids and moist body substances with non-intact skin or mucous membranes

  • Hand Hygiene Personal Protective Equipment (PPE) (gloves, gowns, masks, eye protection, face protection)AccommodationEquipmentEnvironmental ControlsSharps

  • LinenWasteSpecimen CollectionVisitors GuidelinesEducation for Healthcare Workers, Patients/Residents/Clients and VisitorsPost Mortem Care

  • Routinely treat all patients/residents/clients as if they are infectious

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  • Infectious Agent:A microorganism with the ability to cause an infectious diseaseInfectious agents are bacteria, viruses, fungi and parasitesReservoirs:A place within which microorganisms can thrive and reproduceExample: Human beings, animals, water

  • Portal of Exit:A place of exit providing a way for a microorganism to leave the reservoirExample: Microorganisms may leave the reservoir through the nose or mouth when someone sneezes or coughs

  • Means of Transmission:Route or method of transfer by which the infectious microorganism moves or is carried from one place to another to reach their new host

  • Contact:DirectIndirectDropletAirborneCommon VehicleVector

  • Portal of Entry:Means by which the infectious microorganism gains entry into the new hostExample: ingestion, breathing, skin punctureSusceptible Host:A person who cannot resist a microorganism invading the body, multiplying and resulting in infection

  • Direct physical contact between an infected or colonized individual and susceptible host (e.g., Scabies)Indirect contact involves passive transfer via intermediate object to susceptible host (e.g., contaminated equipment, hands of HCWs)Example: C.Difficile

  • Large droplets > 5 um propelled from respiratory tract, coughing, sneezing suctioning or bronchoscopy, a short distance < 1 meter to nasal or oral mucosa of a new hostDroplets dont remain suspended in airExample: N. Meningitidis

  • Dissemination of microorganisms by aerosolizationOrganisms suspended in air in droplet nuclei particles < 5 umCan be widely dispersed by air currentsExample: Tuberculosis

  • Common Vehicle:Contaminated vehicle (water/food)SalmonellaVector:Non human that transmits infectionWest Nile

  • Hand hygiene is the single most effective way to prevent infection

  • Artificial fingernails, gel nails or extenders should not be wornNatural nail tips should not be longer than 0.635 cm (1/4 inch) longNail polish should be removed when chippedAvoid wearing hand jewellery

  • Hand Lotions:Minimize skin irritation that can occur with frequent hand hygieneSelect lotions compatible with products and gloves usedDispensers:Do not top up partially empty containersHand lotion bottles should not be used

  • When to Perform Hand Hygiene Before: -Direct, hands-on care with a patient, resident, or client -Performing invasive procedures. -Handling dressings or touching open wounds. -Preparing, handling, serving, or eating food. -Feeding a patient. -Shifts and breaks.

  • Between: -Procedures on the same patient where soiling of hands is likely, to avoid cross contamination. After: -Contact with blood, body fluids, non-intact skin, and/or mucous membranes.-Contact with items known or considered to be contaminated.-Removal of gloves.-Personal use of toilet or wiping nose.-Shifts & breaks.

  • Must contain a minimum of 60% alcoholUse in all clinical situations, except when hands are visibly soiledUse as an alternative to plain or antimicrobial soap except when hands are visibly soiled

  • Apply 2-3 mls of product to the palm of one handRub hands together, covering all hand surfaces, including fingernails, web spaces, thumbs & palms.Ensure hands are dry before performing another task (dries within 15-20 seconds).NB: Alcohol products are flammable.

  • Plain Soap (Non-antimicrobial) For routine hand washing. Hands must be washed with soap & water when hands are visibly soiled with blood, body fluids, secretions, excretions, and exudates from wounds.

  • Antimicrobial Soap:Before contact with invasive devicesBefore performing any invasive procedure Before contact with immunosuppressed patients, residents or clientsBefore/after contact with patients, residents or clients on infection control precautions/isolation

  • Wet hands under warm running water. Apply soap and distribute over hands. Rub hands together vigorously for 10-15 seconds to create a good lather. Using friction, cover all hand surfaces including fingernails, web spaces, thumbs and palms.

  • Rinse under warm running water. Dry hands gently and thoroughly with a disposable towel. Turn off faucet using a clean disposable towel. NB: Faucets are dirty!

  • The selection of gowns, gloves, masks and/or face protection should include consideration of the following:Probability of exposure to blood and/or body fluidsAmount of blood and/or body fluids likely to be encounteredProbable route of transmissionAssessment of Risk

  • GlovesAdditional measure to, not a substitute for hand hygieneClean, non-sterile gloves of appropriate size should be wornSingle-use disposable gloves should never be reused or washed

  • GlovesWorn for contact with blood, body fluids, secretions and excretions, mucous membranes, draining wounds, or non-intact skinWorn for handling items visibly soiled with blood, body fluids, secretions or excretionsWorn when the HCW has open sores of his/her hands

  • GlovesPut on directly before contact with patient, resident or client or just before task/procedure requiring glovesChange gloves between:Care activities/procedures with the same patient, resident or clientAfter contact with materials that may contain high concentrations of microorganisms

  • GlovesGloves should be long enough to fit over the cuff of a gownShould be removed prior to leaving the patients or residents roomHand hygiene must be performed following glove removal

  • GownsRoutine gown use is not recommendedUsed to protect uncovered skin and prevent soiling of clothing during procedures/ care activities likely to generate splashes or sprays of blood, body fluids, secretions or excretions

  • GownsRemove gown when task complete, when leaving the room or when gown is heavily soiled/wetGowns are single-use:Disposable gowns are discardedCloth gowns are laundered after usePerform hand hygiene after removing gown

  • MasksSurgical/procedure masks protect the mucous membranes of the nose and mouth during procedures likely to generate splashes/sprays of blood, body fluids, secretions or excretionsShould be worn within 1 meter (3 ft) of a coughing patient, resident or client

  • MasksDiscard masks which are crushed, wet, have dangled around the neck or have become contaminated with patient secretionsPerform hand hygiene following mask removal

  • Eye ProtectionUsed to protect mucous membranes of eyes during procedures/ care activities that are likely to generate splashes, sprays or aerosols of blood, body fluids, secretions or excretionsEye protection must fit over prescription glassesReusable eye protection must be cleanedPerform hand hygiene following removal

  • Face ProtectionUsed to protect the mucous membranes of the eyes, nose and mouth during procedures/care activities that are likely to generate splashes, sprays or aerosols of blood, body fluids, secretions or excretionsFace protection must fit over prescription glassesFace protection shall be of appropriate size-large enough to protect mucous membranes of the face

  • Respiratory EtiquetteSimple measures individuals can utilize to minimize the spread of respiratory organismsCover your coughCover your mouth and nose with a tissue when you cough or sneeze OR cough or sneeze into your upper sleeve, not your hands

  • Respiratory EtiquettePut your used tissue in the waste basketYou may be asked to put on a surgical mask to protect othersClean your hands after coughing or sneezingWash with soap and water OR clean with alcohol-based hand rub

  • Donning:Perform Hand HygienePut on long sleeve gown with opening of gown at backTie neck and waist tiesApply mask/respirator, seal check (if N95) to ensure correct fit, reapply glassesApply protective eyewear if appropriateApply gloves, pulling gloves up over cuff of gown

  • Removing:Prior to Exiting Room or AreaRemove gloves using glove to glove, skin to skin technique, DiscardPerform Hand HygieneUntie neck ties first, then waist ties on the gownPlace fingers of one hand under the opposite cuff and pull cuff over hand

  • Removing:Prior to Exiting Room or AreaUsing the gown covered hand, pull the gown down over the other handPull the gown down off the arms, being careful that the hands do not touch the outside of the gown

  • Removing:Prior to Exiting Room or AreaHold the gown away from your uniform and roll it up with the contaminated side inside in a away that minimizes air disturbance. Dispose into garbage or laundry hamperPerform Hand Hygiene/Use paper towel to open door

  • Removing:Immediately After Exiting Room or AreaRemove eye protection/face shield if wornRemove mask/respirator according to manufacturers instructionsTake care to prevent self contaminationDiscard into garbagePerform hand hygiene

  • Single rooms not required for routine careSingle rooms with dedicated bathro