Infection control for NCHDs at CUH

The term Univeral Precautions has now been replaced with Standard Precautions. Standard precautions are used in conjunction with Trasnmission Based Precautions. Transmission based precautions includes Contact, Airborne and Droplet

Contact precautions

Used for patients who are suspected or known to be infected or colonised with micro-organisms that can be transmitted by direct contact with the patient, his/her environmental surfaces or patient care items, examples include M.R.S.A, Clostridium difficile, Gastroenteritis and Scabies. For these patients the use of gloves and aprons are advised for delivery of direct patient care.

Droplet Precautions

Used for patients who are suspected or known to be infected with respiratory microorganisms transmitted by large particle droplets. Large particle droplets can be generated by the patient coughing, sneezing, talking or undergoing procedures involving the respiratory tract. These droplets do not remain suspended and fall within a close distance of dispersal (approx. 1 metre from the patient) Examples include Neiserria Meningitidis, Rubella and Mumps.

Airborne Precautions

Used for patient who are suspected or known to be infected with a microorganism that has the ability to be disseminated by airborne droplet nuclei. These have a small particle residue (5 um or smaller in size) thus can remain suspended for long periods. Examples include Mycobacterium tuberculosis (TB) Varicella, smallpox, rubeola (measles)

Intensive Care Unit MRSA Screening

MRSA

Patient “isolated” in a single room with contact precautions
White coats OFF and apron ON before entering room
7 Day of topical treatment (protocol)
3 screens post-protocol (Nose/perineum/axilla/wounds/”drips and drains” devices)
The patient is only deemed MRSA negative when they have had 3 consecutive negative MRSA screens post treatment

For X-Ray, theatre and Other Department Procedures, please ensure the department is informed of the MRSA status

All patients to have MRSA screen on admission.

Staff visiting ITU

Remember to use the correct door i.e. the door opposite the x-ray department
Remove white coat and put on protective clothing
Remember protective clothing to be changed at each bedside
Hand decontaminated with alcohol gel

Glove Wearing and Handwashing. No glove gives 100% protection. !! Studies indicate that most gloves have a 37% perforation rate. Glove wearing MUST always be followed by thorough hand washing/decontamination with alcohol gel

Notifiable diseases. The Dept of Public Health must be informed. Written documentation must also be complete. The forms are available in the ward areas

Diarrhoea !!!

Any patient experiencing diarrhoea should have

Be isolated in a single room with contact precautions
Have a stool record/chart
Have a stool sample taken for C&S and clostridium difficile culture

Remember clostridium difficile toxin is a separate test and must be REQUESTED via microbiology extension 22504

Sharps Injury

Bleed the site
Wash the site under running water
Complete an incient form
Attend the Emergency Department (needlestick policy) with completed form

Intravenous drugs

Must be re-constituted on the IV tray and administered using aseptic technique
Gloves must be worn throughourthe procedure
Disposable trays must be used to carry the equipment
Sharps must NOT be carried by hand

Infection control manual

Available in all wards/areas. This “yellow” manual is a referenced book. These guidelines are based on Department of Health, national and international recommendations