PRIVATE 3 INFECTION CONTROL PRACTICES

Hospital Infection Control Guidelines

Infection control practices can be grouped into two categories:

 Standard precautions
 Additional precautions

Transmission of infections in the hospital can be prevented and controlled through the
application of basic application of basic infection control precautions which must be applied to all times,
regardless of diagnosis or infectious status, and additional precautions which are specific to modes of
transmission.

Standard Precautions
These are procedures, interventions or approach that is observed and performed by the health
care staff at all times regardless of the patient’s diagnosis or status of health.
Treating all patient’s in the hospital with the same basic level of standard precautions involve
work practices that are essential to provide high level of protection to patients, health care workers
and visitors.

These include the following:

 Hand washing and antisepsis.

 Use of personal protective equipments when handling blood, body substances, excretions and
secretions.
 Appropriate handling of patient care equipment and soiled linens.

 Prevention of needle stick/ sharp injuries.

 Environmental cleaning and spills- management.

 Appropriate handling of waste.

 Proper segregation of waste.

HAND HYGIENE POLICIES

 Appropriate hand washing can minimize microorganisms acquired on the hands by contact with
body fluids and contaminated surfaces. Hand washing breaks the chain of infection transmission
and reduces the person to person transmission.

 All health care personnel and family caregivers of patients must practice effective hand washing.
Patients and primary care givers need to be instructed in proper techniques and situations for
hand washing.
 Utilization of Personal Protective Equipment or Barrier Protection as Standard Precaution

 Health Care Staff must utilize barrier protection to prevent being exposed to body fluids
from the patient.
 When to use a Barrier Protection/PPE:
1. Probability of exposure to blood and body substances.
2. Amount of blood or body substances likely to been countered.
3. Probable route of transmission.

Kinds of Barrier Protection:

i. Gloves (Clean or Sterile)
ii. Face Mask
iii. Gown/ Apron
iv. Face/ Eye shields/Googles
v. Respirators (PAPR)
vi. Surgical Cap/ Hairnet
vii. Shoe Cover/ Boots

Full personal protective equipment needs to be worn before entering the patient care area.

The putting on personal protective equipment is very vital to avoid the spread of any microorganisms
and contaminations , however, for practicality, the following sequence is given an example:

1. Wash hands
2. Wear scrub suit or old set of thin clothes before entering the designated changing room or
area.
3. Wear boots/ or shoe covers with trousers tucked inside
4. Wash hands
5. Wear cap
6. Wear the mask
7. Wear the gown
8. Wear an impermeable apron if splashes of blood or body fluids are expected.
9. Wear protective eye wear/ goggles
10. Wash hands and dry them
11. Wear gloves with gown sleeve cuff tucked into glove

Removing personal protective equipment when leaving the patient care area
The order in which personal protective equipment is removed is not as important as the
principle behind choosing such order. The key principle is that when removing personal protective
equipment the wearer should avoid contact with blood, body fluids, secretions, excretions and other
contaminants. When hands become contaminated they should be washed with mild soap and/or
decontaminated with 70 percent alcohol solution.
Steps in Removing PPE (General) / Doffing
 Using gloved hands, untie the gown string if tied in front and remove shoe covers.
 Remove gloves and discard in an appropriate manner.
 Wash hands.
 Remove gown and apron, without contaminating clothing underneath. Touch only inside of
gown and apron while removing. Place in appropriate disposal bag.
 Remove goggles, mask, and cap and place in a container.
 Wash hands up to wrists thoroughly with soap and water, dry and decontaminate hands
using 70 percent alcoholic hand rub before leaving facility.
1. GLOVES

Gloves are worn to prevent the health care worker’s hands from becoming contaminated with blood or
body substances. Gloves should be worn for:

 Procedures involving direct contact with the blood and body substances of any patient.
 Procedures where contact with blood and body substances might be expected to occur.
 Procedures involving direct or potential contact with the mucous membranes of any patient.
 Procedures involving direct or potential contact with the non – intact skin of any patient.
Non – intact skin is skin that is cut, chapped, abraded, afflicted with weeping or exudative
lesions, or is otherwise broken.

Sterile Gloves should be used for all sterile procedures and for activities that involve contact with areas
of the body that are normally sterile.

Gloves used in patient’s care should be worn only for contact with the patient. Once used, gloves
must be discarded before leaving the patient’s room.

1.1 Procedure for donning sterile gloves

i. Remove all jewelry , watch and any accessory on hands.

ii. Wash hands following the Hand washing protocols.
iii. Remove the packet of Gloves from the outer wrapper. Place this packet on a clean, dry, flat
surface.
iv. Unfold the packet as if opening a book. Position the packet so that the cuffed ends of the gloves
are nearest you.
v. Grasp the center flaps and open. Both gloves must have folded cuffs. Position the packaging so
that it lies flat.
vi. Use one hand to glove the other. Grasp the edge of the right glove cuff with the fingers of the
left hand, and slip the right hand into this glove. Pull it on by holding onto the cuff, but do not
touch the outside of the glove.
vii. Adjust both gloves so they fit properly. Make sure there are no gaps between the fingertips and
the ends of the gloves.
viii. Inspect the gloves for nicks and tears before and during the procedure. Obtain a new pair of
sterile gloves if there is a break in aseptic technique or if a nick or tear occurs.
i. Remove used gloves by turning it inside out, avoid touching the outside part of the gloves, then
perform Hand Hygiene.
2. FACE MASK

Standard surgical masks are to be used:

ii. When splashing, splattering, or spraying of blood or body fluids are likely in order to prevent
exposure to the mucous of the nose/mouth. Additionally, eye protection is warranted in such
situation as well.
iii. When within 3 feet of a patient on Droplet Precaution.
iv. When working in a sterile field to prevent droplets from contaminating the field.

Surgical masks do not provide adequate protection for those diseases spread by the airborne route
(PTB). For suspected or confirmed patients with pulmonary TB, A N-95/ HEPA respirator must be worn.

2.1. Procedure on Donning Surgical Face Mask

i. Clean your hands with soap and water or hand sanitizer before touching the mask.
ii. Removed a mask from the box and make sure there are no obvious tears or holes in either side
of the mask.
iii. Determine which side of the mask is the top. The side of the mask that has a stiff bendable edge
is the top and is meant to mold to the shape of your nose.
iv. Determine which side of the mask is the front. The colored side of the mask is usually the front
and should face away from you, while the white side touches you face.
v. Follow the instructions below for the type of mask you are using.
 Face mask with ear loops: Place a loop around each ear ties: bring the mask to your
nose level and place the ties over the crown of your head and secure with a bow.
 Face Mask With Bands: Hold the mask in your hand with the nosepiece or top of the
mask at fingertips, allowing the headbands to hand freely below hands. Bring the mask
to your nose level and pull the strap over head so that it rest over the crown of your
head. Pull the bottom strap over your head so that it rests at the nape of your neck.
viii. Mold or pinch the stiff edge to the shape of your nose.
ix. If using a face mask with ties: then take the bottom ties, one in each hand, and secure with a
bow at the nape of your neck.
x. Pull the bottom of the mask over your mouth and chin.

2.1. Procedure on removal of surgical face mask

i. Clean your hands with soap and water.

ii. Avoid touching the front of the mask. The front of the mask is contaminated. Only touching the
ear loops/ties/bands.
iii. Follow the instructions below for the type of mask you are using.

Face mask with ear loops: Hold both of the ear loops and gently lift and remove the mask.
Face mask with ties: Untie the bottom bow first then untie the top bow and pull the mask away
from you as the ties are loosened.
Face mask with bands: Lift the bottom strap over your head first then pull the top strap over
your head.
 iv. Throw the mask in the proper receptacle.
v. Clean hands with soap and water.

3. RESPIRATORS (PAPR)

Respirators are masks specifically designed to filter small particles spread by the airborne route. These
respirators are: N-95 Respirators and HEAP Respirators. All personnel who care for a patient with
suspected/ confirmed pulmonary TB and other airborne diseases such as COVID-19 must wear masks
upon entering the room of such patient.
Personnel using these respirators must be fit- tested before using either respirator.

4. GOWNS

Gowns, aprons, and other protective apparel are worn to prevent clothing from becoming soiled with
blood and body substances. Selection of the appropriate apparel is based on the amount of blood and
body substances likely to be encountered and the probability that clothing may be soiled. Gowns should
be worn:

i. During activities that involve the management of large amounts of blood and bloody substances
that may be difficult to contain.
ii. During procedures that may result in the splashing or splattering of blood or bloody substances.

4.1. Gowns should be:

i. Large enough to cover the clothing which is likely to contaminated.

ii. Made of moisture-resistant material that provides an effective barrier to body substances.
iii. Sterile gowns should be worn for procedures that require a sterile field.

4.2. Gowns should be changed:

i. After giving care to an individual patient.

ii. After performing any procedure involving instruments, equipment, or surfaces contaminated by
blood or bloody substances.
iii. Whenever gross soiling occurs
iv. Discard used gowns in the patient care area or in the other areas in which they are used.
v. When performing patient care, Hospital staff must consider all blood and body fluids as
potentially infectious.
vi. Before using Protective Barriers (gloves, gowns), Hospital staff must first assess risk assessment
to ensure appropriate PPE is used for all patient.

4.3. Procedures for donning clean gown

i. Use the clean gowns intended for Standard Precautions Purposes. The standard hospital
gowns worn by patients should never be used by staff.
ii. Slide gown over the hands and arms by holding arms forward and slightly above head.
iii. Fasten gown at the back of the neck, and tie the gown securely at the waist.
iv. If gloves will also be worn, pull the cuffs over the sleeves of the gown.
5. PROTECTIVE EYEWEAR

i. Protective eyewear is worn to prevent blood and body substances from containing the mucous
membranes of the eyes.
ii. Protective Eyewear is commonly utilized is the Labor and Delivery Unit, Operating Room, ICU
and ER.

Note: Patients on droplet precautions and contact precautions who have an infection with the same
microorganism may share a room provided that there are no other factors, infections, or circumstances
present that would require the use of a private room.

Standard Cleaning and Disinfection of (Confirmed or Suspect) Infectious Patient’s Room

These guidelines are intended for Cleaning and Disinfecting of Infectious Patient’s Room. Areas in which
a person with a suspect or confirmed infectious disease has confined and need to be disinfected before
resuming its use to prevent the spread of communicable disease an protect cleaning staff and next user
from possible infections.

1. After the patient is discharged from the period of confinement, vacate the room for about 6
hours.
2. The admitting together with Nurse on Duty will inform the Procare Staff and AirconTech on
room disinfection and cleaning with time allotment.
3. After 6 hours, Procare on Duty will activate the UV Devices for about 2 hours. This effectively
eliminates microorganisms. Procare staff should set up the UV Device safely with signage
included outside the room. After the UV device has completed disinfecting the patient room, it
should be returned to its assigned storage space and properly secured and locked.
4. While the UV disinfection process is being completed in the patient’s room, Procare staff should
set up for cleaning using WALL TO WALL METHODS.
5. Cleaning of Aircon Filter should also be done at the same time by our AirconTech.
6. After a patient room has been prepared for cleaning, another disinfection is applied using
Klorsept Spray. Wait for 15-30 minutes until the disinfectant gets dry.
7. The disinfected room will not be available for 12-24 hours after the wall to wall method.
8. Once the patient room has been completed, the Procare staff will inform the Nurse on Duty and
Admitting Section that the room is already for admission.