Infection Prevention and Control Practices

The assignment focuses on infection prevention and control practices in healthcare. It includes a review of guidelines, studies on nurses' behaviors related to infection prevention, and discussions on surgical site infections, multidrug-resistant bacteria, and the role of surveillance in infection control. Additionally, it examines biofilms and their impact, attitudes towards infection prevention among nursing students and mentors, and best practices for preventing Clostridium difficile infections.

INFECTION PREVENTION
AND CONTROL

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
Importance of infection preventing and control..........................................................................1
Different risks involved in health care setting............................................................................1
Standard precautions to manage risk...........................................................................................2
Additional precautions required..................................................................................................2
Ways in which infection risk and relevant controls are documented and recorded....................2
Measures that should be taken when accident occurs.................................................................3
Measures taken if there are contaminated waste, spill of blood and bodily fluid.......................3
Use of PPE..................................................................................................................................3
Hand washing, hand care and personal hygiene.........................................................................4
Methods of ensuring clean zones................................................................................................5
Necessity of clean zones.............................................................................................................6
Contaminated equipments and instruments should be segregated..............................................6
Various types of waste generated at these workplaces...............................................................6
Handling, storing and disposing of different types of wastes.....................................................7
Environmental surface and equipment must be cleaned and decontaminated............................8
Cleaning and storing of cleaning equipments.............................................................................8
Legislations related to risk management, infection control and waste management..................9
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Infection prevention and control refers to microbiology's clinical application that is in
workplace. This is an area that needs to be considered by health service organisation so as to
ensure patient’s health and safety. This is an integral part of increasing resistance against
microbial attacks. These are highly dangerous especially if it occurs in the health care
organisations as numerous patients come to these places (Adams and et. al., 2011). St Vincent's
health Australia is one of the largest nation's Catholic non-profit organisation in health and care
sector. It is operating in many parts of the country namely south Wales, Queensland and
Victoria. It was established in the year 1857 by sisters of charity. It has 6 public and 9 private
hospitals under it with around 18500 hundred staffs. This report highlights the importance of
preventing infection and control measures in health care organisations in Queensland Australia.
It also showcases about the waste management practices that is prevalent in this sector.
Importance of infection prevention and control
It is important to save patients and visitors from the infections that are caused while
visiting to health service organisations. Infections that are acquired at health care organisations
are highly dangerous and most common. It is one of the important complications that arise for
any health care unit (Backman and et. al., 2011). As visitors at these places are in great threat of
getting in contact of several transmitting diseases. If control measures are not implemented
people will be vulnerable to Infection or diseases that are caused by prions, fungi, bacteria or
viruses.
Different risks involved in health care setting
There are several risks that are involved in health care setting. Some of these are as follows:
 Infection due to contaminated equipment
 Proper handling of waste material
 Chances of getting in touch with radiation while handling radioactive materials
 Contamination of food served at these settings.
 Cuts due to improper handling of sharp instruments
 Transfer of air Bourne diseases
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Standard precautions to manage risk
Standard precautions are the minimum requirement for controlling infection. There are
various preventive measures and precautions that are required at health care units. Some of these
standard precautions are as follows:
 Hygienic practices such as washing and drying hands before and after contact with
patients (Basu and et. al., 2014)
 Personal protective equipment such as gown, masks, googles, gloves, plastic aprons and
eye shields.
 Proper disposable of contaminated clinical waste and preventive handling of sharp tools.
 Appropriate handling of patient’s body fluids, non-intact skin, blood, saliva, mucous
membrane, etc.
Additional precautions that are required
There are various other precautions that are required apart from minimum standard
precautions at health care settings:
 Airborne transmission such as chicken pox, tuberculosis can be prevented by using mask.
 Rubella, influenza and pertussis caused by droplet transmission of respiratory secretion
can be restricted by mask and googles.
 Use of gloves before being in contact with the patients having faecal contamination from
carriers like vancomycin resistant enterococci and those who are colonised with
methicillin resistant staphylococcus aureus.
 Allocation of specific rooms and dedicated toilets to patients with proper facilities.
 If single rooms cannot be provided then cohorting can be used.
 Proper distillation of the tools used in check-ups.
Ways in which infection risk and relevant controls are documented and recorded
Before the use of technological equipments there where manual methods in which risk
and relevant controls are documented and recorded (Burnett, 2011). With the introduction of
computers in the medical sciences record keepings of these incidents are done online. Some of
the methods are as follows:
 Online record keeping through use of cloud storage
 Incidents are documented in the computer storage
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 User manuals and registers can be used to store all these documents
Measures that should be taken when accident occurs
Various processes are necessary at the time when an accidents occur:
 Suppose any glassware gets break then immediate reporting must be done so as to clean
those pieces and the area must be caught an off (Cohen and et. al., 2015).
 Contaminated area must be sealed with barriers.
 Suppose any blood sprays enter into mouth or eyes, proper rinsing is required.
 If any cuts occur then proper medication must be applied at that place immediately.
Measures taken if there is contaminated waste, spill of blood and bodily fluid
These wastes are highly dangerous in terms of how much they can spread diseases at
health service organisations like St Vincent's Health Australia. Some of the measures that must
be taken are as follows:
 Workers must clean small spills of blood or bodily fluid by cleaning it with detergent
 Use proper PPE like gloves and aprons while removing these wastes and spills
 Larger spill can be handled and removed by the following methods:
1) Disposable papers or towel can be used to remove visible organic matters
2) Remove broken glass or other sharp materials using forceps
3) Excess liquid is soaked up by absorbent clumping agent
4) Use of disinfectant can be beneficial at the places where contaminated waste is to be cleaned
5) Place contaminated waste into containers that are impervious like plastic bags
 Wet vacuums can be used to clean contaminated wastes.
 Use of alcohol in cleaning spillage is not suitable.
Use of PPE
PPE is highly useful in protection against infections (Damani, 2011). These protect health
care workers from any kind of exposure to bacteria, viruses or others. PPE that is used in the
cited organisation are as follows:
 Gloves: These are important to be in used when touching the infected or suspected
patients. Use of these gloves can be understood by the following points:
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1) Wear gloves while touching contaminated waste, blood, non-mucous membranes and other
body fluids
2) Change gloves between procedures on same or different patients after contact with equipment
that may contain highly concentrated micro-organisms (Elliott and Weinstock, 2012)
3) Wash and dry hands after the disposing gloves
 Gowns: Use of these can be understood by the following points:
1) Wear gown so as to prevent soiling of clothes during procedures related to health care
activities. It helps to prevent from getting contaminated with germs arising from body fluids or
blood sprays.
2) Selection, removal and cleaning of gowns must be on the basis of vulnerability that are
possessed by amount of fluid that are likely to be encountered.
 Masks: These are generally used to save mouth and nose from getting contaminated with
infected blood or body fluids. It safeguards against the transmission of airborne and
respiratory related diseases.
 Waterproof Aprons: In the places where there can be chances of being in contact of
blood or other body fluids, these aprons are highly useful. At the time of cleaning of
patient's used clothes, these aprons are to be used.
 Googles: These PPE equipment are highly beneficial in protection of eyes from blood
sprays and other body fluids. Members of surgical theatres are in high risk of getting eye
contaminations.
 Footwear: It is used to protect foot from getting in contact with the contaminated waste
that are generated during various health services (Edwards and et. al., 2012). Blood and
sharp materials that may be contaminated can cause severe diseases and in protection
with these footwear is useful.
Hand washing, hand care and personal hygiene
Hand washing, hand care and personal hygiene is important for the workers, patients and
visitors at these places. Washing of hands and drying them after various procedures of health
services is highly important in protection against contamination that is caused by touching of
blood, secretion, body fluids, excretion and use of equipment. This has to be done irrespective of
use of gloves. This must be done immediately after the removal of gloves.
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Hand care is properly ensured by selecting right kind of gloves according to work that
needs to be done in the health services (Gould and Drey, 2013). Proper handling of needles and
other sharp equipment can ensure any damage to the hand. Use of liquid soaps can protect the
hands from infections.
Personal hygiene maintenance at these places is highly important so as to provide safe
guard against infections. Use of toilet and hand washing afterwards help the workers in
safeguarding against diseases. Workers should protect their food items from any contamination.
Selection of the places where they can have their food is highly important. Use of PPE at these
places are some of the factors on which personal hygiene depends.
Methods of ensuring clean zones
It is necessary to ensure clean zones at health care units. There are several methods that
are used for cleaning purpose.
Methods are as follows:
 Proper monitoring of places through reporting by workers.
 Use of proper cleaning methods according to floors or places that are to be cleaned like
use of driers and towels at the places where small spills are made.
 Proper disposal of contaminated waste.
 Maintain the slip resistant property of floor at various place.
 Cleaning schedules must be made irrespective of whether any spills are reported or not.
 These cleaning must be well planned and managed.
 Rapid and urgent response to any spills.
 Use of proper equipment in cleaning procedures is important in ensuring clean zones at
St. Victoria's health Australia.
 Use of barriers and signs for keeping staff and people away at the time when cleaning is
done.
 Dedicated workers for cleanliness and waste management (Halpin, H., et. al., 2011).
Necessity of clean zones
Clean zones are necessary for these organisations because of the following reasons:
 It provides a place that can be used by the workers for various processes like eating or
relaxing.
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 They can keep their personal use items like bags at these places.
 In keeping visitors isolated from the patients who are infected or suspected to be
infectious (Hookey and et. al., 2013).
 Clean zones can be used for normal and day to day interactions between staffs and other
personnel.
Contaminated equipment and instruments should be segregated
Answer to the question that why these contaminated instruments and equipment should
be segregated can be understood by the following points:
 It transmits diseases which are caused by bloods or other body fluids.
 It helps to prevent workers from getting ill.
 Diseases like HIV can be stopped if needles are properly disposed after one use.
Contaminated instruments and equipments should be segregated by:
 Use of dustbins for immediate disposal of wastes
 Use of sterilising machines for cleaning of these equipment after each procedure
 Use of plastic bags for keeping these instruments
Various types of waste generated at health care organisations
The amount of infectious waste generated is large in amount and is of different kinds.
Some of the types of wastes are as follows:
 Infectious waste: These are those wastes that may contain or are subjected to have
pathogens in it. For example: equipments are after contact with patients fluid.
 Pathological waste: These wastes are generated by various pathological procedures that
are associated with human tissue or fluid (Jackson, Lowton and Griffiths, 2014). E.g. of
these wastes are blood and other fluid.
 Sharp waste: These are those wastes that have sharpness in its shape. E.g. needle,
knives, blades, broken glasses or other infusion sets.
 Pharmaceutical waste: The wastes that are generated by operations of pharma
department are known as pharmaceutical wastes. For example: expired medicines, bottles
and plastic wrappers of medicines.
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 Genotoxic wastes: Wastes consisting of substance with genotoxic properties comes
under this category of waste. like cytostatic drugs using in treatment of cancer (Junker, et.
al., 2012).
 Chemical wastes: Laboratory reagents, disinfectants etc. comes under this category of
waste.
 High content of heavy metals: Batteries, thermometers and blood pressure gauges are
some of the examples of these kinds of waste.
 Other wastes: Gas cylinders, aerosols, unused liquid, contaminated glassware, urine
excreta of patients and radioactive particles are some of these wastes.
Handling, storing and disposing of different types of wastes
There are several procedures of collecting, storing and disposing of wastes. Handling of
these wastes is one of the important practices that is needed to be implemented by various
organisations. Proper ways of collection are:
 Nursing and other staffs must ensure that waste bags are tightly closed after it is more
than half filled. Light gauged bags are closed by tying the neck whereas heavy gauged
bags requires plastic sealing.
 Waste must not be allowed to assemble at the point from where it was produced.
 It should be collected regularly.
 Labelling must be done on waste that contains information about content and point of
production.
 Bags must be replaced by the new ones of same type.
Handling of these wastes include segregation and packaging:
 Sharps must be collected irrespective of the fact that whether they are contaminated or
not. Containers of these sharps must be puncture proof (Khan, Dancer and Humphreys,
2012). Containers of dense cardboards can be used if metal containers are costly.
 Bags of infectious waste must be marked with signs with international infectious
substance symbol.
 Cytotoxic waste must be collected in leak proof strong container with proper labelling.
 Pharmaceutical waste can be collected with infectious waste.
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 Colour coding must be used for the bags of health care waste; highly infectious and
sharps waste (yellow), chemical and pharmaceutical waste (Brown), General health
service related waste (black).
Storage of these wastes can be done by the following methods:
 Waste and these bags must be stored in separate room, area or building.
 These areas must be big enough to store all these wastes.
 Cytotoxic wastes must be stored in designated place that is separated from other wastes
(Mayhall, 2012).
 Radioactive waste must be stored in dispersion less containers and should be labelled
with the type of radionuclide it contains.
Environmental surface and equipment must be cleaned and decontaminated
These surfaces and equipment must be cleaned on a regular basis and these frequencies
must be fixed. Everyday and immediate cleaning of certain places is necessary. These surfaces
are cleaned accordingly:
 Minimal touch surfaces: Detergent solutions are adequate for cleaning of general
surfaces. Damp Mopping is sufficient for routine cleaning. Walls, sinks, wash basins and
floors in the patients ward must be cleaned with detergent solutions. Further, curtains
should regularly be changed.
 Frequently touched surfaces: These must be cleaned on regular basis. General purpose
cleaning methods must be used for cleaning. Toilets must be cleaned with detergent
impregnated wipes.
Cleaning and storing of cleaning equipment
Cleaning equipment are used on regular basis in these organisations. So, proper cleaning
and storing of these equipment are necessary. Process used for storing and cleaning must depend
on the level of infections it encountered (McHugh and et. al., 2011). Packaged, dry and sterile
equipment must be stored in dry environment away from sharp instruments that may damage the
packaging. Cleaning of equipment: Equipment that are in contact with cavity or blood stream: Clean equipments thoroughly
with steam under pressure immediately after the use. If the instrument is sensitive
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towards temperature than sterilized through automated low temperature chemical like
ethylene oxide. Equipment that are in contact with intact mucous membrane: Thermal disinfectant for
temperature sensitive equipment other wise steam sterilisation is enough for the cleaning
purpose. (Pegram and Bloomfield, 2015).
 Contact with intact skin: Detergent or disinfectant can be used to clean these items.
Legislations related to risk management, infection control and waste management
In Queensland Australia, there are various legislations related to infection control, risk
and waste management. Work health and safety act 2012 was the act that provides legislative
framework for risk management. Key elements of this is as follows:
 Establish health and safety duties while protecting persons from exposure to hazard and
risk that arise at workplace (Mitchell and Gardner, 2014).
 A person or organisation must ensure that health and safety of other persons is not put at
risk by the work or business carried out at that place.
 Part 2, division 2 of this law ensures that safe use and handling of equipments, and proper
disposal of waste (Percival, et. al., 2014).
 Proper training of workers at regular intervals so as to safeguard them from health service
related hazards.
CONCLUSION
From the above based report it is concluded that health service acquired diseases are most
common. There must be safety measures that needs to be implemented so as to safeguard
workers, visitors and patients from health related issues. It has been assessed from the report that
transmission of diseases can be through viruses, bacteria and fungi that can be spread by
instruments or equipment used in these organisations. PPE are highly useful in protecting
workers from these hazards. Report shows that proper cleaning at regular intervals is required.
Work health and safety act 2012 provides legislative framework to implement health safety for
the workers in Queensland Australia.
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REFERENCES
Books and Journals
Adams, S., et al., 2011. Visitation in the intensive care unit: impact on infection prevention and
control. Critical care nursing quarterly. 34(1), pp. 3-10.
Backman, C., et al., 2011. An integrative review of infection prevention and control programs for
multidrug-resistant organisms in acute care hospitals: a socio-ecological perspective.
American journal of infection control. 39(5). pp. 368-378.
Basu, D., et al., 2014. The importance of the central sterile supply department in infection
prevention and control. infection control and hospital epidemiology. 35(10). pp. 1312-
1314.
Burnett, E., 2011. Outcome competences for practitioners in infection prevention and control:
infection Prevention Society and Competency Steering Group. Journal of Infection
Prevention. 12(2). pp. 67-90.
Cohen, C.C., et al., 2015. Infection prevention and control in nursing homes: a qualitative study
of decision-making regarding isolation-based practices. BMJ Qual Saf. 24(10). pp. 630-
636.
Damani, N., 2011. Manual of infection prevention and control. OUP Oxford.
Edwards, R., et al., 2012. Optimisation of infection prevention and control in acute health care
by use of behaviour change: a systematic review. The Lancet infectious diseases. 12(4).
pp. 318-329.
Elliott, D.E. and Weinstock, J.V., 2012. Helminth–host immunological interactions: prevention
and control of immune‐mediated diseases. Annals of the New York Academy of Sciences.
1247(1). pp. 83-96.
Gould, D. and Drey, N., 2013. Student nurses' experiences of infection prevention and control
during clinical placements. American journal of infection control. 41(9). pp. 760-763.
Halpin, H., et al., 2011. Hospital adoption of automated surveillance technology and the
implementation of infection prevention and control programs. American journal of
infection control. 39(4). pp. 270-276.
Hookey, L., et al., 2013. Summary of guidelines for infection prevention and control for flexible
gastrointestinal endoscopy. Canadian Journal of Gastroenterology and Hepatology.
27(6). pp. 347-350.
Jackson, C., Lowton, K. and Griffiths, P., 2014. Infection prevention as “a show”: a qualitative
study of nurses’ infection prevention behaviours. International journal of nursing studies.
51(3). pp. 400-408.
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Junker, T., et al., 2012. Prevention and control of surgical site infections: review of the Basel
Cohort Study. Swiss medical weekly. 142, p.w13616.
Khan, A.S., Dancer, S.J. and Humphreys, H., 2012. Priorities in the prevention and control of
multidrug-resistant Enterobacteriaceae in hospitals. Journal of hospital infection. 82(2).
pp. 85-93.
Mayhall, C.G., 2012. Hospital epidemiology and infection control. Lippincott Williams &
Wilkins.
McHugh, S.M., et al., 2011. The role of topical antibiotics used as prophylaxis in surgical site
infection prevention. Journal of antimicrobial chemotherapy. 66(4). pp. 693-701.
Mitchell, B.G. and Gardner, A., 2014. Addressing the need for an infection prevention and
control framework that incorporates the role of surveillance: a discussion paper. Journal
of advanced nursing. 70(3). pp. 533-542.
Pegram, A. and Bloomfield, J., 2015. Infection prevention and control. Nursing Standard.
29(29). pp. 37-42.
Percival, S.L., et al., 2014. Biofilms in Infection Prevention and Control: A Healthcare
Handbook. Academic Press.
Ward, D.J., 2012. Attitudes towards infection prevention and control: an interview study with
nursing students and nurse mentors. BMJ Qual Saf, pp.bmjqs-2011.
Wilkinson, K., et al., 2011. Infection prevention and control practices related to Clostridium
difficile infection in Canadian acute and long-term care institutions. American journal of
infection control. 39(3). pp. 177-182.
World Health Organization, 2014. Infection prevention and control of epidemic-and pandemic-
prone acute respiratory infections in health care. World Health Organization.
Zingg, W., et al., 2015. Hospital organisation, management, and structure for prevention of
health-care-associated infection: a systematic review and expert consensus. The Lancet
Infectious Diseases. 15(2). pp. 212-224.
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