Infection Control Policy

• Introduction
• Standard precautions
  • Handwashing
  • Barrier creams
  • Waterless handwashing
  • Personal Protective Equipment (PPE)
  • Sharps management
  • Linen handling
• Additional precautions

Introduction

In the health care setting infection can easily spread from person to person.

• A client may be infected while receiving care.
• A health worker may be infected while carrying out their duties.
• People who work or interact with clients in a health care setting may be infected.

This transmission of infection is called cross infection.

It is essential to understand the way infection is controlled in any health care setting including hospitals, residential aged care, community services, dental practices, mortuaries or alternative health care services.

At Sunset Bay Health Campus we aim to create a safe and healthy work environment. There is a two-tier approach to management of cross infection:

• standard precautions, and
• additional precautions.

Standard precautions

Standard precautions can be defined in three ways. They are:

• safe work practices for the care and treatment of all clients regardless of their known or presumed infectious status,
• the minimum required level of infection control in all settings and all situations, and
• designed to protect both clients and health care workers.

Standard precautions include the following five procedures:

• hand washing,
• use of personal protective equipment,
• correct handling and disposal of waste,
• appropriate cleaning of client care equipment, and
• hygienic environmental control.

Standard precautions apply whenever you may come in contact with the following four bodily substances:

• blood (including dried blood),
• all body substances, secretions and excretions (excluding sweat), regardless of whether or not they contain visible blood,
• non-intact skin, and
• mucous membranes.

Handwashing

Handwashing is the single most effective way to reduce the number of microorganisms on the surface of the skin. It should always be performed:

• before and after contact with a client,
• before and after eating,
• after using the toilet,
• before and after using gloves,
• after contact with used equipment, and
• immediately following contact with bodily fluids.

Standard handwashing procedure:

1. Remove jewellery.
2. Wet hands thoroughly all over.
3. Use pH neutral soap.
4. Lather soap all over hands.
5. Rub hands together vigorously for 15-20 seconds. Pay particular attention to the fingertips, thumbs, wrists, finger webs and the backs of the hands.
6. Rinse under running water.
7. Pat hands dry with paper towels.

Barrier creams

The best protection against bacteria is intact skin, so each time you wash your hands you should apply barrier cream. Take care when cutting your finger nails and pay attention to maintaining intact cuticles. Any wound or abrasion should be covered using a waterproof dressing.

Waterless handwashing

There are waterless alcohol based hand wash solutions that are as effective as soap and water hand washing. These preparations should only be used when there is no visible soiling of the hands. If there is visible soiling, then soap and water hand washing should be used. These waterless preparations contain an emollient and aid in reducing damage to the hands.

Gloves do not replace hand washing, it is an additional protective measure to handwashing. Hands should be washed before and after using gloves.

View the standard handwashing technique and check your knowledge.

Personal Protective Equipment (PPE)

Some of the duties that you perform in the workplace may require you to protect yourself from either the environment in which you are working, infectious clients, or to protect the client from you if you are infectious.

Personal protective equipment also includes any substance, such as sunscreen, used to protect health. Sunset Bay Health Campus gives our staff training in the relevant protective equipment necessary for their workplace. This training covers:

• recognising the risk or hazard,
• knowing when to use protective equipment,
• basic understanding of the equipment and how it is protective,
• selection of the correct equipment,
• safe working practice when using equipment following organisations policies and procedures,
• correct fit and comfort of PPE,
• disposal/cleaning and storage of the goods,
• limitations in use, and
• replacement of equipment.

Yearly refresher courses are held to ensure that all staff are up to date with the equipment. This regular education on the correct use of the equipment ensures that when staff needs to use protective equipment they fully understand how and when to use which equipment. All equipment for protective purposes must also meet with Australian standards.

The Sunset Bay Health Campus requires all employees to comply with correct personal protective equipment standards while at work.

Respiratory Protection

Masks are worn to protect you from the environment in which you are working, and infection from clients. They are also worn to protect the client from you if you are infectious. The correct mask must be worn depending on the situation at hand.

Type of protective equipment	Type of use	Correct usage	Photo of the item in use
1. Paper Mask	Wear in areas where droplet infection of the client is a concern. Wear when the worker has a cold. Cannot be worn for extended periods.	Cover the nose and mouth. Secure correctly behind your ears with elastic fastenings.
2. Surgical mask	Wear in areas where droplet infection of the client is a concern. Can be worn for extended periods.	Cover the nose and mouth. Secure correctly behind the ears with tape fastenings.
3. Specialised particulate respiratory filter mask	Wear to protect from droplet infection from active pulmonary tuberculosis clients.	Cover the nose and mouth. Secure correctly behind the ears with elastic fastenings.
4. Respiration mask	Wear when there are noxious fumes, harmful dusts, sprays, vapours and mists.	Has an inbuilt filtration system. Cover the nose and mouth. Secured correctly behind the ears by straps.

Foot Protection

Appropriate footwear should be worn at all times for your own safety and to prevent the spread of infection.

Type of protective equipment	Type of use	Correct usage	Photo of the item in use
1. Shoe covers	Wear to protect from contamination when entering an area of infection. Wear to prevent contamination from spreading.	Cover shoe completely and tie securely. Made from polypropolene. Discard after use.
2. Enclosed, waterproof footwear with non-slip soles	Wear at all times to reduce contact with blood, bodily secretions, excretions, disinfectants, chemicals.	Upper section of footwear should cover all of the upper foot and be made of waterproof material. Soles should be made of a substance that reduces the chance of slipping. Shoes should be flat, with a heel of not more than 2.5 cm.
3. Protective footwear	Wear to protect from splashes, drips, and the dropping or rolling of heavy objects.	Footwear with a steel toecap, a heavy duty upper and rubber soles.

Hand protection

Hand washing should be carried out before and after glove use as gloves may have pinholes or other defects.

Workers who develop an allergy or sensitivity to glove powder or contact with latex proteins need to advise their supervisor that they require alternative gloves. You can read about latex allergies here.

Type of protective equipment	Type of use	Correct usage	Photo of the item in use
1. Sterile gloves	Wear when likely to have contact with sterile body cavity or tissue of a client.	Always check for holes.Only wear once. Discard after use.
2. Non sterile gloves	Wear to reduce contact with blood, bodily secretions, excretions, disinfectants, chemicals.	Always check for holes. Only wear once. Discard after use.
3. General-purpose utility gloves	Wear for cleaning and during manual decontamination of used instruments and equipment	Always check for holes. Clean and store dry between uses. Replace when showing signs of deterioration.
4. Heavy duty gloves	Wear to reduce the risk of cuts, punctures or lacerations. Wear to reduce the risk of injury from chemical or thermal burns.	Always check for holes. Clean and store dry between uses. Replace when showing signs of deterioration.

Body Protection

Gowns and clothes such as overalls will reduce the possibility of contact with hazardous or contaminated substances. They also protect from contact with microorganisms.

Type of protective equipment	Type of use	Correct usage	Photo of the item in use
1. Fabric or paper gown	Wear to protect self from infectious client. Wear to protect client from possible exposure to microorganisms.	Has ties at the neck and at the waist. Both sets of ties need to be tied securely. Discard paper gown after use. Wash fabric gown. If infectious, place in correct linen bag and secure. Change between clients.
2. Plastic Apron	Wear to reduce contact with blood, bodily secretions, excretions, disinfectants, chemicals.	Has ties at the neck and at the waist. Both sets of ties need to be tied up. Clean and store dry between uses. Change between clients.
3. Overalls	Wear when there is a risk of splashing from corrosive materials.	Change if overalls become contaminated. Wash after use. Disposable overalls should be correctly discarded after use.

Eye Protection

Eyewear provides the worker or client with protection from splashes. Splashes may be from bodily fluids, chemicals spray or splash, dust or particles.

Type of protective equipment	Type of use	Correct usage	Photo of the item in use
1. Safety spectacles	Wear when there is the risk of eye injury from splashing.	May look like normal glasses or may have side shields. Cannot wear glasses underneath. Clean after use.
2. Goggles	Wear if required when using potentially dangerous equipment. Wear when handling dangerous substances such as chemicals Wear instead of safety spectacles if you wear glasses	Have a larger area of coverage. May wear glasses underneath. Clean after use.

Head Protection

Protection of the head is important in many areas. It is also important as a means of preventing contamination.

Type of protective equipment	Type of use	Correct usage	Photo of the item in use
1. Hairnet/Cover	Wear to prevent contamination from falling hair.	Hair should be tied up and completely tucked into cover.
2. Hard Hat	Wear when there is a danger of falling objects	Should be correct type of hat for different work areas

Ear Protection

Ear protection is necessary when there is a risk of auditory damage.

Type of protective equipment	Type of use	Correct usage	Photo of the item in use
1. Ear Plugs	Wear to reduce harm from noise.	Roll the ear plugs until they are thin and then place them into your ear canal where they will reexpand to the shape of the canal
2. Ear Muffs	Wear when operating loud machinery.	Place them firmly over your ears so that your entire ear is covered. The strap sits across the centre of your head joining the 2 ear pads

Sharps Management

Sharps are any item that has the possibility to puncture or penetrate. They include:

• needles, scissors, scalpels, razors, or
• anything that could constitute a danger of penetration such as a sharp piece of metal, broken glass or a sharp piece of plastic.

Methods to reduce the incidence of needle stick injuries and contamination include:

• safe work practices and on going training,
• the development and use of retractable needles and syringes and needle-free IV delivery systems,
• rigid sharps disposal containers placed strategically in all work and clean up areas, and
• the correct use of personal protective equipment where possible to reduce injury, eg; heavy-duty leather gloves for maintenance personnel.

Sharps containers:

• are made of a puncture proof, rigid plastic material, with a non-opening lid,
• have an opening section through which all "sharp" objects should be placed,
• come in different sizes with larger and smaller openings, and
• may be portable or fixed to a wall.

Sharps containers should be:

• removed and replaced with a new one when full,
• kept in areas where staff may easily access them,
• kept separate from other containers and be easily seen if transported, and
• taken to the area where the sharps are being used to reduce the transporting of the sharps.

Each staff member:

• is responsible for the safe disposal of any sharp they use or come across,
• should at no time try to empty the container, and
• should be educated as to Sunset Bay Health Campus’s sharps management policy during induction and again during regular in service training.

Linen Handling

• All linen should be handled carefully so that there is minimum dispersion of microorganisms.
• Appropriate personal protective equipment should be worn when handling linen soiled with bodily substances.
• Used linen should be bagged at location of use in appropriate laundry receptacle.
• Linen that is heavily soiled with blood or other bodily substances should be placed in leak proof bags and securely tied.
• Hands should be washed after handling used linen

Additional precautions

Additional precautions are put into place when there is a higher level of protection required to prevent the transmission of infectious diseases. They are used in addition to standard precautions.

There are three types of infection transmission possible in health care settings:

• Airborne transmission which includes pulmonary tuberculosis, Varicella (chickenpox), measles.
• Droplet transmission which includes rubella, pertussis, influenza and some types of meningitis.
• Contact transmission which includes Vancomycin Resistant Enterococci (VRE), open or discharging purulent wounds, skin ulcers or clients with Methicillin Resistant Staphylococcus Aureus (MRSA).

Additional precautions may include the following five procedures:

• client isolation,
• the use of gloves and gowns, where the protective equipment is removed and discarded into the waste bin in the room prior to exiting,
• hands are washed before and after glove use,
• equipment stays in the room rather than going back into general population use, and
• there is specialised equipment cleaning and disinfection of both the equipment and the environment.