Key Aspects of Clinical Hand Wash
To ensure appropriate hand decontamination health care workers should wash with soap and water when hands are visibly soiled and use the 6-step approach to hand decontamination.
1. Before, after eating/smoking, after the toilet
2. Before significant contact with patient
3. Before and after routine use of gloves
4. After patient, instrument contact
The use of personal protective equipment such as wearing gloves is based on an assessment of the risk of transmission of infectious agents to the patient or health Care staff by patients’ blood, body substances, secretions or excretions
Factors to be considered are;
• probability of exposure to blood and body substances;
• type of body substance involved
• probable type and probable route of transmission of infectious agents.
Standard precautions are guidelines or practices put in place with a purpose of controlling infections (Thomson et al., 2013). The standard precautions may include good hygiene practises such as washing hands, putting on personal protective gears such as, gloves, masks while undertaken a given task, proper handling and disposal of contaminated wastes used in the health care set up.
Gowns or waterproof aprons are worn when close contact with a patient or equipment with infected material and blood or body fluids. The main reason for wearing a gown or water proof apron is prevent soiling of clothes during contact with patients. Gowns may also be required for contact precautions which depends on the expected amount of exposure to infectious material.
mplementation of droplet precaution for a patients known or suspected to be infected with agents transmitted by respiratory droplets such as coughing, sneezing or talking. For example patient suspected to have infuenza, Respiratory syncytial virus (RSV) and meningococcus, norovirus or pertussis.
Implementation of droplet precaution for patients known or suspected to be infected with agents transmitted person to person by airborne route. For example Rubella virus (measles), varicella virus (chicken pox) and Mycobacterium tuberculosis or SARS. Wearing a mask covers your face and nose and protects against splashed body fluids.
All clean materials, equipment and supplies are stored in a clean, hygienic area free from the possibility of contamination and not come into contact with waste, dirty linen or other contaminants.
Disinfection is the process or act of destroying pathogenic microorganisms and removes most organisms present on surfaces. Sterilisation is a process that eliminates or kills all forms of life, including transmissible agents such as viruses, bacteria, fungi and spore forms.
When to Use Gloves and Masks
All surface area should be disinfected between patient transfers. All surfaces should be allowed to completely dry before placing the ambulance back online. Where possible the vehicle should be aired in the full sun light as often as practical, with all vehicle compartments open.
Pathogenic organisms can be found in ambulances and health care facilities. These maybe transmitted to patient via direct contact from environmental sources, indirectly through contact with health care workers. It is important to conduct surface disinfection to minimise the risk of transmission. Frequently touched surfaces should be cleaned daily (bedrails, light switches, door handles, tables).
Surface cleaning, also known as dry cleaning is a mechanical technique of cleaning used to decrease superficial grime, soil, dust, droppings of insects, accretions and other surface deposits.It is used in paper conservation, and does not make use of organic solvents. There are three basic types of eraser materials used generally by paper conservators: vinyl, factice and rubber.
The purpose of surface cleaning is to reduce the potential damage to paper artifacts by removing foreign materials which can be abrasive, acidic, hygroscopic or degradative.The NHMRC Guidelines recommends the following practises when engaging with spills of blood and other body fluids.
Cleaning the urine spill on the stretcher;
• Standard precautions always apply
• Wear PPE and employ transmission-based precaution
• Confine spill
• Remove visible matter with absorbent disposable material
• Clean are with detergent
• Chemical Sodium hypochiorite As per risk assessment
• Paper towel, dispose all items in Biohazard bag.
The NHMRC Guidelines recommends the following practises when engaging with spills of blood and other body fluids.
Cleaning the urine spill on the stretcher;
• Standard precautions always apply
• Wear PPE and employ transmission-based precaution
• Confine spill
• Remove visible matter with absorbent disposable material
• Clean are with detergent
• Chemical Sodium hypochiorite As per risk assessment
• Paper towel, dispose all items in Biohazard bag.
The NHMRC Guidelines recommends the following practises when engaging with spills of blood and other body fluids.
Cleaning the urine spill on the stretcher;
• Standard precautions always apply
• Wear PPE and employ transmission-based precaution
• Confine spill
• Remove visible matter with absorbent disposable material
• Clean are with detergent
• Chemical Sodium hypochiorite As per risk assessment
• Paper towel, dispose all items in Biohazard bag.
- Preliminary rinse in cold water to remove organic residues.
2. Cleaning at temperature of 40-60 degrees celcious.
3. Intermediate rinse to remove cleaning solution by means of cold or hot water.
4. Thermal disinfection conducted with demineralised
water at temperature between 80-93 degrees celcious.
5. Drying.
Bacteria are single celled organisms microscopic known as either prokaryotes and eukaryotes. Bacteria enters the body through natural openings, such as the nose, mouth and even breaks in the skin. In addition to transfer of bacteria through natural openings, bacteria is also transferred from one person to another by means of food, water and air. Harmful bacteria thrives in diverse environments found in: soil, water, plants, animals, radioactive waste, deep in the earths crusts, organic material, artic ice and hot springs, basically everywhere except for places that humans have sterilised.
Standard Precautions for Infection Control
Clostridium species-a genus of gram positive bacteria which includes several significant human pathogens including causative agent of botulism, tetanus and gangrenes.Bacillus species-are aerobic, rod shaped, endospore forming gram positive bacterial species. Bacillus anthracis species causes anthrax and other associated complications of the disease such as cutaneous anthrax and pulmonary anthrax.Paenibacillus alvei- is a bacterial associated with honey bee disease. It is a species of bacteria belonging to the order bacillales and its species grow in novel, vortex-like or branched patterns.
Colonization is the presence of microorganisms in or on the body without causing sickness or symptoms of sickness, as infection refers to the presence of germs in or on the body which makes the individual display signs and symptoms of sickness such as fever, pus discharge from wound and a change in blood parameters, while an infectious disease is a disorder caused by organisms such as bacteria, viruses, fungi or parasites which are highly transmitted from one person to another through bites, droplets and body fluids or close contact with an infected person.
Fungi is a group of eukaryotic organisms, whose examples include moulds, mushrooms and yeasts, and whose study is known as mycology. They are heterotrophs like any other organism.
Fungi play vital role in the ecosystem. They are essential in the recycling of nutrients in all terrestrial habitats because they are the most dominant decomposers of a complex components of plant debris such as cellulose and lignin.
During medication, fungi can become opportunistic when the usual normal flora of that body is eliminated by the drug, or the drugs such as corticosteroids and others have caused immunosuppression of the host resulting into a disease vulnerability.
Fungi is a group of eukaryotic organisms, whose examples include moulds, mushrooms and yeasts, and whose study is known as mycology. They are heterotrophs like any other organism.
Fungi play vital role in the ecosystem. They are essential in the recycling of nutrients in all terrestrial habitats because they are the most dominant decomposers of a complex components of plant debris such as cellulose and lignin.
During medication, fungi can become opportunistic when the usual normal flora of that body is eliminated by the drug, or the drugs such as corticosteroids and others have caused immunosuppression of the host resulting into a disease vulnerability.
A virus is a very tiny and small particle that is capable of causing an infection to a cell and potentially causing a disease. It is unable to reproduce without help of a host cell. All viruses contain genetic material either DNA or RNA enclosed in a case made of protein. Not all viruses carry diseases.
A virus differs from bacteria in that; a virus is an acellular organism while a bacteria is a prokaryotic organism, virus lacks ribosome while bacteria has, virus lacks cell wall and instead has a protein coat, while bacterial has a cell wall and last but no least, a virus contains either DNA or RNA enclosed inside a protein coat while bacteria has DNA and RNA freely floating in the cytoplasm, contains a cell wall and a cell membrane.
Cleaning, Disinfection and Sterilization
Contact transmission is a mode of infectious disease transmission which occurs from one person to another. It is divided into direct and indirect contact transmission. Under direct contact direct transmission,a disease can transmitted via person-to-person contact such as touching and also droplet spread during coughing or sneezing.
Indirect contact transmission can occur through airbone transmission and contaminated ojects or instruments.
An example including infection with ebola virus after touching an infected person, or infection with measles after entering a room where infected person coughed and departed a while ago.
As an healthcare worker, i have numerous responsibilities in infection control and prevention. I shall;-
1. Raise an alarm to those in authority in case of occurrence of an infectious disease and prevent further spread of the disease as well as finding the cure to the disease.
2. Ensure colonized and infected patients receive appropriate treatment as well as communicate the reason for treatment and infection control precautions with patients and relatives.
Assist in defining appropriate control measures, obtain list of cases and where relevant their contacts, with the cooperation of the wards/facility staff and occupational health, assist in collection of environmental samples and assist in development of case definition.
As a health care worker, i have a responsibility to maintain clean and contaminated zones which will help to minimize the risk of contamination and make it easier to remember that anything entering a clean zone must be decontaminated. I will also ensure that anything clean entering a contaminated zone must not be taken back to the clean zone without being decontaminated thoroughly. To ensure this, the various processes for records should be put in order and appropriate, the used and unused equipments should be labelled clearly so as to avoid possible confusion. Also, the medicaments and instruments should be well placed in the best conditions possible. Signage is also very crucial and must be put in the appropriate places indicating clean zones and contaminated zones.
The contaminated clothing should be removed with no delay, and the injured area should be cleaned with an antiseptic or normal saline in absence of water. The exposed mucous membranes should be cleaned as well. The exposure incident should be reported as soon as possible for the necessary measures to be taken. The exposed person has to be examined to confirm the nature of exposure and counselled about the possibility of transmission of blood-borne disease. In relation to the possible outcome of exposure, the person should be put in line of treatment to minimize the chances of infection or negative outcome of the exposure.
As health care workers regular hand hygiene such as washing hands increase in the breakdown of the keratinised epithelium of the hands, due to the drying out the skin leading to cracks and skin breakdown. To prevent skin breakdown and portal entry/exit for a microgram it is recommended to apply hand moisturiser after hand washing.
Hand Care Australia recommended that health care workers should avoid wearing jewellery such as; bracelets, wrists watch and rings with stones or ridges. Wearing jewellery can harbour microbes and rug against skin causing shedding of skin cells.
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