Hand hygiene is a personal hygiene practice which is aimed at reducing the infectious agents’ transmission risks through contact. These infectious agents can contaminate hands through contact with patient’s surroundings, other healthcare workers, the environment and the patient. In practice, hand hygiene should be practiced after every episode of contact with the patient and any other activity that can result into contamination of the hands including removal of gloves. Therefore, regular hand hygiene should be conducted before a procedure, before touching a patient, after touching a patient and their surroundings and after risk of exposure of a body substance/ a procedure. In addition to that, hand hygiene should be practiced before starting or leaving work, handling or eating any foods or drinks and using computer keyboards in clinical areas. It should also be done after visiting the toilet, removing gloves, touching the mouth or nose, using computer keyboard especially in a clinical area, hands becoming soiled (visible), being in patient care during infection outbreaks and handling waste/laundry/equipment. It is also important familiarize oneself with hand hygiene procedures provided in the particular organization and use the hand care products that they provide for different situations and as directed.
Hand hygiene can be done using hand rubs which are alcohol-based since they are more effective against a greater part of ordinary infectious agents as compared to water with antiseptic soap. Attending education sessions on hand hygiene can also help in refreshing skill and knowledge on hand hygiene.
One page 22 of the guidelines is a table describing the transmission-based precautions. Chose one of the precautions then go to the section of the guide relating to that precaution. Summarize in your own how you would apply those precautions in a healthcare environment.
Transmission based precautions are put in place with standard precautions. They reduce further transmissions of particular pathogens arising from specific transmission route opportunities. Environmental cleaning which involves physical cleaning of the surfaces known or suspected to contain infectious agents is done by use of detergents to avoid their transmission. Then a TGA (registered hospital grade disinfectant) is used e.g. 2-in-1 clean or 2-step clean to disinfect the surfaces where applicable. Surfaces are classified into; those with frequent contact (high risk surfaces) and those with minimal hand contact (low risk surfaces). The frequently touched surfaces should be cleaned more frequently than those which are not frequently touched. When MROs are known or suspected to be existing, the surfaces are intensively cleaned and a disinfectant is used on the surfaces. After cleaning with water, it’s important to also allow the surfaces to dry. A detergent solution can be used for general surface cleaning (walls, blinds and floors) and administrative offices since they are not part of patient care areas. Window curtains should be frequently cleaned and changed. On the other hand frequently touched surfaces and those close to patients e.g. light switches, over bed tables, doorknobs, bedrails and walls around patient room toilets should be frequently cleaned with detergents respective to the nature of the surface.
Describe how you would respond to this risk. Specifically, state what potential risk this case example could cause and how you would respond? (Hint: use the guidelines for use of PPE and cleaning)
First, i will lock out the area around the spillage so that people might not step on it and drag it to a wider area or get cut by the sharps and get infected. Then i will get the spill kit which contains a scoop, single use gloves, surgical mask, absorbent agent, detergent, clinical waste bags, ties, eye protection and scraper. I will wear the gloves and other PPE and scoop the spills putting them into a new bag. I will clean the area with detergent and disinfectant chemical e.g. sodium hypochlorite based on the risk of infectious agents transmission. Then discard the cleaning materials in waste a container. In addition, I will wait for the area to dry before letting people use it.
Other workers can be at risk of slipping on the floor and getting cut by the sharps in the spill and getting infected. They can also increase the contaminated areas if they accidentally come into contact with the spills and walk/ contact different/ new surfaces patients and other medical stuff. The stuff can be informed by word of mouth and by sealing the area and labeling it contaminated they will be able to know and keep off.
Describe briefly the key points in cleaning the healthcare work environment. In your answer please describe:
It is worn when there is a risk of transmission of infectious agents to reduce the risk. Different PPE are used for different risks. They include gowns, gloves, mask and protective face shield.
Normal detergent is used for everyday cleaning of surfaces, walls and curtains which do not have/are not considered being at a high risk of infection. However, the choice of the detergent also depends on the surface to be cleaned.
Sterilization prevents disease transmission by killing microorganisms on the surfaces of device or instruments. Heat resistant items are reprocessed by steam sterilization because of its safety margin, validity, lethality and reliability while those that are moisture and heat sensitive use sterilization technology of low temperature e.g. hydrogen peroxide plasma, aldehyde, ethylene oxide and peracetic acid. Reprocessing data is recorded for reference. However, to accommodate emerging technologies and changes in equipment design, reprocessing standards should evolve.
Storage should be done in a way that maintains equipments reprocessing level (i.e. high disinfected level, sterile). Therefore, sterile, dry packaged equipments and instruments should be kept in a dry, clean environment and protected from objects that may damage the packaging e.g. sharp objects. Instrument surfaces and equipment should be examined regularly for breaks which might impair cleaning or sterilization. Those that are not in the right working conditions are repaired or discarded.
PPE is required when there is a risk of transmission of infectious agents. They should be changed depending on the Particular PPE e.g. gloves need to be changed after a single activity since they can be torn and increase the risk of infection. They should also be handled according to the recommended guidelines to avoid infecting the person using them when they remove them.
This is vital so as to ensure waste is transported, stored and ultimately disposed off in a manner that complies with regulations of clinical waste disposal. For instance the following color codes are used: back (mixed municipal waste), yellow and black (offensive), blue (medical), Orange (clinical/infectious), yellow (highly infectious), red (anatomical) and purple (cytotoxic).
Healthcare waste should be stored inside the healthcare facility or research center. Waste in containers or bags should be stored in a separate room, building or area appropriate to the frequency and quantities of wastes produced and their collection. The storage should be protected from the sun, inaccessible to unauthorized persons, availability of cleaning water, accessible to waste collection vehicles, inaccessible to animals, birds and insects, should have a hard standing floor that has a good drainage, impermeable, easy to disinfect and clean, not near to food store or preparation areas, should have cleaning equipment, waste bags and protective clothing, good lighting and passive ventilation.
Clinical waste is segregated correctly, stored and transported to the appropriate facilities for its safe disposal to avoid risk to the environment and humans.
What is the purpose of a clean zone and what should be maintained within this area?
This are specifically designated places/areas for non-contaminated items. These items include those that are sterile and disinfected. They include: material and equipment storage areas, administration and medical record areas, medical preparation areas-dressing/materials/equipment/medicines etc.
What is the purpose of a contaminated zone in the healthcare environment and what should be confined to this space?
Contaminated areas include areas that have become contaminated during medical procedures and those for processing dirty equipments. They may be marked by signs like, “no gloved hands past this point” so as personnel can remove contaminated gloves before leaving. These zones include cleaners’ room, dirty linen sorting areas, dirty utility rooms, and disposal rooms.
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