Infection Control Manual of KFH Makkah

 

 

 

 

STANDARD PRECAUTIONS

A. Hand washing

1.      Wash hands after touching blood, body fluids, secretions, excretions and contaminated items, whether or not gloves were worn.

2.      Wash hands:

                  - Immediately after gloves are removed.

                  - Between patient contact.

B. Gloves

1.      Wear ( clean, nonsterile gloves) when touching:

                  - Blood, body fluids, secretions, excretions and contaminated items.

2.      Apply clean gloves just before touching: mucous membrane non-intact skin.

3.      Remove gloves promptly after use:

                  -Before touching non-contaminated items and environmental surfaces.

-Before going to another patient wash hands immediately to avoid transfer of microorganism to other patients or environment.

C. Mask, Eye protection, Face shield

1.      Wear a mask and eye protection or a face shield during procedures and patient care activities that are likely to generate splashes or sprays of blood, body fluids, secretions and excretions.

D.  Gowns

1.      Wear a gown ( a clean, nonsterile gown is adequate) during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions or excretions or cause soiling of clothing.

2.      Remove a soiled gown promptly.

3.      Wash hands.

E.  Patient-care Equipment

1.      Handle used patient-care equipment soiled with blood, body fluids, secretions and excretions in a manner that prevents skin and mucous membranes exposures, contamination of clothing and transfer of microorganism to other patients and environments.

2.      Ensure that reusable equipment is NOT used for the care of another patient.

3.      Ensure that single use items are properly discarded.

F.  Occupational Health and Blood borne Pathogens

1.      Take care to prevent injuries:

-When using needles, scalpels and other sharp instruments or devices.

                  -When handling sharp instrument after procedures

                  -When cleaning used instruments.

                  -When disposing of used needles.

 

2.      DO NOT:

                  -Recaps used needles.

-Manipulate then using both hands and any technique that involves directing the point of a needle toward any part of the body.

 

ISOLATION CATEGORIES

(specific isolation precaution)

Nosocomial infections occur at a rate of approximately 5 to 10 per 100 admissions and remain as an important Health Care problem worldwide. To cope with the growing problem of nosocomial infections, we need to follow exactly Infection Control and Isolation Recommendation that actually include standard precautions and specific isolation precaution.

1.      Airborne Precautions

a)     Use a negative-pressure room.

b)     Keep doors closed.

c)      Wear a respirator, grade N95 (not surgical mask), if entering the room of a patient who is suspected of having tuberculosis.

d)     For patients with measles or varicella (e.g. chicken pox) infections; immune persons may enter the room of such patients but if it is absolutely necessary they should wear mask.

e)     If patient transport is absolutely necessary, the patient should wear a surgical mask.

f)        Instruct the patient to cover his or her mouth when coughing or sneezing even if alone.

2.      Droplet Precautions

a)     Keep door closed.

b)     Wear surgical mask if entering the room.

c)      Discard mask after leaving the room.

d)     If patient transport is absolutely necessary, the patient should wear surgical mask.

3.      Contact Precautions

a)     Wear a gown and gloves to enter the room.

b)     Use a dedicated stethoscope and B/P apparatus.

c)      Remove gown and gloves before leaving the room.

d)     Wash hands with antimicrobial soap before leaving the room.

In addition to the main type of precautions, Standard Precautions should be practiced on all times for all infectious and non-infectious diseases.

 

 

Table 1- Infections and duration of isolation

 

 

 

MRSA

 

1. Minimum Precautions for ALL Patients:

1.1 For patients with draining skin and decubitus lesions at any site:

-            Cover lesions whenever possible.

-            Contain visibly soiled dressings or linen in the appropriate leak proof container or bag.

-            Wear gloves when touching drainage and wash hands well before and after gloving

-            Wear gowns only if soiling of clothing is likely.  Do not wear gowns outside the patient’s room.

 

 

 

1.2 For patient with urinary catheters:

-            Change catheters when necessary, such as when they become crusted or clogged.

-          Use a closed drainage system.  Keep drainage bags off the floor, but below the level of the patient’s bladder.

-            Use a separate graduate container for each patient, and thoroughly clean it after each use. Avoid touching the catheter bag or drainage spout to the side of the graduate container.

-            Cleanse the patient’s perineal area daily and as necessary.  Wear gloves during this procedure.  Avoid tension or movement of the catheter.

-            Wash hands well after manipulating the catheter system and after removal of gloves.

1.3 For patients with respiratory symptoms:

-            Teach the patient to cough into a tissue and provide a bag for tissue disposal.

-            Wear masks when in close contact with the patient (i.e. when suctioning or giving mouth or tracheostomy care).

-            Use good hand washing after removing gloves.

2. Precautions for MRSA Colonized/Infection Patients:

2.1 For patients with MRSA colonization/infection of skin lesions and decubiti:

-            Cover lesions whenever possible.

-            Contain visible soiled dressings of linen in the appropriate leak proof container or bag.

-            Wear gloves when touching drainage and wash hands well before and after gloving.

-            Wear gowns only if soiling of clothes is likely.  Do not wear gowns outside the patient’s room.

-            Masks are not necessary.

2.2 For patients with MRSA colonization/infection of the urinary tract:

-            Use minimum precautions.

-            Use good hand washing and wear gloves.

-            Masks are not needed.

-            Wear gowns only if soiling of clothes is likely.                                

2.3 For patients with MRSA colonization/infection of the respiratory tract:

-            Wear masks only if the patient is coughing or when performing suctioning procedures.

-            Wear gowns only if clothes are likely to become soiled.

-            Practice good hand washing and wear gloves when handling respiratory secretions.

 

 

 

2.4 General recommendations for patients colonized with MRSA:

            The physician will make the decision whether or not to treat the patient colonized with MRSA.  However, treatment for colonization is seldom indicated because MRSA is difficult to permanently eradicate.

2.4.1   Dishes:

         Disposable dishes are unnecessary.  Never allow patients to eat food from another patient’s tray.

2.4.2   Linen:

            All soiled linen should be bagged at the location where it is used.  It should not be sorted or rinsed in the patient care area.  Linen that is heavily soiled with moist body substances that may soak through a linen bag must be placed in an impervious bag to proven leakage.  Linen handlers must wear barrier protection, which includes gloves, and take special precaution with soiled linen by bagging to proven leakage.  Soiled linen need not be washed separately.

2.4.3   Trash:

-            Routine waste from all patients’ rooms is considered dirty, not infectious.

-            Persons assigned to handle trash should wear gloves, wash hands, and report all accidents.  It is important that all persons be discouraged from searching through trash (e.g. for aluminum cans).  Contaminated dressings should be placed in a leak proof bag and tied before placing in the trash receptacle.

2.4.4   Housekeeping

                        Daily, routine cleaning must be done in all patients’ areas to reduce bacterial load.  Cleaning must be done with a disinfectant registered with the EPA and performed in a sanitary manner as is done in all rooms regardless of the presence of MRSA.  Equipment should be routinely cleaned, disinfected or sterilized per hospital policy.

 

INTRAVASCULAR CATHETER

·        Hand hygiene before and after palpating catheter insertion sites, as well as before and after inserting, replacing, accessing, repairing or dressing an intravascular catheter. Palpitation of the insertion site should not be performed after the application of antiseptic, unless aseptic technique is maintained.

·        Use of gloves does not obviate the need for hand hygiene.

·        Aseptic technique during Catheter care.

1.      Maintain aseptic technique for the insertion of intravascular catheters.

2.      Wear clean or sterile gloves when inserting an intravascular catheter.

 

3.      Sterile gloves should be worn for the insertion of arterial and central catheters.

4.      Wear clean or sterile gloves when changing the dressing on intravascular catheters.

·        Catheter-site care

1.      Disinfect clean the skin with an appropriate antiseptic before insertion and during changes. Although a 2% chlorohexidine-based preparation is preferred, tincture of iodine or 70% alcohol can be used.

2.      Allow the antiseptic to remain on the insertion site and to air dry before catheter insertion. Allow providone iodine to dry to remain on the skin for at least 2 minutes or longer if it is not yet dry before insertion.

·        Catheter -site dressing regimens

1.      Use either sterile gauze or sterile, transparent, semi-permeable dressing to cover the catheter site.

2.      Tunneled CVC sites that are well healed might not require dressings.

3.      If the patient is diaphoretic, or if the site is bleeding or oozing, gauze dressing is preferable to a transparent, semi-permeable dressing.

4.      Replace catheter-site dressing if the dressing becomes damp, loosened, or visibly soiled.

5.      Do not use antibiotic ointment or creams on insertion sites (except when using dialysis catheters).

·        Selection and replacement of intravascular catheters:

1. Select the catheter, insertion technique, and insertion site with the lower risk for complications for the anticipated type and duration of I.V. therapy.
2. Promptly remove any intravascular catheters that are no longer essential.
3. Do not routinely replace central venous or arterial catheters.
4. Replace peripheral venous catheters at least 72 hours.

·        Replacement of administration sets, and parenteral fluids:

                        A.  Administration Sets:

1.      Replace administration sets, including secondary sets and ass-on devices, no more frequently than at 72-hour intervals, unless catheter-related infection is suspected.

2.      Replace tubing used to administer blood, blood products, or lipid emulsions.

3.      Replace tubing used to administer propofol infusion every 6 or 12 hours, depending on its use.

                       

 

 

B.  Parenteral fluids:

1.      Complete the infusion of lipids-containing solutions (e.g. 3-in-1 solutions) within 24 hours of hanging the solution.

2.      Complete the infusion of lipids emulsion alone within 24 hours of hanging the emulsion. If volume considerations required more time the infusion should be completed within 24 hours.

3.      Complete infusions of blood or other blood products within 4 hours of hanging of blood

4.      No recommendation can be made for the hang time of other parenteral fluids.

·        IV-injection ports:

1.      Clean injection ports with 70% alcohol or an iodophor-before accessing the system.

2.      Cap all stopcocks when in not in use.

·        If multidose vials are used:

1.      Refrigerate multidose vials after they are opened if recommended.

2.      If multi dose vials are used in clinical area, is their use approved, e.g.: insulin labeled with hour and date opened.

3.      Clean the access diaphragm of multidose vials with 70% alcohol before inserting a device into the vial.

4.      Discard multidose vial if sterility is compromised.

·        In-line filters:

                        Do not use filters routinely for infection-control purposes.

 

I.V. CANNULATION AND C.V.P. LINE

 

1. I.V. Cannulation

1.1. Selection of peripheral catheter

a)           Select catheters on the basis of the intended purpose and duration of use.

b)           Avoid the use of steel needles for the administration of fluids and medication that might cause tissue necrosis if extravasation occurs.

c)            Use midline catheter when the duration of I.V. therapy will likely exceed 6 days.

1. 2. Selection of peripheral-catheter insertion site

a)           Use an upper -instead of a lower -extremity site for catheter insertion. Replace a catheter inserted in a lower-extremity site to an upper -extremity site as soon as possible.

 

1.3. Replacement of cannulation

a)           Evaluate the catheter insertion site daily, by palpitation through dressing to discern tenderness and by inspection if a transparent dressing is in use. Gauze and opaque dressing should not be removed if the patient has no clinical sign of infection.

b)           Remove peripheral venous catheters if the patient develops sign of phlebitis (e.g. Warmth, tenderness, erythema, and palpable venous cord) infection, or a malfunctioning catheter.

c)   Replace short, peripheral venous catheter at least 72-96 hours to reduce the risk for phlebitis. If sites for venous access are limited and no evidence of phlebitis or infection is present, peripheral venous catheters can be left place for longer period, although the patient and the insertion site should be closely monitored.

d)      Do not routinely replace midline catheters to reduce the risk of infection.

1.4. Cannulation-site care

Do not routinely apply prophylactic topical antimicrobial or antiseptic ointment or cream to the insertion site of peripheral venous catheter.

2. CVP Line (Central Venous Catheter)

2.1. Selection of CVP line site

a)           Weigh the risk and benefits of placing a device at a recommended site to reduce infections and complications against the risk for mechanical complications (e.g. pneumothorax, subclavian artery puncture, subclavian vein laceration, subclavian vein stenosis, hemothorax, thrombosis, air embolism and catheter misplacement).

b)           Use a subclavian site (rather than a jugular or a femoral site).

c)            No recommendation can be made for a preferred site of insertion to minimize infection risk for a non-tunneled CVC placement.

d)           Place catheters used for hemodialysis and pheresis in a jugular or femoral vein rather than a subclavian vein to avoid venous stenosis if catheter access is needed.

2.2. Maximal sterile barrier precautions during catheter insertion

a)           Use aseptic technique including the use of a cap, mask, sterile gown, sterile gloves and a large sterile sheet for the insertion of CVCs.

b)           Use sterile sleeve to protect pulmonary artery catheters during insertion.

 

 

 

 

3.  Replacement of catheter

a)           Do not routinely replace CVCs, PICCs, hemodialysis catheters, or pulmonary artery catheters.

b)           Do not remove CVCs or PICCs on the basis of fever alone. Use clinical judgment regarding the appropriateness of removing the catheter if infection is evidenced elsewhere or is a noninfectious cause is suspected.

c)            Guide wire exchange:

·        Do not use guide wire exchanges routinely for non-tunneled catheters.

·        Use a guide wire exchange to replace a malfunctioning non-tunneled catheter if no evidence of infection present.

·        Use a new set of sterile gloves before handling the new catheter when guide wire exchanges are performed.

4.  Catheter and catheter-site care

                         a)    General Measures:

Designate one port exclusively for hyper-alimentation if a multi-lumen catheter is used to administer parenteral nutrition.

                        b)    Antibiotic locks solutions:

                    Do not routinely use antibiotic lock solution to prevent CRBSI. Use prophylactic antibiotic lock solution only in special circumstances.

5.  Catheter-site dressing regimens

1)           Replace the catheter-site dressing when it becomes damp, loosened, or soiled or when inspection of site is necessary.

2)           Replace dressing used on short term CVC sites every day for gauze dressings and at least every 7 days for transparent dressing.

3)           Replace dressing used on tunneled or implanted CVC sites no more than once per week, until the insertion has healed.

4)           No recommendation can be made for the use of chlorohexidine sponge dressings.

 

HAND HYGIENE

 

Hand hygiene is the single most effective way to prevent infection.

• Indications for hand hygiene

1)     When hands are visibly dirty, contaminated or soiled, wash with non-antimicrobial or antimicrobial soap and water;

 

2)     If hands are not visibly soiled, use an alcohol-based hand rub for routinely decontaminating hands

• Vigorous and mechanical friction of all surfaces of lathered hands, followed by rinsing under a stream of water and drying with paper towel, will remove most transiently acquired microorganism on the hands. Turn off the tap water with paper towel to avoid recontamination of hands.
• In high risk areas and isolation rooms use chlorohexidine gluconate 4% detergent solution antiseptic skin cleanser.

a.      Wet your hands, wrist and forearms with clean running water.

b.      Apply a squirt of chlorohexidine 4% detergent solution about 5 ml. and wash hands for one minute and dry.

c.      Chlorohexidine 4% in isopropyl alcohol could be used for hand rub between cases after initial hand washing provided the hands are not obviously contaminated.

• Surgical Disinfection of Hands.

a.      Wet hands, wrist and forearms with warm water.

b.      Apply about 5 ml of chlorohexidine 4% and wash about 2 minutes. Use sterile disposable or autoclavable nail brushes to clean the finger nails only. Do not use it to scrub the hands and forearm. Scrubbing tends to damage the skin with an increase in the number of resident flora.

c.      Rinse hands, wrist and forearms thoroughly.

d.      Repeat the wash with another 5 ml for 3 minutes. Rinsed thoroughly and use elbow to turn the tap off.

e.      Dry hands carefully with sterile towels.

• Hand washing technique (When washing hands with plain or antimicrobial soap):

a.      Wet hands first with water (avoid hot water).

b.      Apply 3-5 ml of soap to hands.

c.      Rub hands together for at least 15 seconds.

d.      Cover all surfaces of the hands and fingers.

e.      Rinse hands with water and dry thoroughly.

f.        Use paper towel to turn off water faucet.

• Alcohol hand rubs technique (When rubbing hands with alcohol-based hand rub):

a.      Apply 1.5 to 3 ml of an alcohol gel or rinse to the palm of one hand and rub hands together.

b.      Cover all surfaces of your hands and fingers, including areas around and under finger nails.

 

c.      Continue rubbing hands together until alcohol dries.

If you applied a sufficient amount of alcohol hand rub, it should take10-15 seconds of rubbing before your hands feel dry.

 

 

NEEDLE PRICK INJURY

 

1- IMMEDIATE ACTIONS:

1-1 Needle Pricks:

1-1-1 if gloves are worn, remove glove immediately and wash hands.

1-1-2 Encourage bleeding by GENTLE PRESSURE (avoid hard pressure or excessive squeezing as this may increase tissue injury).

1-1-3 Wash thoroughly with water and soap or available antiseptic solutions.

(Concentrated alcohol can be used; but do not delay washing to look for antiseptics)

1.1.4 Do not expand the lesion.

1.1.5 Identify the source patient clearly.

1.1.6 Report the incidence to your supervisor.

1.1.7 The HCW should be evaluated by the Infection Disease Control on call for need of

PEP for HBV and HIV and proper counseling.

1-2 Splashes to the mouth or eyes.

1-2-1 Rinse thoroughly with plenty of running water immediately.

1-2-2 Identify the source patient clearly (name, medical record no., ward etc).

1-2-3 Report the incident to your supervisor. (E.g. Head nurse).

1-2-4 The HCW should be evaluated by the on call ID specialist or Infection Control for need of PEP for HBV and HIV and provide counseling.

II- MANAGEMENT:

2-1 Fill incident report including

2-1-1 Date and Time of incident.

2-1-2 Details of injury:

Hollow V.ss Closed

Size of the needle

                                    Depth and site of injury, etc.

 

2-2 Details of Health Care workers (HCW) vaccination status (Date, doses, response etc).

2-3 Record the details of the source patient, review the file for clinical diagnosis and result of

            HBV, HIV, HCV if available in the file.

2-4 Provide health counseling for the HCW, utilizing the facts about risk of transmission. Commonly, the HCW is anxious and very worried, so reassurance is needed.

2-5 Obtain blood from HCW for HBsAb, HBsAg, HCV, HIV, and CBC.

2-6 Inform the doctor in charge of the source patient (the on call team) for permission to do HBsAg, HIV and HCV from the exposure.

2-7 Assessment regarding the need of PEP for HIV or HBV. For best results of PEP for HIV start very early after exposure.

2-8 The Infection Control Nurse should ensure the availability of HIV PEP drug (basic and expanded), HB1 G and HB vaccines. And arrange with Pharmacy Department for quick delivery.

III. FOLLOW UP:

3-1      The Infection Control Nurse should follow all the results of both the source patient and the HCW and arrange with the lab to ensure:

§         Quick processing of the samples to obtain results within 24-48 hours.

§         Immediate delivery of the results from lab to Infection Control Office.

§         Immediate review of the results with the Infectious disease specialist or Medical Specialist managing the incident.

3-2      Appointment with I.D. Specialist or Medical Specialist for 2-3 days to decide on PEP need after the results of both HCW and Employee.

3-3      If HIV PEP is used, the HCW should be seen at 2 and 4 weeks for side effects, CBC and if acute febrile illness.

3-4      HIV, HBsAg and HCV for HCW at 3,6,and 12 months. Positive results for HIV or HCV should be confirmed by Western Blot or RIBA respectively.

3-5      HCW is advised not to donate blood during follow up period.

 

IV- PREVENTION OF NEEDLE STICK INJURIES:

4-1       Implementation of isolation recommendations in hospital. Including standard precautions for all patients

4-2      Proper disposal of used needles and sharps "(see Recommendation for Sharp   Disposal)".

4-3      HB vaccination for all HCW who are not immune to HBV.

4-4      Training and Education of HCW on Isolation Precautions

4-5      During Exposure prone procedures, The Operator (HCW) should have the best possible visibility (e.g. positioning of the patient, adjusting good light source and control of bleeding).

 

 

SAFE HANDLING OF SHARPS AND CONTAMINATED NEEDLES

 

ý     Do not RECAP, BEND or BREAK Disposable needles.

ý     Dispose used needle immediately in a puncture in SHARP CONTAINER.

ý     Locate SHARP Container close to the point of use e.g. Treatment room, Patient Room.

ý     Do not place used SHARPS in other waste container

ý     Keep all SHARPS and SHARPS CONTAINER out of reach of children.

ý     Always dispose off your own SHARPS do not pass them from one person to another.

ý     Prevent overflow of SHARP Container use until three quarters full.

ý     Wear heavy duty gloves and take care when transporting SHARPS Container.

 

MEDICAL WASTE MANAGEMENT

 

1. General information related to Infection Control activities:

1.1 Hazardous substances are those potentially or obnoxious materials, which may release infectious, irritating, flammable, explosive, corrosive, asphyxiating, toxic or dangerous, dusts, fumes, gases, mists, vapors, aerosols, fibers, agents or ionizing radiations.

1.2 Biohazardous (infectious) waste and items are hazardous substances (materials). They are considered to be those containing blood or coming into contact with blood, infectious patients' secretions, discharges or excretion (body fluids).

·        Infected Waste ( Yellow Bag):

Any disposable materials contaminated with blood and body fluids:

                                                                          i.      Diapers/under pads faeces, blood.

                                                                        ii.      All bloody IV sets, protective wears.

                                                                      iii.      Urinary catheters and bags.

                                                                       iv.      Used drainage bags, drain and tubing.

                                                                         v.      All waste from isolation rooms.

                                                                       vi.      All soiled dressings.

                                                                     vii.      Heamodialysis tubing

                                                                   viii.      Disposable suction catheters, endotracheal tubes.

·        Contaminated Sharp Container Waste:

1)     Broken Glasses

2)     IV needles

3)     Glass specimen needles

4)     Specimens tubes-used/unused.

5)     Pasteur pipette, wooden applicator, capillary tubes.

6)     Intravenous Catheters

7)     Lancet, scalpels and scissors

8)     Used syringes and needles

9)     Glass medication vials

10) Slides and cover glasses.

·        Pathological Waste (Red Bag):

Human Body Parts (should be kept refrigeration until handled according to Islamic Fatwa No. 8099 dated 21 Safar 1405H).

1.3. Contaminated items are considered to all items used in providing patient care.   All clinical waste equipment and linen used and collected.

1.4 Responsibilities:

1.      Department Head and Administrators:

Management of solid waste and soiled linen can only be successful if complete and diligent cooperation is received from department and their immediate administrator.

The responsibilities include:

                                                              i.      Knowing the hazardous substances used and managed in their areas.

                                                            ii.      Evaluating and reviewing the entire process to ensure the adequate controls and maintained at all times.

                                                          iii.      Educating and training employees on the materials that they work with which include identification of the materials, Its hazardous effect, safe work procedures and emergency procedure prior to assignment in an area or activities where substances are or where they are to be managed.

                                                           iv.      Reporting immediately any of the following conditions:

·        Hazardous substances spill.

·        Employee complaints relating to unsafe conditions.

·        Employee alleged exposure.

 

·        System malfunction where there may be potential to injury/exposure.

2.      Employees:

                 Employee responsibilities include:

·       Following procedures appropriately.

·       Asking for assistance when unaware or unsure of the proper method for handling or control of hazardous materials.

·       Reporting unusual or hazardous conditions that could lead to injury/exposure.

1.5. Disposable of Solid Waste:

1.   Use sturdy plastic black bags to line waste blankets and other receptacles for trash collection.

2.   Use sturdy plastic (yellow) to line waste blankets and other receptacles for clinical waste collection.

3.   Use sturdy plastic (black) bags for collection of all used linen.

4.   Use sturdy plastic (blue) bags for collection of used soiled linen. Then soaked to 1 to 10 concentration.

5.   Use sturdy plastic (yellow) bags for collection of used infectious linen.

6.   Use non-penetrable "Sharp Containers" and when 2/3 full, sealed and placed into (yellow)"Infectious Waste" bags for final disposal.

7.   Tie all bags securely and remove when 2/3 filled to the storage containers.

1.6 All "infectious" items and soiled used linens shall be handled only by nursing personnel or specially trained technical personnel in departments where such items are located. Housekeeping personnel shall only transport such items to their final disposition point.

1.7 Housekeeping personnel shall handle trash items as part of their routine environmental cleaning duties. This does not negate the responsibility of any hospital personnel from handling trash appropriate in their areas of work. Trash containers should never be allowed to overflow, but should be closed securely and remove 2/3 filled to the storage containers whenever warranted.

1.8 Prior to the end of each shift, all soiled wastes, and solid linen should be removed appropriately, and the area straightened up as warranted leaving a tidy, clean environment prior to leaving.

1.9 Use carts for transportation of all solid waste and soiled linen.

• Avoid overfilling carts.
• Only designated elevators (service work) should be used and not elevators used by visitors, transport of patients for equipment/supplies.

 

1.10 Appropriate storage of wastes and used linen.

• All waste and used linen should only be stored in appropriate designated area of the department until transport to the area of final disposition. These items should never be piled or left on corridors (hallway).
• Pick up and transportation should be twice daily to prevent over accumulation in the storage areas.

2. Appropriate care of carts:

• Collection carts should be exchanges and cleaned on a daily schedule and the storage rooms cleaned daily.
• All transportation carts should also be cleaned daily.

 

HANDLING OF BIOHAZARDOUS WASTE AND CONTAINATED ARTICLES OF NURSING UNITS

1. All items used in providing patient care will be considered contaminated.
2. Nursing personnel will clean all reusable items of gross contamination using a disinfectant solution.
3. Contaminated articles will be stored in only designated areas on nursing units.
4. All surgical dressing will be placed in yellow bag (clinical waste) containers in the dirty utility room.
5. All glass or plastic containers must be emptied of their fluid contents prior to disposal
6. (i.e. I.V bags, irrigation bottles, but not infectious bottles, etc. but NOT infectious items).
7. Aerosol Cans should be kept separately from any waste that will be incinerated and identified appropriately for their appropriate disposal.
8. All plastic items containing bloody drainage, patient secretion and discharge will be put in a yellow" infectious" bag designated for infected waste disposal.
9. For articles used in isolation precautions, refer to policies and procedures for isolation precautions. Any question regarding handling of any article should be referred to the Infection Control Practitioner at telephone ext. no.1405

 

 

 

 

 

 

References:

1.      Infection Control Manual, Ministry of Health 1422 H.

2.      APIC Text of Infection Control and Epidemiology, Revised Edition 2002.

3.      CDC –http:// www.cdc.gov

 

 

Prepared by                                                   Reviewed by

    Abdullah Al-Azeery                                        Dr. M. Gamal Makhdoom

 

 

 

Head of Infection Control                               Medical Director                         

 

 

Approved by

Dr. Abdurrahman Bakhsh

 

 

 

Hospital Director