Standard Precautions

Transcription

1 Standard Precautions Speciality: Infection Control 1. Indications 1.1 Background Standard Precautions This definition broadens the coverage of the previously known Universal Precautions by recognizing that any body fluid may contain contagious micro-organisms. It includes saliva, sputum, nasal secretion, vomitus, semen, urine and faeces. 1.2 Aim/Purpose This policy covers the care of all patients regardless of their diagnosis or presumed infection status. Standard Precautions are designed to reduce the risk of colonisation and transmission of pathogens from both recognized and unrecognised sources of infection in the hospital. The purpose of this policy is to ensure that Standard Precautions are applied to all patients receiving healthcare in Salisbury NHS Foundation Trust, regardless of their diagnosis and are to be used when handling: Blood Body fluids, secretions and excretions, regardless of whether or not they contain visible blood. 1.3 Patient/Client Group Applies to all hospital patients attending Salisbury NHS Foundation Trust for treatment as an inpatient and/or an outpatient. 2. Clinical Management 2.1 Staff & Equipment Staff with patient contact: All staff must comply with the policy and procedures established by the Infection Prevention & Control Team (IP&CT) Nursing Staff: Document the date, time and category of precautions required and the name of the person who initiated the type of precautions in the nursing documentation and/or patient notes Infection Prevention & Control Committee (IPCC): Approves all infection control policies and procedures Infection Prevention & Control Team: Order the initiation and discontinuation of any transmission-based precautions i.e. over and above standard precautions whenever needed. The IP&CT develops, reviews, revises and approves policies and procedures, and monitors compliance of this policy within the Trust. Page 1

2 2.1.5 Housekeeping Staff: Clean patient room/area floors, bathrooms, walls, and remove rubbish in accordance with the Facilities Department policies and procedures. 2.2 Method/Procedure Hand washing and decontamination: To ensure safe practices and infection control measures, all staff must adhere to the Trust s Hand Hygiene Policy (Hyperlink to policy) Gloves: Must be worn when staff are likely to touch blood and body fluids or other potentially infectious materials and contaminated items. Must be changed to clean ones before touching mucous membranes and non-intact skin. Must be worn when performing venepuncture or other vascular access procedure. Gloves must be worn by the bedside, immediately prior to task. Gloves must be replaced if torn, punctured or damaged as soon as patient safety permits. Must be removed promptly after use or if main task is interrupted (e.g. to answer ward telephone), before touching non-contaminated items and environmental surfaces, patient's notes or files and privacy curtains and before going on to another patient or task. Gloves should not be worn away from the bedside, at nurses station, to handle charts, clean linen, clean equipment or clean patient supplies, or in hallways or lifts Disposable aprons and other protective garments: The appropriate type of garment used should be based on the task and the degree of exposure anticipated. Gowns are worn to prevent contamination of clothing and protect the skin of personnel from blood and body fluid exposure. Must be worn to protect skin and to prevent soiling of clothing during procedures and patient care activities that are likely to generate splashes or sprays of blood or other potentially infectious materials e.g. changing heavily soiled linen. s and disposable gowns must be replaced after each use. Used aprons and disposable gowns must be discarded into a YELLOW biohazard bag Protective eyewear (goggles or eye-shield): Must be worn whenever splashes, spray, splatter, or droplets of blood or other potentially infectious materials may be generated towards the eyes Masks: Masks must be worn whenever splashes of blood or other potentially infectious materials may be generated towards the nose, or mouth e.g. during suctioning (due to aerosol effect). mask is required during suctioning using a closed suction system. Page 2

3 Masks are also worn to protect staff from transmission of infectious droplets during close contact with symptomatic patients, when droplet transmission is a risk. Respirator masks must be worn whenever attending to patients who are airborne transmission risk e.g. those with active pulmonary tuberculosis. Masks must cover securely over both the nose and mouth at all times when in use. Used masks must be discarded into YELLOW biohazard waste bags Needles, syringes and other sharps: To ensure safe disposal of sharps, all staff must adhere to the Trust s Sharps Policy (Hyperlink to policy) Reusable patient care items/equipment: To ensure correct cleaning of reusable items and equipment, all staff must adhere to the Trust s Decontamination Policy (Hyperlink to policy) Environmental Cleaning: Any environmental contamination with blood, body fluids or infectious materials must be cleaned immediately with a hospital-approved detergent and chlorine based disinfectant Linen: All used linen must be handled using Standard Precautions. Linen should be handled minimally and placed into the appropriately coloured laundry bag by the bedside. Linen that has been soiled must be handled in a manner that prevents skin or mucous membrane exposure, contamination of clothing and/or transfer of micro-organisms to others and the environment. Linen that is visibly soiled with potentially infectious materials must be handled wearing apron and gloves and placed in an alginate lined RED laundry bag. Linen that is visibly soiled with blood or other body fluids must be handled wearing apron and gloves and placed in an alginate lined BLUE laundry bag. Linen that is NOT visibly soiled must be placed in an ordinary WHITE laundry bag. DO NOT place soiled linen on the floor or any clean work surface Clinical waste: All clinical waste must be disposed of safely, according the Trust s Waste Management Policy (Hyperlink to policy). 3 Patient Information The use of Standard precautions should be explained to the patient. Page 3

4 4 Evidence Base 4.1 Sources of Information Garner, J.S. (1997) Guidelines for Isolation Precautions in Hospitals. Part I. Evolution of Isolation Practices, Part II Pugliese, C.G. (1991) Universal Precautions: Policies, Procedures and Resources, American Hospital Publishing Inc Centre for Disease Control, Guidelines for Isolation Precautions in Hospitals. Infection Control Hospital Epidemiology (1996) Centre for Disease Control, Part II, Recommendations for Isolation Precautions in Hospitals (1997) Isolation Precautions Policy and Procedures NPP dated March Appendices 5.1 Guidelines for the Use of Personal Protective Equipment Page 4

5 GUIDELINES FOR USE OF PERSONAL PROTECTIVE EQUIPMENT Task Personal Care: Bathing & hair care (shampooing) Hand- Washing Gloves / Gown Mouth care Handling containers of body fluids Care of an Incontinent patient Stoma Care: Removing/emptying Pouch application (2) Irrigation / flush Irrigating: Naso-gastric tubes Eye / Face Shield (1) (3) Comments (1) If high risk of patient coughing. (2) May need to remove gloves when handling adhesives. (3) When blood or body fluids are evident, protect eyes and mouth. Respiratory: Naso-tracheal Suctioning Trachy Care: Suctioning (4) (4) Increased incidence of splashes in the adult care areas occurring with this task. Intravenous Insertion (5) Arterial Lines: Blood sampling Wound Care Invasive Diagnostic Procedures (5) (5) May be needed if dealing with agitated patient. (6) (6) Wound irrigations increase risk of splash. (7) (7) Wear HEPA (N95) respirator if suspected or known TB. Operating Room: Scrub Nurse & Gown Eye sheild & mask Circulating Nurse Last Office Care (8) (8) Wear when removing tubes e.g. NG tube or drains. Page 5