Hospital s for Accreditation for Afghanistan Section : Clinical Care Infection Prevention: Patient/Client Education
Hospital s for Accreditation for Afghanistan: Assessment of Progress in Achieving the s Hospital Department or Area: Infection Prevention: Patient/Client Education Hospital Facility: Assessor: Date of assessment: There are educational posters for patients/ clients about infection prevention (IP) measures. Infection Prevention: Patient/Client Education Meeting Observe if: There are posters or stickers visible and in good condition about hand washing and hygiene located in: o Corridors o Waiting areas o Toilets o Wards There are signs saying no littering to encourage patients/clients and relatives to avoid littering on the grounds There are posters or stickers visible and in good condition about visiting hours and number and age of visitors Section : Clinical Care. Infection Prevention: Patient/Client Education Hospital s Manual Afghanistan of 4
Infection Prevention: Patient/Client Education Meeting There are posters or stickers visible and in good condition about cough etiquette There are informational posters about patients /clients rights concerning IP during the provision of care. Observe if there are posters visible and in good condition informing patients/clients about the critical IP practices (e.g., hand washing, injection safety, use of gloves during invasive procedures) that should be followed by providers during the provision of care, located in: Outpatient facilities Wards Casualty area Laboratory Dental department 3 There are signs to alert patients/clients about Observe if there are signs in these areas: restricted or risky Laboratory areas. Isolation areas Central supply and Sterilization Department and operating room Labor and delivery areas Nursery Mortuary Waste storage areas Section : Clinical Care. Infection Prevention: Patient/Client Education Hospital s Manual Afghanistan 3 of 4
4 The hospital works with community organizations on IP education. Infection Prevention: Patient/Client Education Verify with the hospital director/manager if: Meeting There is a written plan to conduct educational activities on IP for the community and for the relatives who accompany patients/clients There is a record of activities implemented Row Scoring compliance with the standards A Total Score (sum total checks for full, partial and no compliance) B Score for each category ( compliance =, compliance = and Non-compliance =) C Score of, and Non-compliance (Multiply Row A times Row B) D TOTAL: Sum of scores for, and Non-compliance (Add all three columns in Row C) E Score possible (Total criteria times less any N/A) 4 F Percentage Compliance with these standards (Divide Row D by Row E) % Total criteria x pts = maximum 4 point s possible (less any N/A) Section : Clinical Care. Infection Prevention: Patient/Client Education Hospital s Manual Afghanistan 4 of 4
Hospital s for Accreditation for Afghanistan Section : Clinical Care Infection Prevention: Food Service and Catering
Hospital s for Accreditation for Afghanistan: Assessment of Progress in Achieving the s Hospital Department or Area: Infection Prevention: Food Service and Catering Hospital Facility: Assessor: Date of assessment: Infection Prevention: Food Service and Catering Meeting. There are written routines/guidelines Verify with the person responsible for food preparation if: for pest control and There are written routines/guidelines for presence of animals pest control in the kitchen. The presence of animals (e.g., cats, dogs, etc.) is forbidden in the kitchen They are physically placed in this unit There is a system to screen and control the health of kitchen personnel. (posted or in a procedure manual) Verify with the person responsible for food preparation if: The responsible person screens/controls kitchen personnel for: o Personal hygiene including uniform o Acute diarrhea o Draining abscess and impetigo Section : Clinical Care. Infection Prevention: Food Service and Catering Hospital s Manual Afghanistan of 7
3 The kitchen has an adequate physical plant and equipment. 4 The area for food preparation is clean. Infection Prevention: Food Service and Catering Meeting Kitchen personnel have work restrictions if they have these conditions There is a record keeping book with the information on screening and control measures applied Verify if there is: Food preparation area: o Sink with running hot and cold water o Working drainage system o Windows with screens Storage area: o Cupboards o Shelves o Refrigerator o Freezer o Windows with screens Verify the absence of dust, soil, blood, trash, spider webs, leftover food, flies, and pests in the following areas: Work area: o Floors o Walls o Counters o Sink o Utensils and cooking pots Section : Clinical Care. Infection Prevention: Food Service and Catering Hospital s Manual Afghanistan 3 of 7
5 The food is stored properly Infection Prevention: Food Service and Catering Meeting o Chopping boards Storage area: o Floors o Doors o Walls o Shelves or cupboards Equipment: o Stove o Refrigerator o Freezer Vehicles and/or trolleys used to transport food Verify if: All goods are stored in clean wrappers or containers with covers All wrappers or containers are marked with date and contents The food is stored at least 6 inches above floor level and away from walls All goods stored are within the expiration dates The temperature of the refrigerator is check and recorded daily Section : Clinical Care. Infection Prevention: Food Service and Catering Hospital s Manual Afghanistan 4 of 7
6 Food preparation is performed properly. 7 The kitchen has an adequate process for holding and serving Infection Prevention: Food Service and Catering Meeting Observe during food preparation if the personnel: Wear a hair net or cap Wash hands with running water and soap for 5 seconds and dry with an individual clean towel, paper towel, or allow hands to air-dry: o Before food preparation o After using toilet o After contact with unclean equipment or work surfaces o After handling raw food Clean with soap or detergent and running water (utensils and cutting boards between uses) Clean and disinfect the working surfaces and all utensils after each period of use Limit the traffic of unauthorized individuals into the food preparation area (e.g., vendors, personnel from other departments, etc.) Verify if: Food is defrosted only once and then consumed or discarded Section : Clinical Care. Infection Prevention: Food Service and Catering Hospital s Manual Afghanistan 5 of 7
Infection Prevention: Food Service and Catering Meeting prepared food. Cooked perishable foods are served within hours of preparation, and after this are disposed of During transportation, food is protected from vectors using nets, clean cloths, or covers 8 The waste is managed properly in the kitchen. Verify if: There are washable, leakproof garbage containers with tight-fitting lids The garbage is immediately placed into the containers The garbage containers are stored outdoors after use The garbage containers are collected daily The garbage containers are washed daily or sooner if needed Section : Clinical Care. Infection Prevention: Food Service and Catering Hospital s Manual Afghanistan 6 of 7
Row Scoring compliance with the standards A Total Score (sum total checks for full, partial and no compliance) B Score for each category ( compliance =, compliance = and Non-compliance =) C Score of, and Non-compliance (Multiply Row A times Row B) D TOTAL: Sum of scores for, and Non-compliance (Add all three columns in Row C) E Score possible (Total criteria times less any N/A) F Percentage Compliance with these standards (Divide Row D by Row E) % Total criteria x pts = maximum point s possible (less any N/A) Section : Clinical Care. Infection Prevention: Food Service and Catering Hospital s Manual Afghanistan 7 of 7
Hospital s for Accreditation for Afghanistan Section : Clinical Care Infection Prevention: Laundry
Hospital s for Accreditation for Afghanistan: Assessment of Progress in Achieving the s Hospital Department or Area: Infection Prevention: Laundry Hospital Facility: Assessor: Date of assessment: The laundry has Verify if: adequate physical plant, traffic flow, and equipment. Infection Prevention: Laundry Meeting There are separate areas for: o Receiving and sorting o Washing linen o Ironing, folding, repairing, and storing of clean linen There are washbasins with running water for rinsing soiled linen There are washing machines for washing clothes There are drying machines or clotheslines to dry the linen There are tables and shelves to handle, fold, and store clean linen Section : Clinical Care. Infection Prevention: Laundry Hospital s Manual Afghanistan of 5
The process of handling used and/or soiled linen is performed properly. Infection Prevention: Laundry Meeting Observe in the laundry: Workers wear personal protective equipment while handling soiled linen: o Utility gloves o Plastic aprons o Goggles o Masks o Gumboots or enclosed shoes Soiled linen is separated from non-soiled linen Soiled linen is checked for foreign objects such as instruments, needles, human tissue, and personal property Workers perform hand hygiene after handling used and/or soiled linen: o Wash hands with running water and soap for 5 seconds and dry with an individual clean towel, paper towel, or allow hands to air-dry, or o Rub hands with 3 5 ml of an alcoholbased solution until the hands are dry (if hands are not visibly soiled) Utility gloves and plastic aprons are cleaned thoroughly and dried after use Section : Clinical Care. Infection Prevention: Laundry Hospital s Manual Afghanistan 3 of 5
Infection Prevention: Laundry Meeting 3 The process of washing Verify if: of used and/or soiled Soiled linen is washed separately from linen is performed non-soiled linen properly. Detergent is used to wash linen All linen is washed for a minimum of 5 minutes in a washing machine or according to the machine cycle Linen is re-washed if still visibly soiled/dirty Washed linen is not placed on the floor 4 The process of drying clean linen is performed properly. 5 The collection and transportation of linen is performed properly. Observe if: Linen is dried in a drying machine or hung outside on a clothesline Dried, clean linen is not placed on the floor Verify in the laundry if: Used linen is collected in the wards in leak-proof containers with lids or covers Used linen is transported from the wards to the laundry in leak-proof containers with lids or covers Carts, trolleys, or other leak-proof containers are cleaned before taking clean linen back to the wards Section : Clinical Care. Infection Prevention: Laundry Hospital s Manual Afghanistan 4 of 5
Infection Prevention: Laundry Meeting Clean linen is transported separately from used/soiled linen in a clean cart, trolley, or other container. Clean linen is covered or wrapped during transportation Row Scoring compliance with the standards A Total Score (sum total checks for full, partial and no compliance) B Score for each category ( compliance =, compliance = and Non-compliance =) C Score of, and Non-compliance (Multiply Row A times Row B) D TOTAL: Sum of scores for, and Non-compliance (Add all three columns in Row C) E Score possible (Total criteria times less any N/A) 58 F Percentage Compliance with these standards (Divide Row D by Row E) % Total criteria 9 x pts = maximum 58 point s possible (less any N/A) Section : Clinical Care. Infection Prevention: Laundry Hospital s Manual Afghanistan 5 of 5
Hospital s for Accreditation for Afghanistan Section : Clinical Care Infection Prevention: Waste Management
Hospital s for Accreditation for Afghanistan: Assessment of Progress in Achieving the s Hospital Department or Area: Infection Prevention: Waste Management Hospital Facility: Assessor: Date of assessment: There is a written plan for waste management. The hospital promotes good practices for waste management and disposal. Infection Prevention: Waste Management Meeting Verify with the person responsible for waste management if: There is a written plan for waste management including: o Segregation at point of use o Transportation o Interim storage o Final disposal Observe if: There are sufficient dustbins outside of the hospital (in the grounds) for general waste to avoid littering The grounds (outside of the hospital) are clean. Section : Clinical Care. Infection Prevention: Waste Management Hospital s Manual Afghanistan of 9
3 The staff uses the PPE when handling waste. Infection Prevention: Waste Management Meeting Observe during the visit, if: Housekeeping personnel wear personal protective equipment (PPE) when handling medical waste: o Utility gloves o Gumboots o Plastic apron o Masks covering nose and mouth Disposable PPE (examination gloves, surgical masks) are decontaminated in.5% chlorine solution (if applicable) and disposed in a leakproof container after use Re-usable PPE (e.g., utility gloves, gumboots, plastic apron, face shield) are reprocessed after use: o Decontaminated in.5% chlorine solution o Washed with soap and water o Dried and stored Section : Clinical Care. Infection Prevention: Waste Management Hospital s Manual Afghanistan 3 of 9
4 The staff washes hands after handling waste and removing gloves. 5 Waste segregation is performed according to the standards. Infection Prevention: Waste Management Meeting Observe if housekeeping staff performs hand hygiene after handling waste and removing gloves: Wash hands with running water and soap for 5 seconds and dry with an individual clean towel, paper towel, or allow hands to air-dry, or Rub hands with 3 5 ml of an alcoholbased solution until the hands are dry (if hands are not visible soiled) Observe if there is a segregation system at point of use: Sharps o Sharps are discard and collected in puncture-resistant containers (e.g., heavy cardboard box, hard plastic, or can containers) o Sharps containers are closed and collected when three quarters full o Each sharp container is used only once Other medical waste (e.g., used cotton rolls, gauze, dressing, etc.): o Are disposed of in leak-proof containers with a plastic bag Section : Clinical Care. Infection Prevention: Waste Management Hospital s Manual Afghanistan 4 of 9
6 There is a system for interim storage of waste. Infection Prevention: Waste Management Meeting o Are closed and collected when threequarters full General waste: o Is collected from all areas in adequate closed containers and transported to the interim storage area or for disposal Observe if: The traffic in the interim storage area is controlled (accessible only to the incharge personnel) Containers are leak-proof and closed with tight lids All waste is inside of the containers The interim storage area is free of waste on the grounds Verify with the manager if: There is a written plan for a short-term storage of waste (maximum of two days) and cleaning of storage area and containers Waste is transported in vehicles or containers used only to transport waste Vehicles transporting waste have a cover or tarp to prevent waste from littering during transport Section : Clinical Care. Infection Prevention: Waste Management Hospital s Manual Afghanistan 5 of 9
7 The contaminated waste is disposed properly. 8 The non-contaminated waste is disposed properly. 9 The waste disposal process is performed properly. Infection Prevention: Waste Management Meeting Verify if: Contaminated waste is disposed of on-site by: o incinerating, or o burying, or o burning in a closed pit Verify if: Non-contaminated waste is disposed of on-site by: o incinerating, or o burying, or o burning in a closed pit OR Non-contaminated waste is sent off-site (e.g., to a municipal waste or sanitary landfill) Verify: If the waste is incinerated: The traffic in this area is controlled and accessible only to the in-charge personnel During incineration, there are flames Ash from incinerated material is disposed of as non-contaminated waste There is no waste lying around the grounds Section : Clinical Care. Infection Prevention: Waste Management Hospital s Manual Afghanistan 6 of 9
Infection Prevention: Waste Management Meeting OR If the waste is buried in a pit: The area is not accessible to other staff, community, and domestic animals The burial site is lined with a material of low permeability (e.g., clay) The burial site is at least 5 meters away from any water source, and it is located in an area free of floods The pit is about meter square and meters deep The disposed waste is covered with 5 cm of dirt each day The final layer of dirt is 5 6 cm The burial pit lasts a maximum of 3 6 days There is no waste lying around the grounds OR If the waste is burned: The area is not accessible to other staff, community, and domestic animals The waste is burned in a small designated area Section : Clinical Care. Infection Prevention: Waste Management Hospital s Manual Afghanistan 7 of 9
Infection Prevention: Waste Management Meeting The waste is transported to the area just before burning During burning, there are flames The person in charge remains with the fire until it is out A layer of dirt is used to cover the burned waste The grounds around this area are free of waste Section : Clinical Care. Infection Prevention: Waste Management Hospital s Manual Afghanistan 8 of 9
Row Scoring compliance with the standards A Total Score (sum total checks for full, partial and no compliance) B Score for each category ( compliance =, compliance = and Non-compliance =) C Score of, and Non-compliance (Multiply Row A times Row B) D TOTAL: Sum of scores for, and Non-compliance (Add all three columns in Row C) E Score possible (Total criteria times less any N/A) F Percentage Compliance with these standards (Divide Row D by Row E) % Total criteria 5 x pts = maximum point s possible (less any N/A) Section : Clinical Care. Infection Prevention: Waste Management Hospital s Manual Afghanistan 9 of 9
Infection Prevention s Compliance Performance Scoring Summary Summary of Performance Scoring Column A B C D Total Total Points Actual Points Percentage Criteria for Possible Scored Compliance Infection Prevention Areas Assessed Assessment ( pts * # of criteria) ( pts * Column A) From assessment (Column C/ Column B) Central Sterilization and Supply Department (CSSD) 44 % Surgical Unit 76 35 % Isolation Systems 33 66 % Labor and Delivery Unit 37 74 % Emergency, Surgical and Medical Wards 97 394 % MCH & Family Planning Clinic 99 98 % Dental Unit 79 58 % Laboratory 3 6 % Blood Bank 35 7 % Post-Mortem Care 3 64 % Administrative Functions 63 6 % Patient Education 4 % Food Service and Catering 5 % Laundry 9 58 % Waste Disposal 5 % TOTAL for Infection Prevention 337 674 % Section : Clinical Care. Infection Prevention: Summary Form Hospital s Manual Afghanistan of