INFECTION CONTROL VS GOLDEN KEY POINT

INFECTION CONTROL VS GOLDEN KEY POINT

1- SEVEN STEPS NORMAL HAND WASHING

Wet the palms with water & take liquid soap

1. Rub palms together & gather sufficient foam

2. Rub the back of both palms

3. Interlace finger and rub hands together

4. Interlock fingers and rub the back of fingers of both hands

5. Rub thumb in a rotating manner followed by the area between index finger and thunb for both hands

6. Rub fingertips on palm for both hands

7. Rub both wrists in a rotating manner and dry hands thoroughly by lifting the hands slightly upward.

Total duration 40-60Seconds

Nail should be cut & hands should be without jewelry for best results

2- HOW TO HANDRUB

1. Take adequate quantity to wet all surface of both hands

2. Apply to dry hands. Do not apply to latex gloves

3. Dry the solution by rubbing the hands by six steps as above.

Duration of the entire procedure 20-30 seconds.

• The solution should remain wet on the hands for at least 20-30seconds for adequate disinfection.

3- WHEN HANDRUB & WHEN HANDWASHING

1. Rub hands for hygiene and wash hands only when hand is visibly dirt & soiled

2. During COVID pandemic hand wash in each 2hours

4- FIVE MOMENTS OF HAND HYGIENE(pg-86)

1. Before touching patient

2. Before clean/aseptic procedure

3. After body fluid exposure risk.

4. After touching patient

5. After touching patient surroundings

• During COVID use gloves when there is contact with any person or surface.

5. WHEN TO USE GLOVES

1. Before examination of patient.

2. Before conducting any procedures

3. During blood transfusion

4. in lab during blood collection.

5. Waste handling.

 Difference between Clean Gloves & Sterile gloves

Clean gloves :Only clean not sterile/unsterilized clean gloves

Sterile gloves: new pack, untorn & within expiry date

7- CORRECT METHOD OF WEARING AND REMOVING GLOVES

1.Hand washing & drying in air

2. Wearing Without touching the external surface hold the left hand gloves in right hand & wear in with touching skin

3.By gloves left hand right gloves in the fold on external surface and wear in right hand without touching in skin or external surface

4.Removing-Hold the left palmer area and remove

5. Put the necked left finger on right & remove with left glove with right glove & discard

6. Use reusable gloves and mask after sterilization properly

8- CORRECT METHOD OF WEARING MASK

3 layer mask

1. Mold the metallic strip over nose bridge

2. Covering nose, mouth and chin

3. Tie the upper strips first then the lower

N-95 Mask

Hold molded metallic strip on nose, put the lower elastic on the head first then the upper elastic

9- SIX STANDARD PRECUATION

1. Hand hygiene

2. Use of personal protective equipment (PPE) Sequence of wearing PPE-1-gown, 2-mask, 3-goggles,4-Cap 5-gloves Sequence of removing PPE-1-gloves 2-cap,3-goggles, 4-gown,5-mask

3. Respiratory hygiene/cough etiquette

4. Sharp Safety

5. Safe infection practices[l.e-Aseptic technique]

6. Sterile instruments & Devices

10- ADDITIONAL PRECAUTIONS(to control transmission based infection) (pg-82)

1. Airborne precautions-follow the respiratory etiquette (sneeze, cough) in to a tissue paper/handkerchief/into the folded angel of the left hand of the shirt. Dispose it in appropriate container.

2. Droplet precaution-maintain 6 feet distance

3. Contact precaution I-wash hand in every 2 hours

II- Avoid touching Frequently touched object surface/Used by the COVID Positive patient.

III- Avoid handshake and embracing

11-HOW TO MAKE 1% CHILORINE SOLUTION FROM BLECHING POWDER

1. Take one liter of water

2. Take 33 gms of bleaching powder.

3. Mix the Bleaching powder with little water (our of one literjand let it settle the sediments and then pour it into remaining of one liter water and use it.

4. Use it for disinfection of BMW/Biological spill management.

12- HOW TO MAKE 0.5% CHLORINE SOLUTION FROM BLECHING POWDER

1. Take one liter of water

2. Take15gm of bleaching powder

3. Mix the Bleaching powder with water (out of one liter) and let settle the sediments and then pour it into another and use it. bowl

4. Use it for disinfection of instruments, bed, delivery table top etc.

13- HOW TO MAKE 1% & 0.5% HYPOCLORITE SOLUTION From 5% HYPOCHLORITE SOLUTION

1. Mix 200ml mi of 5% Hypochlorite solution 800ml water=(1%)

2. Mix 100ml of 5% Hypochlorite solution in 900mlwater=(0.5%)

14- HOW TO MAKE 1% & 0.5% HYPOCLORITE SOLUTION From 10% HYPOCHLORITE SOLUTION

1. Mix 100ml of 10% Hypochlorite solution in 900ml water (1%)

4. Mix 50ml of 10% Hypochlorite solution in 950ml water(0.5%)

15-STEPS OF CLEANING INSTRUMENTS

1. Disassembly

Unless otherwise recommended by the manufacturer equipment / device should be disassembled prior to cleaning

The manufacture's recommendation shall be followed when disassembling medical equipment

2.Sorting and Soaking

Segregate sharps/delicate equipment/devices to prevent injury to personnel and damage to the equipment/devices.

Soak equipment/devices in a hospital approved instrument soaking to prevent drying soil, making cleaning easier wear appropriate PPE.

Saline should nit be used

Detergents (including enzymatic detergents) are a appropriate to the equipment/devices.

3. Physical removal of organic material

Completely submerge the items during the cleaning process

Remove gross soil using tools such as brushes & clothes

Tools used to assist in the cleaning such as brushes should be cleaned and disinfected after use.

Rinsing

Rinse all equipment/devices thoroughly after cleaning with (boiled cold water/safe drinking water)

5. Drying

follow the manufacture's instruction for drying of equipment/devices

Equipment/devices may be air dried by hand with a clean, lint free towel.

Dry stainless steel equipment/devices immediately after rinsing to prevent spotting.

6. Inspection

Visually inspect all equipment/devices once the cleaning process has been completed.

Repeat the cleaning on any item that is not clean.

Follow the manufacturer's guideline for lubrication.

7. Packaging

*Packaging for sterilization is necessary to ensure that the packaging material can be penetrated by sterilization agent (e.g. steam). The packaging also provides protection during transport and storage. Proper packaging protects the sterilized goods from micro bacterial recontamination during transport and storage.

16. DISINFECTION OF INSTRUMENTS(PR-106) (Acceptable method)

Disinfection is not a sterilizing process. This is an alternative to sterilization when either sterilization equipment is not available or it feasible to carry out sterilizations. Three level of disinfections-

1.Low level Disinfection- Kills most bacteria, some virus and some fungi but not kill more resistant bacteria like M. Tubersulosis

2 Intermediate level Disinfection- Inactivate M Tuberculosis, most virus & most fungi but not always kil bacteria spores.

3. High Level Disinfection (HLD)- Destroy all microorganism except some bacterial spores. 2 types of HLD

1-Pasteurization-boiling in water for 20 minutes (After boiled 20Minutes)

II-Chemical Disinfectant-Soak in 2% Glutaraldehyde for 20 minutes

17. STERILISATION OF INTRUMENTS(pg-108) (preferred Method)

Sterilization is the elimination of all disease producing microorganisms including spore. Sterilization is used on critical medical instruments/devices & whenever possible semi critical medical equipment/devices. Sterilization of

the medical instruments through

1. Thermal Sterilization

I-Wet sterilization- Exposure to steam with water at temperature 121 degree Celsius, 15LB pressure for 30minutes (wrapped) &20minutes (Unwrapped).

II-Dry serialization- Exposure to 160 degree for 120minutes. It should be used for lab glass ware. Metal instruments are damaged by this process particularly for hollow medical devices.

2. Chemical Sterilization-Chemical sterilization with the use chemical also known as cold sterilization. Chemical sterilization may be achieved through use of 2-4% Glutaraldehyde solution for minimum contact of 10 hours.

3. Flash Sterilization- Flash sterilization is a modification of steam sterilization. It is performed on unwrapped object at 132 degree with 37 to 28LB pressure & minimum exposure time of 3 minutes. Flash sterilization should be used only in case of dropped instrument during method of sterilization.

18. HOW TO STORE THE SHARP INTRUMENT AFTER CLEAN

Deep the instruments within 2% Glutaraldehyde (change the Gluteraldehyde 14 days/28days as per instruction/ if frequently use) and this solution is diluted discard it.

19. HOW TO CLEAN OPERATING SURFACE, TABLE, TOPS, AND LIGHT HANDLE.

• Wiped with a detergent and then 0.5% chlorine solution/0.5% Hypochlorite solution/Basillocid

20. HOW TO STORE THE INSTRUMENTS

1. After sterilization cool immediately and use.

2. Store in a covered, air tight and dry high level disinfectant container for up to 3 days.

3. If store in an ordinary covered container, the objects can be used for up to 24 hours.

21. SEGREGATION PROTOCOL OF WASTE MANAGEMENT (POLYTHENE INSIDE BIN)

1. Yellow Bin: Anatomical waste like placenta, dead fetus of less than 20 weeks, bloody cotton and gauge/Expiry

medicine

2. Red Bin: Infected plastics, syringe, gloves, saline bottle and tubes, catheter etc.

3. Blue Bin: Any Broken and unbroken glasses (vial, ample) and metals(body implants)

4. Black Bin: all general waste. (Green-Bio degradable/Black-Non degradable)

5. Jerry can: Sharps like needle, blades, scalpel etc and put it in 1% chlorine solution/1% Hypochlorite solution (prepared daily every 6 hours)

22. HOW WASTE TRANSPORTED FROM GENERATION SITE TO STORE/DISPOSAL SITE

In trolley having bins covered with Lid.

23. WHAT IS WORK PLACE MANAGEMENT (SS)?

Sort/2. Straighten or set in order/3. Shine /4. Standardize/5. Sustain

24. TYPES OF SPILL(PR-112)

1. Biological spill- A. small Spill (few drops) &B. Large spill (>10ml)

2. Chemical spill

3. Mercury spill

25. MATERIALS REQUIRED FOR BIOLOGICAL SPILL KIT

1. No Entry board

2. PPE(workman's gloves/Apron/Mask/Shoe cover/Shoe Etc)

3. 1% ChlorineSolution/1% Hypochlorite Solution/5% phenyl 4. Waste paper or cloth as absorben

5. Curden

6. Disposal bag Yellow

26. PROCEDURE OF BIOLOGICAL SPILL MANAGEMENT

1. Confine the contaminated area

2. Wear Workman's gloves & other PPE

3. Cover the spill with Waste paper or cloth as absorbent

4. Flood the spill with 1% chlorine solution/1% Hypochlorite Solution/5% phenyl.

5. Alternatively Bleaching powder can be sprinkled then paper put over it