Methods of reducing the spread of infection
Infection control practices can be grouped in two categories;
·
Standard precautions: routinely applying basic infection
prevention and control strategies to minimize risk to both patients and
healthcare workers, such as hand hygiene, personal protective equipment,
cleaning and appropriate handling and disposal of sharps (standard precautions); and
·
Transmission- based precautions: effectively managing infectious
agents where standard precautions may not be sufficient on their own - these
specific interventions control infection by interrupting the mode of
transmission (transmission-based precautions;
formerly referred to as additional precautions).
Standard precautions
Standard precautions refer to those work practices that are
applied to everyone, regardless of their perceived or confirmed infectious
status and ensure a basic level of infection prevention and control.
Implementing standard precautions as a first-line approach to infection
prevention and control in the healthcare environment minimizes the risk of
transmission of infectious agents from person to person, even in high-risk situations.
Standard precautions include the following:
·
Personal
hygiene practices, particularly hand hygiene, aim to reduce the risk of contact
transmission of infectious agents.
·
The
use of personal protective equipment, which may include gloves, gowns, plastic
aprons, masks/face-shields and eye protection, aims to prevent exposure of the
healthcare worker and patients to infectious agents.
·
Appropriate
handling and disposal of sharps assists in preventing transmission of blood - borne
diseases to healthcare workers.
·
Environmental
controls, including cleaning and spills management, assist in preventing
transmission of infectious agents from the environment to patients.
·
Appropriate
reprocessing of reusable equipment and instruments, including appropriate use
of disinfectants, aims to prevent patient-to-patient transmission of infectious
agents.
·
Practicing
respiratory hygiene and cough etiquette reduces risk of transmission of
infection.
·
Aseptic
non-touch technique aims to prevent microorganisms on hands, surfaces or
equipment from being introduced into a susceptible site.
·
Appropriate
handling of waste and linen assists in reducing transmission of infectious
agents.
Transmission - based precautions
Transmission-based precautions are recommended as extra work
practices in situations where standard precautions alone may be insufficient to
prevent transmission. Transmission-based precautions are also used in the event
of an outbreak (e.g. gastroenteritis), to assist in containing the outbreak and
preventing further infection.
Transmission of infectious agents can occur
in a number of ways.
·
Indirect or direct contact
transmission - when
healthcare worker hands or clothing become contaminated, patient-care devices
are shared between patients, infectious patients have contact with other
patients, or environmental surfaces are not regularly decontaminated.
·
Droplet transmission - when healthcare workers' hands
become contaminated with
respiratory droplets and are transferred to susceptible
mucosal surfaces such as the eyes, when infectious respiratory droplets are
expelled by coughing, sneezing or talking, and come
into contact with another's mucosa (eyes, nose or mouth),
either directly into or via contaminated hands.
·
Airborne transmission - when attending healthcare workers or
others inhale small particles that contain infectious agents.
Strategies for
implementing transmission-based precautions
Transmission-based precautions may include one or any
combination of the following:
·
allocating
a single room with closing door to patient with a suspected or confirmed
infection (isolation)
·
placing
patients colonized or infected with the same infectious agent and antibiogram
in a room together (cohorting)
·
wearing
specific personal protective equipment
·
providing
patient-dedicated equipment
·
using
a TGA-registered disinfectant with label claims specifying its effectiveness
against specific infectious organisms
·
using
specific air handling techniques and restricting movement both of patients and
healthcare workers.
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