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 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.