Infection Prevention and Safety Compliance



Infection Prevention and Safety Compliance






Hand Hygiene


Policy

Hand hygiene is a routine infection prevention practice that decreases the potential risk of microbial contamination and cross-contamination.

Hand hygiene facilities with adequate running water, liquid soap or antiseptic solution dispensers, and single-use towels or hot-air drying equipment must be provided and accessible to all health care workers.

When provision for hand hygiene facilities is not feasible, the organization must provide antiseptic hand cleanser or alcohol-based hand rubs/gels, clean cloths, or paper towels.

Artificial nails are not to be worn when providing direct patient care.

Proper hand hygiene is to be taught to patients and/or caregivers involved in care of the patient.



Procedure



  • Perform hand hygiene:



    • Before and after touching a patient


    • Before handling an invasive device


    • Before moving from a contaminated body site to another site


    • Before putting on and after removing gloves


    • After contact with inanimate objects in the immediate vicinity of the patient


  • Use alcohol-based hand rubs/gels preferentially:



    • Remove jewelry.


    • Dispense approximately 5 mL of waterless product into cupped hands.


    • Use friction over all surfaces of both hands and rub vigorously until dry, approximately 20-30 seconds.


  • Use liquid soap or antiseptic solutions with running water alternatively and when hands are visibly soiled:



    • Remove jewelry.


    • Dispense soap or antiseptic solution into cupped hands and use continuously running water.


    • Thoroughly cleanse the palms and backs of both hands.



      • Avoid splashing that may cause contamination of clothing and other skin surfaces


    • Rinse hands thoroughly under running water.


    • Use clean paper towel to dry hands. Never wave hands or blow on skin to dry.


    • Turn off faucet using same paper towel.




Bibliography

Boyce JM. New insights for improving hand hygiene practices. Infect Control and Hosp Epidemiol. 2004;25(3):187-188.

McGoldrick M. Infection prevention and control. In: Alexander M, Corrigan A, Gorski L, Hankins J, Perucca R, eds. Infusion Nursing: An Evidence-Based Approach. 3rd ed. St Louis, MO: Saunders/Elsevier; 2010:209-211.

Registered Nurses Association of Ontario. Hand hygiene review panel report: nursing best practices guideline program. http://www.rnao.org/Storage/19/1385_Hand_Hygiene_ Review_Panel_Report.pdf. Published May 2006. Accessed July 28, 2010.

World Health Organization. WHO Guidelines on Hand Hygiene in Health Care. Geneva, Switzerland: WHO; 2009.



Management of Sharps, Hazardous Materials, and Hazardous Waste


Policy

Organizations that handle hazardous drugs and generate, collect, and dispose of medical and regulated wastes, which may include, but not be limited to, biological and radioactive materials, and pharmaceutical agents, and solutions will:



  • Follow state regulations regarding the definition, generation, handling, transportation, storage, treatment, and disposal of medical and regulated waste


  • Have written procedures to ensure safe handling of medical and regulated waste


  • Have a written list of hazardous drugs


  • Educate employees in the safe handling of hazardous drugs, medical and regulated waste, and complete written documentation that such training occurred

The Occupational Safety and Health Administration (OSHA) defines medical and regulated waste as:



  • Liquid or semiliquid blood or other potentially infectious materials


  • Contaminated items that would release blood or other potentially infectious materials in a liquid or semiliquid state if compressed


  • Items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling


  • Contaminated sharps


  • Pathologic and microbiologic wastes containing blood or other potentially infectious materials

Infusion-related supplies that may be considered medical waste after use are:



  • Catheter and steel winged infusion sets


  • Infusion-related administration sets


  • Syringes


  • Lancets


  • Dressings


  • Isolation materials


  • Sutures


  • Blades


  • Solution containers




Procedure


Designation



  • Designate wastes that are considered infectious, medical, or regulated based on definitions from OSHA and federal, state, and regulatory agencies, as well as the health care organization.


  • Ensure that all health care workers (HCWs) are aware of these definitions.


Handling



  • Don gloves and other personal protective equipment (PPE) as appropriate before handling hazardous drugs or medical and regulated waste.


  • Sharps will not be:



    • Broken


    • Bent


    • Sheared


    • Recapped


    • Resheathed


  • Activate devices with built-in safety controls during use as appropriate, according to manufacturer’s directions for use. Note that with passive safety devices, mechanisms to prevent needlesticks are automatically activated during product use.


Packaging



  • Place medical or regulated waste in a properly identified container or by affixing a BIOHAZARD label to the external bag. Waste can include:



    • Blood and blood products


    • Unused specimens such as cultures, blood, and tissue


    • Sharps containers


    • Large collection systems for body fluids such as wound drainage systems, auto-transfusion systems, and suction canisters


  • If the outside of the bag or container becomes contaminated, place within a second bag.


Collecting and Storing



  • Transport properly packaged medical or regulated waste to the designated area for collection or storage.


  • Transport waste to the collection or storage area during a time and by a route that minimizes exposure of others to the waste; clean the transport vehicle thoroughly before returning it to service.


  • If transporting waste by motor vehicle (eg, in the home care setting), ensure that medical and regulated waste is properly contained and separated from clean equipment and supplies.



  • Collection or storage areas for medical and regulated waste are restricted to authorized personnel. Areas must be:



    • Properly contained (ie, separate from clean patient care and equipment areas)


    • Marked with signage: AUTHORIZED PERSONNEL ONLY and BIOHAZARD with a biohazard symbol


Disposal



  • In some organizations, an in-house incinerator is used to destroy medical and regulated waste; if the organization does not use an incinerator, a management company must remove waste.


  • Body fluids and waste are not considered hazardous and may be disposed of via the sanitary sewer (eg, the patient’s bathroom or toilet); however, do not use handwashing sinks for disposal of body fluids and wastes.


  • Place a sharps container that is puncture-resistant, leak-proof, tamper-proof, and labeled with the BIOHAZARD symbol in an easily accessible location for immediate use.


  • Dispose of all expended sharps in sharps container.


  • Consult the manufacturer’s directions for use in sealing sharps containers.


  • Dispose of the sealed sharps container as established by the organization.


Medical Waste Spills



  • Don gloves.


  • Immediately begin to clean the spill:



    • Use paper towels to wipe the initial spill, followed by use of the appropriate cleansing agent


    • If spill is on equipment, follow the manufacturer’s directions for use for cleaning


  • Properly dispose of contaminated supplies.


  • Remove gloves and perform hand hygiene.


Cytotoxic Agent Spills



  • When working with cytotoxic agents such as antineoplastic drugs, a spill kit will be available in patient care areas, in the pharmacy compounding area, and in the homes of patients receiving infused antineoplastic drugs.


  • HCWs will be trained in handling cytotoxic agents and use of spill kits.


For ALL exposures and spills

Follow the organization’s procedure for Unusual Occurrence Reporting and documentation.


For eye exposure:



  • Immediately flush affected eye with copious amounts of water or eye rinse solution


  • Obtain medical attention


For skin exposure:



  • Remove contaminated clothing and gloves


  • Wash skin with copious amounts of soap and water


  • Obtain medical attention


For general spills:



  • Restrict access to the spill area


  • Don protective eyewear, double set of gloves, gown, and mask


  • Absorb the liquid using spill kit


  • Wash spills on inert surfaces with appropriate solution for the type of spill


  • Place all contaminated material into a hazardous waste receptacle


For spills within the controlled air environment:

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Aug 18, 2016 | Posted by in NURSING | Comments Off on Infection Prevention and Safety Compliance

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