HLTINF001

Comply with infection prevention and

control policies and procedures
 HLTINF001
1.Follow standard and additional
1. Follow Standard and Additional
Precautions for Infection
Prevention and Control
for infection prevention Follow
standard and additional precautions
for infection and control
1.and control

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What is Infection Control? Ref: Student Resource Book pp. 5-6

• It is the creation of safe healthcare environments through

the implementation of practices that minimises the risk of
transmission of infectious agents

• The aim of infection control is to minimize exposure to

blood, body fluids, secretions (except sweat), broken skin
or mucous membranes

• The concept that body fluids from ANY person can be

infectious must be used for EVERY patient/client

• Infection control is also a direct duty of care

responsibility. It isn‘t possible for patients to be
safe from infection if staff are not also safe

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 Microorganisms
•Infectious agents such as bacteria and viruses are all around us – in the air we
breathe, in the food and water we ingest or on the objects and people we come into
contact with
•The majority of microbes do not cause infections in humans, but are useful to
provide fermentation processes and breaking down of dead matter
•The main groups of microbes are:
– Bacteria - streptococci, staphylococci
– Viruses - smaller than bacteria (influenza, chickenpox, mumps, measles, colds)
– Fungi - mushroom and moulds (ringworm)
– Parasites - an organism living upon or within another where it derives its
nourishment
•Infection occurs when different levels of body defences are damaged
due to trauma, deficiencies in immunity or the offensive capabilities
of some microbes
•Microbes which cause infections are called pathogenic
microbes or infectious agents

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The Body’s Defences Against Infection

• Intact Skin
• Gastro Intestinal Tract
• Respiratory Tract
• Genitourinary Tract
• Normal Flora
• Antibodies
• Vaccination & Sensitization

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How do humans become hosts to
microbes?
• Broken skin – bed sores, wounds,
ulcers
• Breathing airborne microbes
• Invasive procedures - eg.
catheterisation
• Immune suppressant medications
eg. prednisolone
• Concurrent infections

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 Standard Precautions Ref: Student Resource Book pp.7,19-21

• Infection control in Australia is based on a series of practices

known as standard precautions. Standard precautions are
standard, safe work practices required for the basic level of
infection control

• The use of Standard Precautions is essential as the primary

strategy for the successful minimisation of transmission of health
care associated infection because:
- infectious persons may not show any signs or symptoms of
infection that may be detected in a routine history and medical
assessment
- a person‘s infectious status is often determined by laboratory
tests that may not be completed in time to provide emergency
care
- persons may be infectious before laboratory tests are
positive or symptoms of disease are recognised

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 Standard Precautions
Some Standard Precautions include:

1. Hand Hygiene

2. Personal Hygiene

3. Coughing/Sneezing Etiquette

4. Proper use of personal protective equipment PPE

- gloves
- eye goggles
- gown
- mask
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 Standard Precautions
5. Sharps Management

6. Appropriate Disposal of Waste

7. Cleaning, Disinfection and Sterilization

(equipment and environmental surroundings)

8. Aseptic Technique

9. Linen Management

10. Occupational Health and Blood borne Pathogens

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 Hand Hygiene
Ref: Student Resource Book pp.12-13

Hand hygiene remains the single most effective infection

control measure for all health care workers. It involves
using soap and water or an alcoholic hand rub to remove
and reduce the number of microorganisms on the hands

Hand hygiene must be carried out:

• Before touching a patient
• Before a procedure
• After a procedure or body fluid exposure risk
• After touching a patient
• After touching a patient surroundings
• BEFORE & AFTER USING GLOVES
• After coughing or blowing your nose
• After using the toilet
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 Hand Hygiene
• Cover cuts and abrasions on the
hands and forearms with blue
waterproof dressings and plasters,
particularly in areas where handling
food or working in kitchen or dining
areas

• Good hand care is very important as

broken skin can leave you open to
infection

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 Application of Alcohol Hand
Rub/Gel
1. Follow standard and additional
• Alcoholic hand rub/gel may be used when
hands are not visibly soiled
• Apply generously to ensure all
surfaces come into contact with
the rub/gel
• Rub vigorously until solution has
evaporated and hands are dry
For additional

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 Hand Washing Technique
1.Follow standard and additional for
infection prevention Follow
standard and additional
precautions for infection and
control
2.and control

There are three types of hand washing: social, hygienic and surgical:

• Social hand washing should take at least 15 seconds

• Hygienic hand washing should take at least 30 seconds
• Surgical hand washing(also includes forearms) should take at least 2 minutes

Rinse hands thoroughly under warm running water. Dry hands carefully
with a disposable paper towel

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 Personal Hygiene Ref: Student Resource Book p.14

1. Follow standard and additional

Because of the communal environment in which you work and the

contact nature of your work, you should always exercise the
highest degree of personal hygiene

• WASH WELL BEFORE AND AFTER YOUR SHIFT

• Shower daily
• Use of deodorant (no excessive perfume)
• Oral Hygiene
• Wear clothing which is suitable for your daily tasks, footwear
should be fully enclosed. Hair should be clean and tied back to
minimise contact with patients
• Hand and wrist jewellery, with the exception of a plain wedding
band, must be removed. Nails must be clean and cut short
(no false nails)
• Maintain good personal health with a well balanced diet,
exercise and adequate sleep
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 Coughing/Sneezing Etiquette
1. Follow standard and additional
• Cover your mouth and nose with a tissue
when
you sneeze or cough and discard tissue in
the bin
OR
• Cough or sneeze into your upper sleeve –
NOT YOUR HANDS
• Wash your hands after coughing or
sneezing

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 Personal Protective Equipment
(PPE) Ref: Student Resource Book pp. 15-18

• Personal Protective Equipment can include:

• Gloves - when contact with blood, body fluids, non intact skin,
mucous membranes and contaminated items is anticipated.

SINGLE USE - Change gloves between tasks and always

remove gloves promptly after use and perform hand hygiene

• Aprons & gowns - to prevent soiling of clothing during

procedures and activities where splashes or sprays of blood
and/or body fluids may be anticipated

• Face mask & goggles - to protect mucous membranes of

the eyes, nose, and mouth during procedures

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 Aseptic Technique
What is aseptic technique?
Aseptic technique is employed to maximize and maintain asepsis,
the absence of pathogenic organisms, in the clinical setting. The
goals of aseptic technique are to protect the patient from infection
and to prevent the spread of pathogens.

When should aseptic technique be used?

Typical situations that call for aseptic measures include surgery and
the insertion of intravenous lines, urinary catheters and drains.

All patients are potentially vulnerable to infection, although certain

situations further increase vulnerability, such as extensive burns
or immune disorders that disturb the body's natural defenses.

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 Glove Use
1. Follow standard and additional
• Disposable gloves should be used when
contact with body fluids is anticipated
• Gloves frequently have minute holes so
hands must be washed after glove removal
• Powder-less gloves may produce less skin
sensitivity than powdered gloves
• Gloves can carry microorganisms from
one patient to another, so must be changed
between patients and between soiled and
clean sites on the same patient
• Some health care workers suffer from varying
degrees of allergy to the latex in rubber gloves
• Latex-free gloves should be available for
affected health care workers
• General purpose utility gloves should be used
for general cleaning

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 Glove Removal Procedure
1.Follow standard and additional
for infection prevention Follow
standard and additional precautions
for infection and control
1.and control

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 Glove Removal Procedure
1.Follow standard and additional
for infection prevention Follow
standard and additional precautions
for infection and control
1.and control

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 Glove Removal Procedure
1.Follow standard and additional
for infection prevention Follow
standard and additional precautions
for infection and control
1.and control

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 General Cleaning Ref: Student Resource Book pp.39-40

1. Follow standard and additional

The Five Golden Rules of Cleaning
1. Work from Clean to Dirty
• Start the cleaning process in the cleanest areas and finish in
the dirty areas
• This method helps to prevent cross infection as it stops
contamination of clean areas with soil, thereby decreasing
the risk of contamination

2. Work from High to Low

• This method also helps to prevent cross infection and
contamination

3. Leave all Surfaces Clean and Dry

• It is important to leave cleaned surfaces as dry as possible
• This prevents mould and bacterial growth, and
helps prevent accidents

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 General Cleaning
1. Follow standard and additional
4. Change Cleaning Solutions and Cloths Often
• One of the main causes of contamination is the
use
of one cloth and bucket for all cleaning
• Changing to a fresh cloth and fresh solution
significantly reduces bacterial growth and
bad odours, with better cleaning results

5. Wash Your Hands Often

• Dirty hands soil clean surfaces
• Contaminated hands are the primary cause
of cross infection
for infection prevention Follow standard and additional
precautions for infection and control
1. and control

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 Methods of Cleaning
1. Follow standard and additional
• Dry cleaning (sweeping, dry dusting) — raises bacteria-carrying
particles into the air causing an infection risk — must not be
used in hospitals
• Wet cleaning (mopping, damp dusting) — is more suitable for
health care facilities. These methods do not raise dust and rarely
increase airborne infection risk
• Dust attractant mops/cloths — specially treated or manufactured
to attract and retain dust particles, cause much smaller increases
in airborne counts than dry sweeping/dusting but they must be
used as directed and require washing or reprocessing as directed
by the manufacturer
• Vacuum cleaning — an efficient vacuum cleaner can assist in
decreasing the amount of airborne dust in the environment.
The vacuum cleaner must be fitted with a suitable filtering
system capable of filtering 97.5% of dust to 0.5 micron
(AS/NZ 3733:1995)

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Colour coding of cleaning equipment
(required in some States in Australia)

• Infectious/isolation areas YELLOW

• Toilets/bathrooms/dirty utility rooms RED
• Food service preparation areas GREEN
• General cleaning BLUE
• Operating theatres
for infection prevention Follow standard and
additional precautions for infection and control
1. and control

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 Linen Management
Ref: Student Resource Book p.47

1. Follow standard and additional

• All used linen is potentially contaminated with infectious
organisms. Handle used linen in a manner that prevents
skin and mucous membrane exposure, contamination of
clothing and transfer of microorganisms to other patients
and environments
• Linen should be bagged at the point of use
• Do not overfill bags: when bags are two thirds full, tie
securely with plastic lock (do not knot cords) and place in
designated holding area for collection
• All rubbish (e.g. sharps, tissues, incontinent pads,
dressings, medical devices etc) must be removed
from linen before placing in linen bags
for infection prevention Follow standard and additional
precautions for infection and control
1. and control

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 Waste Disposal Ref: Student Resource Book pp.50-61

1. Follow standard and additional

• Clinical and related waste can cause injury and infection
transmission if improperly handled
• Waste should be separated at point of use
• Use appropriate colour-coded and labelled containers
• Use gloves and protective clothing when handling clinical and
related waste bags and containers
• Do not over-fill containers
• Never squash waste by hand
• Secure lids during transport
• Use appropriate bins—no decanting from small to large
bins or visa versa
• Contain waste during transport
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 Ward Cleaning
Ref: Student Resource Book pp.41-43

1. Follow standard and additional

• Detergent and water are adequate for cleaning surfaces in most areas

• Disinfectant solutions may be required for certain resistant bacteria and viral
gastroenteritis

• Clean high-touch surfaces (e.g., doorknobs, bed rails, light switches and surfaces
in and around toilets in patients’ rooms) more often than minimal touch
housekeeping surfaces

• Close lid of toilet when flushing to prevent exposure to aerosols as toilet is flushed

• Clean walls, blinds and window curtains in patient care areas when they are
visibly dusty or soiled

• Follow proper procedures for effective use of mops, cloths, and solutions

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 Ward Cleaning
1. Follow standard and additional
• Prepare cleaning solutions daily or as needed and replace
with fresh solution frequently according to facility policies and
procedures
• Change the mop head at the beginning of the day and also as
required by facility policy, or after cleaning up large spills of
blood or other body substances
• Send mops and cleaning cloths to laundry after use for
thermal disinfection via laundry process
• Allow cleaning equipment to dry before reuse—never soak or
store mop heads or any cleaning equipment in disinfectant
solutions
• Use single-use, disposable mop heads and cloths where
instructed

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 Cleaning of Rooms
1. Follow standard and additional
• Wall washing is not routinely necessary, spot clean as necessary - consult
infection control regarding need to wash walls
• Place all disposable cleaning equipment and waste into a clinical waste bag -
place ready for disposal
• Thoroughly clean and, where necessary, disinfect all reusable cleaning
equipment and allow to dry
• Send reusable mops etc to laundry for cleaning
• Remove PPE and discard into a clinical waste bag or
laundry bag
• Wash hands or apply alcohol hand rub
• Leave room to ‘air’ if necessary
• Replenish supplies
• Remake up bed
• Hang clean curtains if necessary
• Call environmental services to remove waste and
linen as soon as possible—do not leave piled up
outside door

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 Cleaning Isolation Rooms
1. Follow standard and additional
• Use appropriate hand hygiene, PPE (e.g., gloves, mask,
gown) during cleaning and disinfecting procedures

• Always speak with nursing staff before entering room

• Keep area around patient free of unnecessary supplies and

equipment to facilitate daily cleaning

• Give special attention to frequently touched surfaces: −

bedrails, bedside and over-bed tables, TV controls, call
buttons, telephones, lavatory surfaces including safety rails,
door knobs, commodes. (Close lid of toilet when flushing to
prevent exposure to aerosols)

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 Cleaning Isolation Rooms
1. Follow standard and additional
• Frequency and level of cleaning will depend on level of
hygiene of patient and degree of environmental contamination

• Disinfectants may be required for some situations, follow

recommendations for the amount, dilution and contact time

• After removing PPE and hand washing, ensure that hands

do not touch potentially contaminated environmental surfaces
or items

• Terminal cleaning of a room after patient discharge may be

necessary - contact environmental services or infection
control for details

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Cleaning Patient Equipment
1. Follow standard and additional
Patient Equipment
• Dedicate the use of non-critical patient-care equipment to a
single patient (or cohort of patients infected or colonized with
the pathogen requiring precautions)
• If use of common equipment or items is unavoidable, then
ensure items are adequately cleaned and disinfected before
use for another patient
Crockery and Cutlery
• No special precautions are needed for eating utensils— the
combination of hot water and detergents used in dishwashers
is sufficient to decontaminate these items
Linen
• All linen is treated as potentially infectious by the laundry
service and should be handled according to ‘linen
management’

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 Definitions
• Cleaning – is the physical removal of visible soil from
surfaces normally accomplished using detergent and water

• Disinfection – is the process that uses disinfectant to

eliminate microorganisms, except bacterial spores

• Sterilisation – is the process to remove all

microorganisms rendering the piece of equipment or
instrument sterile eg. autoclaving, radiation, filtration

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 Terminal Cleaning of an
Isolation Room
1. Follow standard and additional
• Always check with infection control or environmental services manager before commencing
regular cleaning or terminal cleaning in an isolation room

• Use dedicated cleaning equipment reserved for specific isolation

room - if this is not possible thoroughly disinfect equipment after use on isolation room

• Use PPE as advised by infection control

• Strip bed and remove linen

• Wash mattress and bed with general detergent and where necessary disinfect using a
chlorine based disinfectant - check required strength with manager

• Clean door handles and all high touch surfaces and disinfect as instructed

• Clean all furniture and fittings with general purpose detergent, if

instructed to, disinfect using a chlorine based disinfectant, rinse and dry

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 Terminal Cleaning of an
Isolation Room
1. Follow standard and additional
• Clean curtain tracks and all high ledges with
detergent, disinfect if required

• Clean equipment as instructed, disinfect where

appropriate

• Clean all bathrooms/ shower fixtures with detergent,

disinfect, rinse and dry where appropriate

• Mop floor with general detergent, disinfect using a

chlorine based disinfectant if required, rinse and dry

• Take down curtains and send for laundering if

necessary
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Sometimes Additional Precautions
are required! Ref: Student Resource Book pp.22-28

1.Follow standard and additional

for infection prevention Follow
standard and additional precautions
for infection and control
1.and control

37
 Additional Precautions
1. Follow standard and additional
Additional Precautions: are always in addition to
standard precautions and should promote a high level
of protection to patients, staff and visitors
They are for patients that are known to be infectious
and are implemented when standard precautions may
be insufficient to prevent transmission of infection
For example:
• Direct or Indirect – MRSA, VRE (bacteria resistant to
antibiotics)
• Droplet – Mumps/Influenza
• Airborne - Measles/Chicken Pox
for infection prevention Follow standard and additional
precautions for infection and control
1. and control
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 Additional Precautions
1. Follow standard and additional
 CONTACT PRECAUTIONS (Direct or Indirect)
For resistant bacteria which are transmitted by direct or indirect
contact with the patient or the patient’s environment
Example: Gastrointestinal infections, Multiple Drug Resistant
Organisms (MROs) such as MRSA, VRE and blood borne diseases -
Hep B,C and HIV

 DROPLET PRECAUTIONS
For respiratory infections transmitted by larger respiratory droplets
which only travel about one metre and do not remain suspended in air
Example: Whooping cough, Diphtheria, Influenza, Rubella

 AIRBORNE PRECAUTIONS
For respiratory infections transmitted by fine, floating particles
which are easily spread by air currents

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 Additional Precautions may
include:
1. Follow standard and additional
• A single room with ensuite facilities and more frequent
room cleaning
• Room sharing by a person with the same infection
• Negative air pressure (contaminated air from within
isolation room is not discharged outside the room)
• Use of a visible door sign asking people to consult with
nursing staff before entering
• Consideration of staff immunity eg: Chickenpox
• Equipment dedicated to a specific patient
• Antiseptic cleansers for hand washing
• Use of personal protective equipment
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