Infection prevention and control

Routine practices is infection preventing control system endorsed by the public health agency of
Canada for use in all health care settings and for providing care for all patients

Routine practices is part of routine care for all patients all the time

 Why routine practices is important for all patient care

--Preventing the transmission of organisms from patient to patient, patient to stuff, stuff to patient,
visitor to patient, patient to visitors, stuff to stuff
--it’s one system for everyone
--many patient come to hospital with infections that we don’t know about, so routine practice is to
be used on all patients
--routine practice is defined as assessing the risk of exposure to moist body substance and risk of
transmission of organisms, then we can make a informed decision on how to prevent the
transmission by using hand hygiene, personal protective equipment and clear equipment for each
patient contact
 The components of routine practices and when to use them
--routine practices refers to hand hygiene before and after contact with each patient and the use of
personal equipment to prevent contact with:Blood, tissue and other moist body fluids, secretions
or excretions, such as:
Saliva
Sputum
Vomitus
Urine
Feces
Wound drainage
---exposure to perspiration does not require additional precautions
---routine practice includes:
1. Performing hand hygiene before and after each patient contact
2. Not come into work when you are ill
3. Use personal protective equipment appropriately when performing task whether there is
a risk of exposure to blood, body fluids, secretions or ecretions
 How to put on and take off personal protective equipment
---personal protective equipment includes:
1. Gloves
2. Gown
3. Masks
4. Eye protection(glasses)
--using a masks and eye protection when there is risk of splash from blood, body fluids or
secretions into eyes, noses or mouth.
e.g. when performing droplet or aerosol generating procedures or during operative procedures
--wearing gloves when taking blood or when hand maybe contaminated by body fluids, secretion
or excretions. Performing hand hygiene after removing the glove
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--wearing a gown if there is a chance your clothing will become soiled
--cleaning equipment in between patients, e.g. temperature probes, oxygen saturation machines,
bladder scanners
--cleaning diagnostic machines and equipment in between patients

The most important component of routine practices is hand hygiene

---if hands are visibly dirty, soap in running water for 15 seconds
---if hands are not visibly dirty, we use alcohol handrits for 15 seconds
remember to wash for 15 seconds
---remove all hand jewelry
---Nail enhancements, such as false nails or nail wraps are not to be worn by those providing
direct patient care
---when washing hand, adjust water temperature to luke warm, use one full pump of soap and
ensure all surface of the hand is covered, lather for 15 seconds, include area of the hand that
commonly missed, such as the back of hands, finger nails and inbetween fingers, rinse thoroughly
and pad hands dry with paper towel, use the same pare towel to turn off the tap to prevent
recontaminations
---when using alcohol handdrites, use one full pump of alcohol, and ensure all surfaces of the
hands are covered, rub hands for 15 seconds, or until alcohol evaporates, includes backs of hands,
fingernails and in between fingers.

---routine practice also require healthcare provider to assess patient’s symptoms that increase the
risk of exposure to body fluid, secretion and excretion:
1. Is the patient coughing?
2. Does the patient have a fever?
3. Does the patient have diarrhea?
4. Is the patient vomiting?
5. Does the patient have a rash or broken skin?
6. Is the patient soiling his or her environment?
7. Will I come in contact with moist body substances performing this task?

---routine practice require healthcare provider to assess the task to be performed and determine
the risk of contact of worker’s skin or mucus member with body fluid, secretion and excretion.

---routine practice means adding precautions when performing tasks such as

1. Suctioning
2. Aerosol generating procedures, like CPAP
3. Changing a dressing
4. Drawing blood
5. Emptying a catheter bag
6. Transporting a coughing patient
7. Moving equipment between patients
8. Performing any tasks during which there is a chance of contact with moist body
substances
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---additional precaution is required in addition to routine practice based on the transmission of
infection-----A stop sign will be placed on the patient’s door to inform staff and visitors of the
personal protective equipment required to enter the room

---correct way to put on the personal protective equipment

1. Hand hygiene for 15
seconds ( all surface of the hand including fingernails, back of the hands and in between
fingers)
2. High efficacy mask with
good seal covering nose and mouth, and fitting snugly under the chin and over the
bridge of the nose
Exception: --when the patient has air-born infection, hospital requires to use N-95 mask
--A standard surgical mask is used for operative procedures and by the
patient if the patient is required to wear a mask to contain a cough

3. Prescription eye glasses are

not considered adequate eye protection. Safety glasses and face shield must be worn
when indicated
4. Gowns must be tied at the
neck and waist
5. When gloves are worn, they
do not replace hand hygiene
---correct way to remove personal protective equipment
1. Remove gloves using a glove-to-glove, skin-to-skin technique
2. Remove gown carefully, roll it away from the body. Do not shake it
3. perform hand hygiene for 15 seconds, before removing facial protection
4. remove eye protection carefully, down and away from face
5. remove mask, remember to remove carefully down and away from the face
6. perform hand hygiene for 15 seconds

---dedicated equipment is preferred to each patient, but if it’s not possible----the equipment must
be cleaned between each patient use. Example of equipment must be cleaned for each patient
1. All machinery coming out of the patients room
2. Stethoscopes
3. Thermometers
4. Bladder scanners
5. Glucometers
6. BP cuffs
7. Stretchers
8. Lifts
9. Commodes

---the safe handling of sharps

Used needle should not be recapped
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Immediately after use, sharps must be disposed of in the point of views sharps container
It’s the responsibility of the person who use the sharps to dispose of it safely
Sharps container must not be allowed to become overfilled as it can lead to injury

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