Infection control practices are critical to reduce the transmission of infections from one person to another, such as from a healthcare worker to a patient or vice versa. See:
What is Infection Control?
In health care and public health practice settings, infection control includes various measures that prevent and contain the spread of infectious disease. These measures include:
- Hand Washing
- Infection control standard, contact, droplet and airborne precautions
- Procedures for decontamination of persons and disinfection of equipment and the environment
- Quarantine of contacts (if necessary)
- Prophylaxis of exposed individuals
- Control of the vectors of infection
Healthcare-associated infections are the most common complication affecting patients in hospital. They cause unnecessary pain and suffering for patients and their families, and usually result in longer hospital stays. The cost to the health system is also significant.
Infection prevention and control practices play a key role in reducing antibiotic resistance in hospitals. Standard precautions for infection prevention and control should be included in every hospital program and should include:
- hand hygiene
- the use of personal protective equipment
- the safe use and disposal of sharps
- reprocessing of reusable medical equipment and instruments
- routine environmental cleaning
- respiratory hygiene and cough etiquette
- aseptic non-touch technique
- effective waste management
- appropriate handling of linen
- vaccination.
Infection prevention and control guidelines
The Australian Guidelines for the Prevention and Control of Infection in Healthcare (the guidelines) describe the best way to prevent and reduce infections occurring in healthcare settings including resistant infections. The guidelines include how to manage common infectious agents, for example, gastrointestinal viruses and evolving infectious agents, for example influenza or multi-drug resistant organisms.
The guidelines contain recommendations for:
- the key design features for isolation units to minimise infection transmission
- effective work practices to assist healthcare workers, including:
- standard and transmission-based precautions
- basic management of multi-drug resistant organisms
- organisational support
- workplace health and safety.
The guidelines are an important resource to support the National Quality and Health Service Standard: Preventing and Controlling Infections.
National Safety and Quality Health Service (NSQHS) Standard 3
The NSQHS Standard 3: Preventing and Controlling Healthcare-Associated Infections aims to minimise the risk of patients acquiring a healthcare-associated infection.
Standard 3 describes the systems and strategies to prevent infection and to manage infections effectively when they occur. They also explain how to prevent and contain antimicrobial resistance through the development and implementation of effective antimicrobial stewardship programs.
Guidelines for multi-drug resistant organisms
Several governments and organisations have developed specific infection prevention and control guidelines for multi-drug resistant organisms.
The Australian Commission on Safety and Quality in Health Care has updated the national guidelines Recommendations for the control of carbapenemase-producing Enterobacteriaceae (CPE): A guide for acute care health facilities in May 2017. The Commission also developed information sheets on CPE for clinicians and patients.
The Victorian Department of Health and Human Services has developed CPE management guidelines and a suite of information sheets to assist clinicians, patients and visitors in health services. These aim to prevent infections and control the spread of CPE.
The National Health and Medical Research Council, in collaboration with the Australian Commission on Safety and Quality in Health Care has developed fact sheets on healthcare-associated infections from:
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Vancomycin resistant Enterococcus (VRE)
- Clostridium difficile.
Hand hygiene
Healthcare workers' effective hand hygiene is the single most important strategy to prevent healthcare-associated infections.
The National Hand Hygiene Initiative (NHHI) was established in 2008 by the Australian Commission on Safety and Quality in Health Care as part of a suite of initiatives to prevent and reduce healthcare-associated infections in Australian healthcare settings.
The NHHI provides education, audit and feedback to clinicians and hospital executives. Its aim is to protect patients, the health workforce and the community from the spread of infection. Further information and resources about hand hygiene are available from the Australian Commission on Safety and Quality in Health Care.
Infection control procedures are the most crucial part of infection control. Also known as standard precautions, these are the procedures that should be used at all times, in all situations, in all places. They should definitely be used in aged care facilities and other healthcare settings, but they can also be used in the home and in other, non-clinical spaces.
Why should we always use standard precautions? Because we assume that all blood and body fluids/substances are potentially infectious. By always observing these protective procedures, you will be safeguarding yourself from potential infection from a range of sources.
There are five key infection control procedures that should be observed.
1. Hand hygiene
Hand hygiene is one of the most fundamental parts of infection control. The aim of hand hygiene is to reduce the number of microorganisms on your hands It should be performed before and after contact with a person, before and after contact with a person’s equipment, before preparing or eating food, before and after assisting a person to eat, after going to the toilet, after assisting a person with toileting and personal care… the list is almost endless really!
But hand hygiene isn’t just when you do it, it is also how you do it. Whether you are doing a soap and water hand wash, or a hand rub with ABHR, the idea is to rub your hands vigorously. This is because the friction with the hand hygiene product removes/reduces the microorganisms on your hands. And don’t forget, your hands must be dried thoroughly, regardless of whether you are hand washing with soap and water, or using ABHR, as moist hands pick up more germs than thoroughly dried hands.
Hand hygiene is really about technique as much as frequency, so read our 4 tips for more effective hand hygiene for maximum efficiency.
2. Wearing appropriate PPE
PPE, or personal protective equipment, is worn to protect the wearer from other infection risks. The necessary infection control procedures will depend on the risks associated with the task or infection. For example, for this last year COVID, an airborne virus, has been prevalent in the community. Because of this, we have all been wearing facial masks, which are a type of PPE. Masks are one kind of protection against risks that we cannot see, such as respiratory droplets.
If you want to know more about more efficient facial PPE use?
There are many types of PPE, including aprons, face shields and gloves. These offer protection against other types of risk, such as splashes or sprays of body fluids. Simply put, PPE refers to any physical barrier between you and a patient, or the outside environment.
Not sure what PPE is? Read our ‘What is PPE?’ blog post for an explanation!
3. Environmental cleaning
The next infection control procedure is routine environmental cleaning. Simply put, this means cleaning, but like hand hygiene, it requires doing it often enough and well enough. Cleaning is vitally important for infection prevention and control because deposits of dust, soil, and microbes on any surface can transmit infection. There must be written cleaning protocols that include the method of cleaning and the frequency, as well the products to be used for the different surfaces and areas. Then also need to be written procedures for cleaning areas where there is suspected known infection.
Read our blog on environmental cleaning for more information, including whose responsibility it is.
4. Waste management
Waste management is another infection control procedure. It require the appropriate handling and removal of waste, which is typically classified in three main groups: general, clinical and pharmaceutical. All facilities should have policies and procedures for the correct management of all waste generated. The NHMRC has guidelines for the management of waste generated in any healthcare facility.
Remember, waste management includes everything from the skips to the bins in every room in the facility. Do you know whether your bins need lids? Now you can know!
5. Transmission-based precautions
The last infection control procedure we’ll discuss here are transmission-based precautions. These are used in addition to standard precautions when standard precautions alone are not sufficient to prevent transmission of infection. Transmission-based precautions (TBP) are used for people with suspected or known infections that are transmitted in one of three ways: airborne transmission, droplet transmission and contact transmission (direct or indirect). TBP practices need to be tailored to the particular infectious agent involved, and to the mode of transmission. For example, for a resident with gastroenteritis, contact precautions would be introduced, such as ideally isolating them in a single room with ensuite, and the PPE required would be masks, gloves, disposable impermeable gowns.
Infection control procedures are necessary, daily practices that help protect both staff and residents from infection. Not only that, but they’re practices that can be brought into everyday life as well. Infection control is about diligence as well as proper practice, so ensure not only that observing these procedures with the right frequency and attention to execution.
If you’d like more help with IPC in your facility, why not download our free IPC audit checklist? Help can be just a few clicks always. Alternatively, get in touch with Bug Control with any infection control questions. We’d love to help you out.