Infection Prevention and Control Practice Handbook

1 Not controlled if printed Last updated January 2020 Infection Prevention AND Control Practice Handbook Not controlled if printed Last updated January 2020 Clinical Excellence Commission 2020 All rights are reserved. In keeping with the NSW Government's commitment to encouraging the availability, dissemination and exchange of information (and subject to the operation of the Copyright Act 1968), you are welcome to reproduce the information which appears in this publication, as long as the user of the information agrees to: use the document for information only save or print a single copy for personal use only and not to reproduce any major extract or the entire document except as permitted under Copyright Act 1968 (as amended)

2 Without the prior written permission of the State of New South Wales acknowledge the source of any selected passage, table diagram or other extract reproduced not make any charge for providing the Information to another person or organisation without the prior written consent of the State of New South Wales and payment of an agreed copyright fee not modify the Information without the express prior written permission of the State of New South Wales include this copyright notice in any copy made: - Copyright Clinical Excellence Commission for and on behalf of the Crown in right of the State of New South Wales. National Library of Australia Cataloguing-in Publication entry Title: Infection Prevention and Control Practice Handbook ISBN: 978-1-76000-381-4 SHPN: (CEC) 160031 Suggested citation Clinical Excellence Commission, 2020, Infection Prevention and Control Practice Handbook .

3 Clinical Excellence Commission, Sydney, Australia. Any enquiries about or comments on this publication should be directed to: Clinical Excellence Commission Locked Bag 8 Haymarket NSW 1240 Phone: (02) 9269 5500 Email: i IPC Practice Handbook v3 Update January 2020 Not controlled if printed ACKNOWLEDGEMENTS Initial Contributors Jan Gralton, Iain Crawford, Dr Kate Clezy Evette Buono, Kate Callaghan, Ronald Govers, Nina Muscillo, Anne Axam, Paul Smollen, Paul Curtis - Clinical Excellence Commission Jane Rothman - HAI Steering Committee, Clinical Excellence Commission Catriona Furlong - Health Protection NSW Amanda Elliott - Health and Education Training Institute Nicky Gilroy - Agency for Clinical Innovation (BMT Network)

4 Kate Hipsley - NSW Ambulance Bruce Sanderson - Central Coast LHD Wendy Hamilton - Justice Health and Forensic Mental Health Network Louise Bright, Alison Shoobert, John Ferguson - Hunter New England LHD Beth Bint, Annmaree Wilson - Illawarra Shoalhaven LHD Chris Fraser - Nepean Blue Mountains LHD Leigh Boivin, Julie Hunt, Shayne Larymore - Northern Sydney LHD Melainie Ison, Barbara May, Poonam Nagrani, Lindy Ryan - Mid North Coast LHD Sharon Maher - Murrumbidgee LHD Margaret Evans, Fiona Law, Kate Clezy- South Eastern Sydney LHD Genevieve Maguire - Southern NSW LHD Helen McCarthy, Jennifer Morrison, Donna Schmidt, Ravi Srinivas - South Western Sydney LHD Margaret Barker, Marilyn Harris, Jeana Nurmeiyati, Helen Parker- Sydney LHD Dianne Dalton - Sydney Children s Hospitals Network Meegan Connors - Western NSW LHD Kathy Dempsey, Jo Tallon, Tracey Worthington, Lyn Gilbert - Western Sydney LHD Ongoing update contributions provided by Joe-Anne Bendall, Amy Bisson, Kathy Dempsey, Carolyn Ellis, Andie Lee, Susan Jain and subject matter experts from local health districts/specialty health networks and approval provided by the NSW Healthcare Associated Infection Expert Advisory Committee.

5 Ii IPC Practice Handbook v3 Update January 2020 Not controlled if printed CONTENTS INTRODUCTION INITIAL CONTRIBUTORS .. I CONTENTS .. II INTRODUCTION .. 1 PURPOSE .. 1 RELEVANT POLICIES .. 1 DEFINITIONS AND ABBREVIATIONS .. 2 MENTAL HEALTH, DRUG AND ALCOHOL .. 7 THE RISK OF HEALTHCARE ASSOCIATED INFECTIONS .. 13 MODES AND ROUTES OF TRANSMISSION .. 15 CONTACT TRANSMISSION ROUTES .. 15 DROPLET TRANSMISSION ROUTE .. 15 AIRBORNE TRANSMISSION ROUTE .. 16 COLONISATION .. 16 Infection .. 16 NATIONAL STANDARDS .. 18 RISK MANAGEMENT FRAMEWORK .. 19 FIGURE 1. STEPS OF RISK MANAGEMENT, BASED ON THE NSW HEALTH RISK MANAGEMENT FRAMEWORK .. 20 Infection Prevention AND Control PROGRAM.

6 22 table 3. IPC CORE COMPONENTS .. 22 ROLES AND RESPONSIBILITIES OF THE HEALTH WORKER (HW) .. 23 PREVENTATIVE MAINTENANCE AND ASSET MANAGEMENT .. 24 PURCHASING NEW EQUIPMENT .. 24 REVIEW AND MAINTENANCE OF EXISTING EQUIPMENT .. 25 DEMOLITION, REFURBISHMENT AND CONSTRUCTION .. 25 table 4. IPC CONSTRUCTION CHECKLIST EXAMPLE .. 26 STAFF HEALTH AND HAI RISK .. 26 RISK ASSESSING HWS .. 27 MANAGING HWS .. 28 EXPOSURE PRONE PROCEDURES (EPPS) .. 29 HW SCREENING AND VACCINATION .. 29 HWS WITH CYSTIC FIBROSIS .. 30 HWS WITH HERPES SIMPLEX VIRUS .. 30 HEALTHCARE WORKER EDUCATION .. 31 MANDATORY REQUIREMENTS .. 31 LOCAL EDUCATION AND TRAINING.

7 31 CONSUMER/PATIENT/CARER EDUCATION .. 31 EVALUATING THE DELIVERY OF INFORMATION TO CONSUMERS .. 34 COMMUNICATION BETWEEN PROVIDERS .. 34 3 RISK IDENTIFICATION OF HAIS .. 36 RISK ASSESSING THE PATIENT .. 37 iii IPC Practice Handbook v3 Update January 2020 Not controlled if printed RISK ASSESSING THE FUNCTIONAL 38 COMMUNITY 38 AMBULANCE SETTINGS .. 41 PATIENT TRANSPORT SETTINGS .. 41 RISK ASSESSING VISITORS .. 41 4 STANDARD PRECAUTIONS .. 43 HAND HYGIENE .. 45 HAND HYGIENE PRINCIPLES .. 45 HAND WASH BASIN .. 46 HAND HYGIENE PRODUCT SELECTION .. 47 table 5. HAND HYGIENE PROCEDURES .. 48 JEWELLERY AND ACCESS TO 50 FINGERNAILS.

8 50 HAND CARE AND SKIN INTEGRITY .. 50 HAND HYGIENE IN ORAL HEALTH SETTINGS .. 51 HAND HYGIENE IN COMMUNITY AND HOME SETTINGS .. 51 HAND HYGIENE IN JUSTICE HEALTH AND FORENSIC MENTAL HEALTH NETWORK SETTINGS .. 51 PATIENT AND VISITOR HAND HYGIENE .. 51 RESPIRATORY HYGIENE AND COUGH ETIQUETTE .. 51 table 6. INDIVIDUAL AND HO RESPONSIBILITIES FOR RESPIRATORY HYGIENE AND COUGH ETIQUETTE .. 52 PERSONAL PROTECTIVE EQUIPMENT .. 53 GLOVES .. 55 table 7. GLOVE SELECTION GUIDE FOR Infection Prevention AND Control .. 56 FACIAL PROTECTION .. 57 table 8 TYPE OF FACE PROTECTION AND RECOMMENDED USE .. 58 table 9 AS 4381: 2015 SINGLE USE SURGICAL FACE MASK STANDARD.

9 58 GOWNS AND APRONS .. 59 table 10 PLASTIC APRONS/GOWNS RECOMMENDED USE AND CHARACTERISTICS .. 60 table 11 AAMI LEVEL STANDARDS FOR GOWNS .. 61 ASEPTIC TECHNIQUE .. 62 ASEPTIC TECHNIQUE IN ORAL HEALTH .. 64 INVASIVE DEVICES .. 64 SKIN ANTISEPSIS .. 65 THE USE OF ALCOHOL BASED SKIN PREPARATIONS IN OPERATING THEATRES .. 65 SKIN DISINFECTION BEFORE 65 NEEDLE-STICK AND SHARPS INJURY Prevention .. 66 SAFE USE AND DISPOSAL OF SHARPS .. 66 SHARPS IN COMMUNITY AND HOME SETTINGS .. 67 BLOOD GLUCOSE MONITORING DEVICES .. 67 INTRAVENOUS SOLUTIONS .. 68 FLUSHING .. 68 MEDICATION VIALS AND AMPOULES .. 69 MULTI-DOSE VIALS .. 69 iv IPC Practice Handbook v3 Update January 2020 Not controlled if printed CLEANING AND DISINFECTION.

10 71 PATIENT EQUIPMENT - REPROCESSING .. 71 SINGLE USE OR SINGLE PATIENT USE EQUIPMENT .. 72 STORAGE OF STERILE, CLEAN AND REPROCESSED STOCK AND EQUIPMENT .. 72 table 12. EXAMPLES OF ITEMS TO BE STORED IN DESIGNATED CLEAN STORAGE ROOMS AND DIRTY UTILITY ROOMS .. 74 CLEAN LINEN .. 74 HANDLING, DISPOSAL AND TRANSPORT OF USED LINEN .. 75 ENVIRONMENTAL CLEANING .. 76 UTILITY ROOM .. 77 PATIENT ZONE PRIVACY CURTAINS .. 78 table 13 RECOMMENDED CHANGEOVER /CLEANING FREQUENCY FOR PATIENT PRIVACY CURTAINS .. 79 DEDICATED WINDOW CURTAINS AND BLINDS IN CLINICAL AREAS .. 80 WASTE DISPOSAL .. 80 CLINICAL WASTE DISPOSAL IN THE COMMUNITY .. 80 SAFE HANDLING AND TRANSPORT OF PATIENT SPECIMENS.