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The prevention and control of infection is an integral part of the role of all health care personnel.
Standard Infection Control Practices include:
Hands must be decontaminated immediately before each and every episode of direct patient contact or care and after any activity or contact that could potentially result in hands becoming contaminated, including after the removal of gloves.
Hands that are visibly soiled, or potentially grossly contaminated with dirt or organic material, must be washed with liquid soap and water.
Hands must be decontaminated, preferably with a 70% alcohol-based handrub unless hands are visibly soiled, between caring for different patients and between different care activities for the same patient.
Only a plain band, not a stoned ring, must be worn as hand jewellery. Wristwatches and bracelets must not be worn. Cuts and abrasions must be covered with waterproof dressings. Fingernails should be kept short, clean and free from nail polish. False nails and extensions must not be worn.
An effective decontamination technique involves three stages: preparation, washing and rinsing, and drying (see diagrams below). Preparation requires wetting hands under tepid running water before applying liquid soap or an antimicrobial preparation. The hand-wash solution must come into contact with all of the surfaces of the hand. The hands must be rubbed together vigorously for a minimum of 10-15 seconds, paying particular attention to the tips of the fingers, the thumbs and the areas between the fingers. Hands should be rinsed thoroughly before drying with paper towels.
When decontaminating hands using an alcohol handrub, hands should be free from dirt and organic material. The handrub solution must come into contact with all surfaces of the hand. The hands must be rubbed together vigorously, paying particular attention to the tips of the fingers, the thumbs and the areas between the fingers, until the solution has evaporated and the hands are dry.
An emollient hand cream should be applied, preferably at the end of the shift, to protect skin from the drying effects of regular hand decontamination. If a particular soap, antimicrobial hand wash or alcohol product causes skin irritation please contact your on-site NHS Professionals team for advice.
Selection of Personal Protective Equipment (PPE) should be based on an assessment, according to local guidelines, of the risk of transmission of microorganisms to the patient, and the risk of contamination of the healthcare practitioner's clothing and skin by patients' blood, body fluids, secretions or excretions.
Gloves must be worn for invasive procedures, nursing infected patients in isolation, contact with sterile sites and non-intact skin or mucous membranes, and all activities that have been assessed as carrying a risk of exposure to blood, body fluids, secretions or excretions, or to sharp or contaminated instruments.
Gloves must be worn as single-use items. They must be put on immediately before an episode of patient contact or treatment and removed as soon as the activity is completed. Gloves must be changed between caring for different patients, and between different care or treatment activities for the same patient.
Gloves must be disposed of as clinical waste and hands decontaminated after the gloves have been removed.
Sensitivity to natural rubber latex in patients, carers and healthcare personnel must be documented, and alternatives to natural rubber latex gloves must be available. If you have a latex allergy you must inform your NHS Professionals Nurse Liaison Coordinator/Nurse Manager/Facilitator as soon as possible.
Disposable plastic aprons should be worn when nursing infected patients in isolation and where there is a risk that clothing may be exposed to blood, body fluids, secretions or excretions, with the exception of sweat.
Plastic aprons should be worn as single-use items, for one procedure or episode of patient care, and then discarded and disposed of as clinical waste.
Full-body fluid-repellent gowns must be worn where there is a risk of extensive splashing of blood, body fluids, secretions or excretions, with the exception of sweat, onto the skin or clothing of healthcare practitioners (for example when assisting with childbirth).
Face masks and eye protection must be worn where there is a risk of blood, body fluids, secretions or excretions splashing into the face and eyes.
Where the patient is in protective isolation, local guidelines and policy must be followed.
References and sources
NHS Professionals Special Health Authority Infection Control Guidelines www.nhsprofessionals.nhs.uk/download/keydocuments/NHSPinfectioncontrolguidelines.pdf
All information supplied here is done so freely and Adveticus Limited takes no responsibility for the outcome if any or all of this advice is taken. All advice used from these pages is at your own risk.