Infection Control in ICU

Infection Control in ICU free pdf ebook was written by System User on December 22, 2004 consist of 5 page(s). The pdf file is provided by intensivecare.hsnet.nsw.gov.au and available on pdfpedia since May 05, 2012.

wentworth area health service infection control in icu infection control in icu desired..immunosuppression. close proximity to other patients who are predisposed to similar..intensive care are: 1. minimise the risk of infection by: meticulous hand-washing...

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Infection Control in ICU pdf




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Infection Control in ICU - page 1
Wentworth Area Health Service Infection Control in ICU Infection Control in ICU Desired Outcome The prevention of cross infection amongst intensive care patients is dependant on all health care workers maintaining a high level of awareness regarding the susceptibility of such patients to nosocomial infections. ICU patients are susceptible to device-related, respiratory, urinary and wound infections during their stay. With infection control guidelines directed to the ICU environment we can aim to minimise the incidences of cross-infection and contamination through universal precautions and maintaining individual patient care. Purpose There are several risk factors, which increase the susceptibility of Intensive Care patients to infection: Compromised host resistance secondary to underlying illness. Changes in patient flora that accompanies serious illness. Widespread use of empirical broad-spectrum antibiotics selects for resistant microbes, which readily colonize critically ill patients. Variety of invasive procedures. Life saving procedures done on an emergency basis with compromised aseptic technique. Therapeutic immunosuppression. Close proximity to other patients who are predisposed to similar infection. There are also factors, which can lead to the endemic occurrence of multi-drug resistant bacteria in intensive care patients. These include: Admission or re-admission of patients with colonisation of infection. Nosocomial infections. The effects of antibiotics. Little can be done to reduce the risks of infection, which arise as a direct result of the patient’s clinical condition and prior colonisation status. However we can influence cross- infection.
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Infection Control in ICU - page 2
Wentworth Area Health Service Infection Control in ICU Authorisation All health care workers have a duty of care to themselves and the patients regarding infection control precautions. Cross-infection and contamination can be aided by many methods of transmission, including inadequate handwashing, as well as by uniforms/clothing, furniture and equipment. Indications and Contra Indications General Objectives for Infection Control in Intensive Care are: 1. Minimise the Risk of Infection by: Meticulous hand-washing between /after patient care Appropriate sterilisation and cleaning of equipment Ensuring each patient has own set of bedside equipment, for example stethoscope, BP cuff. 2. Segregation of patients which are potentially hazardous to others by: Utilising single negative-pressure rooms when available Staff caring for isolated patients should have minimal contact with other surgical or ventilated patients where possible. When notification of a MRSA positive result of a patient in Intensive Care, the NUM, Clinical NUM, or Intensivist must be notified. All MRSA positive patients are to be placed in a isolation room in ICU 1 when available. MRSA positive patients are not to be placed in ICU 2 whenever possible. 3. To be aware of the scope of infection and be familiar with the guidelines for the prevention of infection. 4. Application of Universal Precautions for all patients: All blood and body fluid substances (including sweat) are considered to be potentially infectious Universal precautions also emphasise the correct handling and disposal of contaminated waste Certain conditions require the wearing of masks eg. TB, meningococcal meningitis (within the first 24hrs of treatment). See Infection Control Manual. 5. Handwashing / Handcare: Gloves must be worn when handling blood and body substances Cuts and abrasions on exposed skin must be covered with a water resistant occlusive dressing and should be changed PRN or when dressing becomes soiled Health Care Workers with hand/other lesions should have the condition assessed by a Medical Officer. Relocation of the Health Care Worker may be necessary on the advice of the employees Doctor or Staff Health Services
Infection Control in ICU - page 3
Wentworth Area Health Service Infection Control in ICU Hands or other skin surfaces that are contaminated with blood or body substances must be washed immediately, or as soon as practicable. Hands must be washed and dried immediately before and after any patient contact. An alcoholic handrub may also be used. Hands must be washed after removal and disposal of gloves. Hand washing facilities must NOT be used for the disposal of blood, body fluids/substances or chemicals, eg. Do not squirt NG aspirate down the handwashing sinks, use the sluice in the pan room. Protective Eye Wear Protective eye wear must be worn when there is likelihood of splashing or splattering of blood or body substances They must be optically clear, anti-fog and distortion free, close fitting, disposable or reusable after cleaning then disinfection. All staff are issued with protective eye wear, issued by the OH&S representative (Kate Rafton, Clinical NUM), and must carry and use them when appropriate. Risks and Precautions Risk Potential exposure of the healthcare worker to blood or body fluids. Cross-infection to other patients. Precaution Use of protective barriers (including gloves, masks, protective eye wear, and gowns) when in contact with body secretions. Gloves and gowns are to be changed between patients. Steps Procedure GLOVES: These are to be worn when: Direct contact is anticipated with blood, body fluids, mucous membranes or non-intact skin. When suctioning patients Handling items or contacting surfaces contaminated by blood/body fluids Performing invasive procedures (eg. Venepuncture, ABG’s, any procedure when penetration of skin is anticipated). Hands must be washed after Rationale To reduce the risk of exposure to healthcare worker from contact with body fluids.
Infection Control in ICU - page 4
Wentworth Area Health Service Infection Control in ICU Procedure removal and disposal of gloves. Gloves must be changed when: They are punctured or torn After contact with each patient When performing separate procedures on the same patient and there is a risk of infection from one part of the body to another. Masks: These must be worn when there is likelihood of splashing or splattering of blood or other body substances They must be worn according to the manufacturers instructions and not be touched by hand whilst being worn They must be removed as soon as practical after they become moist Gowns: Gowns must be worn when: There are likely to be splashes and contamination of clothing by blood or body fluids There is copious drainage Gowns must be: Tied securely using the ties available Removed and discarded after each patient use Replaced if wet or damaged Changed between patients Rationale Gloves must be intact to provide a protective barrier from body fluids The wearing of masks provides a protective barrier from any potential accidental splashes from contaminated body fluids. Gowns or plastic aprons worn during direct patient contact can help significantly reduce the number of bacteria carried on uniforms, and therefore reduce the probability of the transmission of nosocomial infections. References Prevention and control of infections in intensive care Intensive Care Medicine (2000) 26:S22-S25 Intensive care unit design and environmental factors in the acquisition on infection. Journal of Hospital Infection (2000) 45:255-262
Infection Control in ICU - page 5
Wentworth Area Health Service Infection Control in ICU AUTHORISED BY COMMITTEE RESPONSIBLE DATE REVISED DATE EFFECTIVE REVIEW DATE A Mclean, V McCartan ICU Management Committee May 2002 May 2002 May 2005
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