Universal precautions for infection control by Dr Munawar Khan SACP
Universal Precautions for Infection Control Presented by Dr. M. MUNAWAR KHAN BCC Coordinator Sindh AIDS Control Program
Standard Precautions for Infection Control Objectives• Preventing self-infection• Preventing PLHIV-to-caregiver infection and preventing PLHIV-to-sexual partner infection• Preventing caregiver-to-PLHIV infection
Self-infection• In this mode of infection, the PLHIV passes on germs from one part of the body to another, such as by touching a wound, not washing hands after using the toilet, or scratching and breaching the skin, leading to a skin infection.
Caregiver-to-PLHIV infection• The PLHIV has lowered immunity as a result of the HIV infection and is therefore prone to infections.• Caregivers need to ensure hygienic preparation of food and water consumed by the individual they care for, including regular hand washing.• If the caregiver is sick, it is safer to have another care provider to take care of the PLHIV during the period of illness.• Common infectious diseases include the following:• Common cold or flu• Diarrhoea• Skin conditions such as scabies• Chest infections like bronchitis, pneumonia, and tuberculosis• Fungal infections, especially those affecting the skin
PLHIV-to-caregiver infection This can be a very painful situation when a caregiver is infected HIV virus or other infections in the process of caring for the PLHIV. It can :• Acquiring chest infections such as tuberculosis while caring for the PLHIV• Scabies in household sheets and clothing• Not using gloves or other available plastic waterproof material while handling blood and other body fluids and open, uncovered cuts, wounds, or abrasions.
PLHIV-to-sexual partner(s) infection• Being HIV-positive does not mean the person is no longer capable or in need of sex. HIV caregivers need to counsel sexually active clients about safe sex practices
Hygiene• Categories and promotion of hygiene:• Hygiene is a very important factor in living positively with HIV(PLHIV) and AIDS(PALWA) and in keeping the immune system strong.
Personal hygiene• Includes ways in which we keep our body clean and safe from infection.• Always wash hands before and after eating, after going to the toilet, before and after preparing food.• Bath regularly.• Keep nails short and clean.• Brush teeth, after meals and before bedtime.• Keep clothes, bed sheets, and towels clean and dry.• Wash hands immediately after handling soiled articles.• Cover your mouth if you have to sneeze.• Wear a mask if you have TB, which is still contagious.
Food/water hygiene Many infections are borne through contaminated food and water. To prevent this:• Use safe, clean water• If the water is not from a protected source, it should be boiled for 10 minutes before drinking• Care must be taken during collection and storage, and to use clean containers to prevent contamination.• Never eat raw eggs or meat, and never drink un- pasteurized milk. Cont.........
• Only eat raw foods when they have been well- washed or peeled (fruits and vegetables).• Cover foods and beverages to protect them from flies and dust.• Keep uncooked food and juices from coming into contact with other foods.• If possible, use a plastic cutting board rather than a wooden one, because a plastic board is easier to clean.• Keep waste in a covered bin (and empty it regularly)• Germs multiply more quickly in warm food. Storing food in a refrigerator or cool place slows down this growth. Cooking on high heat can also kill most germs.• Serve food immediately after cooking to avoid germs multiplying.
Environmental hygiene• Using a latrine and keeping it clean• Keeping the room where the client sleeps clean, and well ventilated• Keeping surrounding areas free from bad odours and still water (still water sitting is a breeding ground for mosquitoes)• Keeping the house and surrounding area clean, swept, and neat• Hanging clothing and linens in the sun• Soiled materials/waste should be disposed of in a safe place (burnt or buried)• Always using household gloves when handling waste• Soiled linen and body-fluid-stained linen should be cleaned using chlorine solution
What are universal precautionsUnder the “standard precaution”principle, blood and body fluids from allpersons should be considered as infectedwith HIV, Hepatitis B, C or otherinfectious diseases, regardless of theknown or supposed status of the person.Improving the safety of injections is animportant component of universalprecautions.
Importance of hand washing• Research has shown that hand washing is the most important way to reduce the spread of infections in health care settings.• Since hands are the most common vehicle for transmitting infections, it is essential that all staff who come in contact with clients understand the importance of good hand washing practices
Recomended practice• Using soap and water, rub hands for at-least 15 seconds and then wash with running water• Using alcohol-based hand rubs (or antimicrobial soap) and water for routine decontamination.
When should you wash your hands• Always wash your hands.• Immediately when you arrive at work• Before examining each client• After examining each client• Before and after putting on gloves for clinical procedures (such as cleaning a wound)• After touching any instrument or object that might be contaminated with blood or other body fluids, or after touching mucous membranes• After you handle blood, urine, or other specimens• After using the toilet or latrine• Before leaving work• Before preparing food• Before eating food• After handling waste materials (used gauze, soiled sheets)• After coughing, blowing nose
How do gloves prevent infections• Gloves protect service providers from coming into contact with the potentially infectious micro-organisms that can be found in blood, other body fluids, and waste.• Only clean gloves prevent infections in clients. If the gloves used during an examination or clinical procedures are not clean and free of contamination, they can actually spread infections to clients.
The three kinds of gloves• Surgical gloves• Single-use examination (disposable) gloves• Utility or heavy-duty household gloves
Handling and Disposal of SharpsRecommendations for handling of the sharps• Use syringe or needle once only.• Avoid recapping, bending, or breaking needles.• Use puncture-proof container for disposal.• Clearly label container—“SHARPS”.• Never overfill or reuse sharps containers.• Dispose of sharps according to local protocol.
Personal Protective Equipment• Gloves—correct size• Aprons—as a waterproof barrier.• Eyewear—to avoid accidental splash• Footwear—rubber boots or clean leather shoes
Management and disposal of waste materials• Always use plastic bags to dispose of waste materials other then sharps• If there are sharp materials such as scissors which need to be carried out of the home, return them to the steel container they are kept in and either takes them to the health centre for sterilization, or, if that is not possible, wash them and soak them in bleach Cont....
• Identify a place to dispose of waste materials. It is best if this can be at the health centre so the waste can be disposed of through this system. If not, then there is a need to dig a pit on their property and burry the waste there.
How to make a 0.5-percent chlorine solution• Liquid household bleach (Sodium hypochlorite)• Bleach powder: Chlorine compounds available in powder form (calcium hypochlorite or chlorinated lime)• Chlorine-releasing tablets (Sodium dichloroisocyanurate)
Advantages of chlorine• oldest and most common antiseptic compound• powerful killer of micro-organisms• not poisonous to the human being• no poisonous residue• time- and cost-effective