This document discusses basic infection control and prevention measures focusing on hand hygiene and personal protective equipment (PPE). It emphasizes that hand hygiene is the most important measure to reduce cross-infection. It outlines the five indications for hand hygiene and the steps for proper hand washing and alcohol-based hand rub. The document also reviews PPE requirements for different transmission-based precautions and the proper procedure for donning and doffing PPE. It stresses educating nursing home residents and visitors on personal hygiene and hand hygiene. The document concludes with answering sample case scenarios on appropriate PPE and isolation measures for patients with MRSA and Clostridium difficile.

1. Basic Infection Control & Prevention :
Hand Hygiene and PPE
30 March 2020
Ong Poh Ling
Nurse Clinician

2. All rights reserved by Khoo Teck Puat Hospital. No part
of this document may be modified, copied, transferred,
and reproduced in any form, without prior written
permission from Khoo Teck Puat Hospital.

3. Outline
 The importance of hand hygiene
 Transmission Precautions
 PPE donning and doffing
 NH residents and visitors’ Education on personal
hygiene
 Q&A

4. Hand Washing is the
MOST IMPORTANT
measure to reduce cross
infection

6. Hand Washing
(60sec)
Alcohol-based Hand Rub
(30sec)
Hand Hygiene

7. Hand Hygiene
1. Before touching a patient
2. Before clean/aseptic
procedures
3. After body fluid
exposure/risk
4. After touching a patient
5. After touching patient
surroundings

8. 1 Before
patient
contact
WHEN? Clean your hands before touching a patient when
approaching him/her
EXAMPLES: shaking hands, helping a patient to move around,
clinical examination
2 Before
an aseptic
task
WHEN? Clean your hands immediately before any aseptic task
EXAMPLES: oral/dental care, secretion aspiration, wound
dressing, catheter insertion, preparation of food, medications
3 After
body fluid
exposure
risk
WHEN? Clean your hands immediately after an exposure risk to
body fluids (and after glove removal)
EXAMPLES: oral/dental care, secretion aspiration, drawing and
manipulating blood, clearing up urine, faeces, handling waste
4 AFTER
PATIENT
CONTACT
WHEN? Clean your hands after touching a patient and her/his
immediate surroundings, when leaving the patient’s side
EXAMPLES: shaking hands, helping a patient to move around,
clinical examination
5 After
contact
with patient
surroundings
WHEN? Clean your hands after touching any object or furniture in
the patient’s immediate surroundings, when leaving - even if the
patient has not been touched
EXAMPLES: changing bed linen, perfusion speed adjustment

9. Mask
 Wear appropriate mask
when caring
/approaching patients on
droplet or airborne
precaution
 Ensure your nose and
mouth are covered
Surgical
Mask for
Droplet
Precaution
N95 Particle
Mask for
Airborne
Precaution

10. PPE Requirement
(As per institutional policy)
• Apron / long sleeve
gown
• Gloves
• N95 mask
• Long sleeve gown
• Gloves
• Surgical mask
• Apron / Long sleeve
gown
• Gloves

11. Gloves
 Wear gloves when coming in contact with
blood, body fluid and mucous membrane
 Change gloves between patients
 Discard gloves after procedure
 WASH HANDS after removal!

12. Clostridium difficile * ESBL
We are literally working side-by-side with them. Welcome to the reality of working
and staying in the hospital!
VRE * Multidrug resistant Organisms (MDRO).*

13. Infection Control:
It’s Everyone’s
Business

14. Education for residents
• Personal hygiene
• Wear surgical mask if unwell

15. Education for visitors
• Personal hygiene
• Hand hygiene before and after
visiting
• Do not visit if unwell

16. Case scenario 1
• Bed 6 patient had test MRSA
Urine (Catheterized) positive.
• What PPE to don?
??

17. Case scenario 2
• Bed 10 patient tested Clostridium
Difficile positive
• What PPE to don?
• Single room?
• Hand hygiene (Handwashing or
alcohol handrub??)
• As per institutional policy
??

18. Thank
You