Reference Manual - ReproLinePlus
Reference Manual - ReproLinePlus Reference Manual - ReproLinePlus
Basic Maternal and Newborn Care: A Guide for Skilled Providers Infection prevention (IP) practices 3 focus on preventing infection and disease transmission in both clients and healthcare workers. When proper precautions are not taken, people can become very ill or die. Therefore, IP practices should be integrated in the following ways into every component of maternal and newborn care, as needed, to protect the woman, newborn, healthcare worker, and other healthcare facility staff: • Minimizing infections due to microorganisms • Decreasing the risk of transmitting life-threatening diseases such as hepatitis B, C, and D, and HIV to the woman and newborn and to healthcare workers and facility staff, including cleaning and housekeeping personnel In addition to incorporating IP practices during healthcare, healthcare workers should reduce the risk of infection by avoiding harmful traditional practices and talking to women and their families about healthy practices. How Infection Prevention Practices Work Microorganisms cannot be seen by the human eye. A surgical instrument may look clean but be contaminated by microorganisms. IP practices interrupt the cycle of transmission by either destroying microorganisms or preventing transmission from one source to another. For example, handwashing before a procedure and disinfection during housekeeping will interrupt the cycle at the reservoir stage. Also, handwashing, housekeeping, instrument processing, and safe handling of sharps will interrupt the cycle at the method of transmission level. Preventing injuries with sharps will interrupt the cycle at the place of entry stage. IP practices overlap and have a cumulative effect; by applying all IP practices correctly and consistently, the likelihood of causing an infection or transmitting disease is greatly decreased. Infection Prevention Principles IP practices are based on the principles listed below. • Every person (client or healthcare worker) is considered infectious because infections may be present but asymptomatic. • Every person is considered at risk of infection. • Handwashing (or using an alcohol-based handrub) is the most practical procedure for preventing infections. • Gloves are worn on both hands before touching anything wet—broken skin, mucous membranes, blood, or other body fluids (secretions or excretions)—or performing an invasive procedure. • Barriers (e.g., protective goggles, face masks, or aprons) are worn if splashes or spills of any body fluids are anticipated. • Antiseptic agents are used to clean the skin or mucous membranes before certain procedures, or for cleaning wounds. • All healthcare workers and facility staff follow safe work practices (e.g., not recapping or bending needles, proper instrument processing, and suturing with blunt needles when appropriate). • The care site is cleaned routinely, and waste is properly disposed of. • Facility staff who are in direct contact with clients receive as many of the following immunizations as possible: • Rubella • Measles 3 The terms “universal” or “standard precautions” refer to some of the IP practices that focus on protecting the healthcare worker. IP practices include, but are not limited to, universal or standard precautions. 1-48 JHPIEGO/Maternal and Neonatal Health Program
Chapter Three: Key Tools in Basic Care • Hepatitis B virus • Mumps • Influenza (yearly) Infection Prevention Practices Handwashing Handwashing is the most practical procedure for preventing the spread of infection. Wash hands with soap and water (if hands are visibly clean and not contaminated with blood or body fluids, disinfect them using an antiseptic handrub) in the following situations: • Before and after examining a client • After contact with blood, other body fluids, or soiled instruments, even if gloves were worn • Before and after removing gloves because they may have invisible holes in them • Upon arriving at and before leaving the workplace To wash hands, do the following: • Thoroughly wet hands with clean water • Wash hands for 10–15 seconds with plain soap and running or poured water • Allow hands to air-dry or dry them with a clean paper or personal towel Unless the hands are visibly soiled, a waterless, alcohol-based antiseptic handrub is more effective in cleaning hands than handwashing. Antiseptic handrub can be made by adding 2 mL of glycerin (or other emollient) to 100 mL of 60–90% ethyl or isopropyl alcohol solution. Use the guidelines below to clean hands using an antiseptic handrub. • Apply enough antiseptic handrub to cover the entire surface of hands and fingers (about one teaspoonful). • Rub the solution vigorously into hands, especially between fingers and under nails, until dry. Antisepsis When combined with good hand hygiene and other IP practices, proper antisepsis can help prevent infection by reducing the number of microorganisms on the skin. Use the guidelines below for skin preparation for injections. • If the skin is clean, it is not necessary to use an antiseptic before giving a skin injection. • If the injection site appears dirty, wash it with soap and water. • Dry with a clean towel; then give the injection. When cleansing the genitals before and after birth, wash the external genital area with soap and water or antiseptic if visibly soiled. Note: If using an antiseptic, ask the client about allergic reactions. Use a water-based product (such as an iodophor or chlorhexidine), as alcohols or products containing alcohol may burn and irritate mucous membranes. JHPIEGO/Maternal and Neonatal Health Program 1-49
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Chapter Three: Key Tools in Basic Care<br />
• Hepatitis B virus<br />
• Mumps<br />
• Influenza (yearly)<br />
Infection Prevention Practices<br />
Handwashing<br />
Handwashing is the most practical procedure for preventing the spread of infection. Wash hands with soap<br />
and water (if hands are visibly clean and not contaminated with blood or body fluids, disinfect them using an<br />
antiseptic handrub) in the following situations:<br />
• Before and after examining a client<br />
• After contact with blood, other body fluids, or soiled instruments, even if gloves were worn<br />
• Before and after removing gloves because they may have invisible holes in them<br />
• Upon arriving at and before leaving the workplace<br />
To wash hands, do the following:<br />
• Thoroughly wet hands with clean water<br />
• Wash hands for 10–15 seconds with plain soap and running or poured water<br />
• Allow hands to air-dry or dry them with a clean paper or personal towel<br />
Unless the hands are visibly soiled, a waterless, alcohol-based antiseptic handrub is more effective in cleaning<br />
hands than handwashing. Antiseptic handrub can be made by adding 2 mL of glycerin (or other emollient) to<br />
100 mL of 60–90% ethyl or isopropyl alcohol solution.<br />
Use the guidelines below to clean hands using an antiseptic handrub.<br />
• Apply enough antiseptic handrub to cover the entire surface of hands and fingers (about one<br />
teaspoonful).<br />
• Rub the solution vigorously into hands, especially between fingers and under nails, until dry.<br />
Antisepsis<br />
When combined with good hand hygiene and other IP practices, proper antisepsis can help prevent infection<br />
by reducing the number of microorganisms on the skin.<br />
Use the guidelines below for skin preparation for injections.<br />
• If the skin is clean, it is not necessary to use an antiseptic before giving a skin injection.<br />
• If the injection site appears dirty, wash it with soap and water.<br />
• Dry with a clean towel; then give the injection.<br />
When cleansing the genitals before and after birth, wash the external genital area with soap and water or<br />
antiseptic if visibly soiled.<br />
Note: If using an antiseptic, ask the client about allergic reactions. Use a water-based product (such as an<br />
iodophor or chlorhexidine), as alcohols or products containing alcohol may burn and irritate mucous membranes.<br />
JHPIEGO/Maternal and Neonatal Health Program 1-49
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