Guidelines for INFECTION CONTROL POLICY - Safdarjung Hospital

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Drinking WaterBacteriological surveillance is to be done monthly. Potable water testing is routinely carried outfor bacterial cultures in laboratory from all patient care units, hospital kitchen, canteens andhostels – once in a month.Centralised Sterilised Supplies DepartmentAir and surface sterility is monitored from sterile zone. Bowie Dick test and use of biologicalindicators for steam sterilisation is carried out. Disinfectant screening is also done. Recordsto be kept by CSSD.PASSIVE SURVEILLANCEReporting of hospital acquired infectionsPassive Clinical ReportingIt will be mandatory for clinicians to fill the prescribed form for every admitted patient and theform may be sent to Infection Control Nurse (ICN).Passive Microbiological ReportingIn an event of clustering of cases passive surveillance is initiated. Respective clinicians areinformed about the suspected clustering and surveillance specimens are collected. The reportthus generated from the study is sent to the concerned physicians and surgeons. This is beingdone regularly.HAND HYGIENE• Training and compliance needs to be monitored. Availability of hand rubs, Soaps handtowels and water should be ensured. Foot operated and wall mounted dispensing stationsare required. Hand hygiene training programme for doctors, nursing staff, students andhousekeeping staff is done regularly once a month for each category of staff. Handhygiene compliance is not yet initiated.MULTIDISCIPLINARY CONTINUING EDUCATION PROGRAMMEContinuous education programme is conducted on regular basis for all categories of staffensuring each staff attends the programme at least once in three months.DISINFECTION POLICYDISINFECTIONDisinfection is a process where most microbes are removed from defined object or surface,except spores.Disinfectants can be classified according to their ability to destroy different categoriesof micro-organisms:• High Level disinfectants : glutaraldehyde 2%, ethylene oxide• Intermediate Level disinfectant : alcohols, chlorine compounds, hydrogen peroxide,chlorhexidene, glutaraldehyde(short term exposure)• Low level disinfectants : benzalkonium chloride, some soapsGENERAL GUIDELINES FOR DISINFECTION:Critical instruments/equipments (that are those penetrating skin or mucous membrane) shouldundergo sterilisation before and after use. e.g. surgical instruments.10
Semi-critical instruments /equipments (that are those in contact with intact mucous membranewithout penetration) should undergo high level disinfection before use and intermediate leveldisinfection after use. e.g. endotracheal tubesNon-critical instruments /equipments (that are those in contact with intact skin and no contactwith mucous membrane) require only intermediate or low level disinfection before and after use.e.g. ECG electrodesDisinfectants that are in useGlutaraldehyde:Can be used up to 14 days after activation,Contact time - For disinfection 15-30 minutes- For sterilization 8-10 hoursSterilium :Contains 2-propanol, 1-propanol, macetronium ethyl sulphateContact time for patient care hand wash : 1.5 ml for 30 secondsContact time for surgical hand wash : 9 ml for 3 minutesEcoshield :Contains stabilized hydrogen peroxide 11% w/v with 0.01% w/v, diluted silver nitratesolution.For surface disinfection: 10% v/v solution in de-ionized water with contact time of 60minutes.For fumigation: 1 litre of 20% v/v solution /1000 cu ft of space in 60 minutes.Bacillocid :Contains chemically bound formaldehyde, glutaraldehyde and benzalkonium chloride.Used as surface disinfectant at 2% solution in operation theatres and at 0.5% in wards anddressing rooms.Sprayed onto wet surfaces with a low pressure sprayer and allowed to dry slowly.Betadine:Iodophor .This is a high level disinfectant. Used for surgical hand scrub, skin disinfection.Tincture Iodine:For part preparation in operation theatres and blood specimen collection.Sodium Hypochlorite:Used for containing blood spills at 10%, disinfecting counter tops and other hard surfaces at1 %.Used in laboratory for decontamination of waste from equipment and glassware at 5%.Alcohol (70%) :Used for disinfection of non-disposable patient care items in/out- patient departments and alsoin laboratory for cleaning of microscope lenses and surfaces of critical work surfaces.ALDEHYDEGlutaraldehyde may be used in places like the endoscopy unit, cardiac catheterization labs.Formaldehyde is used for fumigation.11
Page 2 and 3: CONTRIBUTORSCreated by : Dr. Rajni
Page 5 and 6: HOSPITAL INFECTION CONTROL TEAM (HI
Page 7 and 8: 12. Training and education of HCW C
Page 9: Schedule may be changed to increase
Page 13 and 14: • The isolation of the patient wo
Page 15 and 16: Microbiological StudyMicrobiologica
Page 17 and 18: Annexure-1Policy on‘Hospital Wast
Page 19 and 20: CONTENTSTOPIC SUB-TOPIC PAGE NO.1.
Page 21 and 22: HOSPITAL WASTE MANAGEMENT COMMITTEE
Page 23 and 24: Color-coded bags & Category wise Tr
Page 25 and 26: MAINTENANCE OF EQUIPMENTMaintenance
Page 27 and 28: • Labelled as with ‘Cytotoxic
Page 29 and 30: MERCURY SPILL MANAGEMENT :If accide
Page 31 and 32: FUTURE PROPOSAL FOR DISPOSAL OF RAD
Page 33 and 34: Minimization (ofwaste)MonitoringOn-
Page 35 and 36: PERFORMA OF BIOMEDICAL WASTE MANAGE
Page 37 and 38: ANNEXURE-2PROTOCOL FOR MANAGEMENT O
Page 39 and 40: ANNEXURE-IIRECOMMENDED POSTEXPOSURE
Page 41: Step-II : Determine the HIV STATUS

Guidelines for INFECTION CONTROL POLICY - Safdarjung Hospital

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