Guidelines for INFECTION CONTROL POLICY - Safdarjung Hospital

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Endoscopes - cleaning and disinfection1. Mechanical cleaning : This is the most important step. Flush the air/water channel for 10-15 seconds to eject any blood or mucus. Aspirate detergent through the biopsy/suctionchannel to remove gross debris. Use a cleaning brush suitable for the instrument andchannel size to brush through the suction channel.2. Disinfection : The endoscope and all internal channels should be soaked in 2% glutaraldehydefor 20 minutes.3. Rinsing : Following disinfection, rinse the instrument internally and externally to removeall traces of disinfectant.4. Drying : Dry the endoscope externally. Flush air through each channel.STEAM STERILIZATIONMicrobiological indicators are used once a week: namely spores of Bacillus stearothermophilusfor steam sterilizers and Bacillus subtilis for ethylene oxide. Vials are removed from sterilizersand sent to microbiology laboratory where they are incubated at relevant temperatures for 48hours. Report is sent to ICN.An expiry date is given for sterile articles based on the packing material used.FOGGING :Eco-shield is used for fogging using Fog spraying machine.Operation theatres are fogged once a week and if necessary such as in case of a septic woundbeing drained.Other patient care areas regular fogging not recommended.Necessary decision is taken by in charge of concerned patient care area.FLOOR MOPPINGGeneral cleaning by plain soap and water in non-critical care areas.In critical care areas generous mopping using wet cloth by 0.5% Sodium Hypochlorite solution.BEDDING AND BLANKETImpermeable covers, mattresses should be mopped with 0.1% Sodium hypochlorite solution orspirit.Blanket may be sent for laundry or dry cleaning.Monitoring of biomedical waste management practicesICN shall take daily rounds in pre-formatted round sheet and will look into the biomedical wastemanagement of various hospital areas.Bedside teaching by ICNs will be undertaken.ISOLATION POLICYAim :• To prevent the transmission of pathogenic microorganisms within the healthcaresettingThe patients of following disease categories should be treated under isolation.• Severe influenza cases, SARS, Open case of tuberculosis, Anthrax, C. diphtheriae,Pertussis, Pneumonic plague, Chicken pox, and patients suffering from multidrug resistantpathogens/MRSA.12
• The isolation of the patient would be done taking following into consideration:(1) Separate ward/room/area is designated for keeping the patient.(2) Isolation wards/area has double door entry with a separate changing room withavailability of Personal Protective Equipment (PPE) and disinfectants and a handwashing area providing negative pressure with adequate air changes (6-12/hour) andHEPA filtered air in case of patients suffering from respiratory pathogens.(3) Central air conditioning and use of desert air coolers is not permitted.(4) Adequate distancing between patient beds (3-6 feet) to be ensured.(5) Overcrowding to be avoided in isolation ward/area.(6) Unauthorised Visitor’s entry is to be prohibited.(7) Nobody is allowed to enter the ward without donning adequate PPE.(8) As far as possible dedicated health care staff to be posted for isolation ward.(9) Regular daily cleaning and proper disinfection of isolation wards to be done at leasttwice a day. in addition, special attention should be given to cleaning and disinfectingfrequently touched surfaces to prevent aerosolisation. Damp sweeping/wet moppingto be performed.(10) Standard precautions which include barrier nursing to be followed with special stresson hand hygiene using soap water and alcoholic hand rubs (Preferably foot operated)and the procedures should be adequately displayed for the same.(11) Appropriate use of PPE should be strictly adhered to e.g. use of face masks,N95 masks, gloves, gowns, aprons , shoe covers, head covers etc as per therequirement (The procedures of donning/undonning of PPE will be displayed).(12) Sharing of equipments among the patients to be avoided, if unavoidable, ensure thatreusable equipments are disinfected before use on other subjects(Equipments likeThermometer, Nebulisers ,Stethoscopes, BP apparatus cuff to be dedicated for eachpatient).(13) All the equipments coming in contact with the patient should be disinfected.(14) Use of mobile phones by healthcare staff to be avoided inside the isolation area.(15) Appropriate waste disposal facilities to be available in the isolation area, All wasteto be treated as infectious and should be segregated and disinfected before removalfrom the isolation area.(16) All paper work/record keeping should be done outside the isolation area.(17) Sample collection to be done using appropriate PPE, following standard work precautions.Sample to be packaged/transported in triple packaging.(18) Used linen to be handled as little as possible with minimum agitation and should betransported in closed containers and should be labelled as infectious before sendingto laundry for washing.(19) Regular training on PPE, standard precautions and other infection control for thehealthcare workers and providers shall be under taken.INVESTIGATION OF AN OUTBREAKThe occurrence of two or more similar cases relating to place and time is identified as a clusteror an outbreak and needs investigation to discover the route of transmission of infection, andpossible sources of infection in order to apply measures to prevent further spread. If the casesoccur in steadily increasing numbers and are separated by an interval approximating theincubation period, the spread of the disease is probably due to person to person spread. Onthe other hand if a large number of cases occur following a shared exposure e.g. an operation,it is termed a common source outbreak, implying a common source for the occurrence of thedisease.13
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 and 10: Schedule may be changed to increase
Page 11: Semi-critical instruments /equipmen
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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