Page 116 - policy and procedure infection control

Policies and Procedures on Infection Control

6.4.10 Management of Hepatitis B positive patients
1. Requires the same infection control precautions recommended for all haemodialysis
patients.
2. Hepatitis B Ag positive patients should be dialysed in separate room using separate
machines, equipment and supplies.
3. Staff caring for Hepatitis Bs Ag positive patients MUST not care for hepatitis B
susceptible patients (anti Hepatitis Bs antibody negative) at the same time
4. Dialysers may be reprocessed but this MUST be done at dedicated reprocessing
area and dedicated reprocessing machines

6.4.11 Management of Hepatitis C positive patients
1. Requires the same infection control precautions recommended for all haemodialysis
patients
2. Hepatitis C positive patients should be dialysed in separate room using separate
machines, equipment and supplies.
3. Staff caring for Hepatitis C positive patients MUST not care for Hepatitis C negative
patients at the same time
4. Dialysers may be reprocessed but this MUST be done at dedicated reprocessing
area and reprocessing machines
5. Hepatitis C positive patients who acquired sustained response after antiviral treatment
should continue to be dialysed with machines at dialysis station dedicated for Hepatitis
C positive patients. However it is preferred that these patients are dialysed during
the first shift.

6.4.12Other infection control procedures
1. Standard ‘no-touch’ dressing changes and care of intravascular catheters should be
performed according to the ward nursing procedures.
2. Patients with temporary or cuffed tunneled dialysis catheters should be screened for
carriage of Staphylococcus aureus, particularly methicillin-resistant strains (MRSA),
and MRSA eradication should be attempted with a short course of nasal mupirocin
and topical chlorhexidine.

B. CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD)

6.4.13Catheter insertion
1. Patients should be screened for staphylococcus (nasal swab) before surgical insertion
of the catheter.
2. Carriers of Staph aureus (MSSA or MRSA) should be treated with nasal mupirocin
and topical antiseptics in order to clear staphylococcal carriage before the catheter
is inserted.

Ministry of Health Malaysia 105