Page 187 - policy and procedure infection control

Policies and Procedures on Infection Control

13.1.3 Prevention of Colonization And Infection With Multi-Resistant Organisms
13.1.3.1 Special units
The Infection Control Team should, in collaboration with the relevant clinical
team, be proactive is assessing the risks and routes of transmission of gram-
negative organisms. Hospital areas of particular concern include:
• neonatal, pediatric and adult intensive care units
• units caring for neutropaenic patients
• ophtalmology department and ophthalmic surgery
• burns units and hydrotherapy pool

13.1.3.2 Antibiotic policies
1. Excessive use of broad-spectrum antimicrobials will encourage the
emergence of multiply-resistant coliforms and non-fermentatives.
2. Antimicrobial prophylaxis for surgery should be as narrow-spectrum as
possible, and restricted to a maximum of 24 hours duration
13.1.3.3 Disinfection of equipment and medical instruments
1. Moist respiratory equipment, such as ventilator tubing, nebulizers and
humidifiers that come into direct contact with the patient, are easily
contaminated with gram-negative organisms and can cause cross-infection.
2. It is therefore important that the correct procedures for decontamination are
followed and that the equipment is thoroughly dried before use for other
patients.
3. Heat disinfection should be used wherever possible for equipment used on
the ward.
4. Disinfectors such as bedpan washers must be maintained and checked
regularly to ensure that adequate temperatures are reached (normally 80°C
for 1 min), and written records of maintenance must be kept.

5. Disinfection procedures should, where necessary, is checked with the
Infection Control Team.
6. All creams, gels and liquids used with such equipment must be stored in
such a way as to prevent contamination and patient-to-patient spread of
Gram-negative organisms. Single-use disposable sachets are preferred.
13.1.3.4 Hand hygiene
1. All staff who have contact with patients must be trained in hand washing
practices, and use disposable gloves and plastic aprons when hand
contamination is likely, for example, when emptying bedpans, changing
catheter bags, etc.
2. Heavy microbial contamination of hands may not be adequately cleaned by
simple washing and, when anticipated, disposable gloves should be used.

176 Ministry of Health Malaysia