Page 34 - policy and procedure infection control

Policies and Procedures on Infection Control

3.2.1 Practice of isolation
1. Patient placement
• Appropriate patient placement is a significant component of isolation precautions.
• Determine patient placement based on the following principles:
• Route(s) of transmission of the infectious agent
• Risk factors for transmission in the infected patient
• Risk factors for adverse outcomes resulting from healthcare-associated infection
in other patients in the area.
• Availability of single-patient rooms
• Give priority to the following types of patients /infections when single rooms are scarce
• Source patient has poor hygienic habits, contaminates the environment, or
cannot be expected to assist in maintaining infection control precautions to
limit transmission of microorganisms (i.e., infants, children, and patients with
altered mental status).
• Source patient has uncontained secretions, excretions or wound drainage.
For patients with obligate or preferential airborne infections which include
pulmonary tuberculosis, measles and chickenpox.
• Cohorting: When single rooms are scarce patients with epidemiological and
clinical information suggestive of a similar diagnosis may be allowed to share
a room, but with a spatial separation of e” 1 m.
• In cohorted areas minimize patient mingling.
• For airborne/droplet transmission ask patients to wear surgical mask and ensure
room is well ventilated
• Increase the cleaning of common areas including bath / toilet facilities (e.g. 4–6 hourly).
• Place alcohol hand rubs beside each patient bed.
• Avoid sharing of equipment, but if unavoidable, ensure that reusable equipment is
appropriately disinfected between patients
• Isolation trolley/tray with all the necessary PPE must be available at the entrance
of the cohorted area.
• Assigning or cohorting healthcare personnel to care only for patients infected or
colonized with a single target pathogen limits further transmission of infectious
agents to uninfected patients but is difficult to achieve in the face of current
staffing shortages in hospitals and in non-hospital healthcare sites.
• For critical / seriously ill patients: patients who will require close monitoring, isolation
requirements should not compromise clinical care. For such patients the options are
o Arrange for intensive monitoring (equipment / personnel with appropriate PPEs)
to be placed in the isolation facility or

o Bring patients out into open area with cohorting requirements (only if the
mode of potential spread is contact / droplet)

Ministry of Health Malaysia 23