Page 42 - policy and procedure infection control

Policies and Procedures on Infection Control

5. Disposable or non-disposable face shields may be used as an alternative to goggles.
As compared with goggles, a face shield can provide protection to other facial areas
in addition to the eyes.
6. Removal of a face shield, goggles and mask can be performed safely after gloves
have been removed, and hand hygiene performed.

3.4.4 Respiratory protection
1. Personal respiratory protection is required when dealing with micro-organisms that
spread by airborne route. Respirators are also currently recommended to be worn
during the performance of aerosol-generating procedures (e.g: intubation,
bronchoscopy, suctioning) patients with SARS Co-V infection, avian influenza,
pandemic influenza and other unknown respiratory syndromes. In these instances,
surgical masks are not effective protection.
2. Respiratory protection currently requires the use of a respirator with N95 or higher
filtration.

3.4.4.1 Fit test
1. All health care facilities using these respirators must have a mechanism to regularly
conduct risk assessment to validate the need for respiratory protection to the staff,
and conduct periodic training on correct usage of the respirators.
2. Fit testing: A fit test is used to determine which respirator fits the user adequately
and to ensure that the user knows when the respirator fits properly.
3. When selecting particulate respirators, US NIOSH-certified N95, EU FFP2 or
equivalent model with inherently good fit characteristics (i.e., adequate fit to > 95%
of wearers) are preferred and could theoretically relieve the need for fit testing.
4. A user-seal check (formerly called a “fit check”) should be performed by the wearer
of a respirator each time a respirator is donned to minimize air leakage around the
face piece. See figure.
5. Caps and boots covers are not very useful.

3.4.5 Respiratory hygiene/cough etiquette

Controlling the spread of pathogens from infected patients (source control) is key to
avoid transmission to unprotected contacts. For diseases transmitted through large droplets
and/or droplet nuclei, respiratory hygiene/cough etiquette should be applied by all individuals
with respiratory symptoms.
All individuals (HCWs, patients and visitors) with signs and symptoms of a respiratory
infection should:
• Cover their mouth and nose when coughing/sneezing;
• Use tissues, handkerchiefs, cloth masks or medical masks if available, as source
control to contain respiratory secretions, and dispose of them into the waste
containers;

Ministry of Health Malaysia 31