Page 53 - policy and procedure infection control

Policies and Procedures on Infection Control

7. When one hand is required to perform a task requiring contact with a non-sterile
object or surface, consciously identify the contaminated hand and perform procedures
with the other hand. These situations include:
o When performing urinary catheterization hold the labia minora or prepuce of penis
with the non-dominant hand (usually left).

o Cleanse the urethra and insert the catheter with the dominant sterile hand (usually
right).
o When performing laryngeal suction (e.g. in a patient with a tracheostomy) hold
the non-sterile sucker tubing with the left hand and the sterile suction catheter
with the right hand.
o When performing tracheo-bronchial suction on a ventilated patient, the aseptic
technique is possible only if two care providers perform the task.
o One person disconnects and reconnects the ventilator tubing to the endotracheal
/tracheostomy tube. The other person performs the suction with a sterile catheter.

4.1.4 Minimizing bacteria at entry points
1. Depends on the site where the procedure is to be performed.
2. The patient’s skin harbour commensals (e.g. Staphylococus epidermidis), which are
harmless on the skin surface but may induce disease in the blood circulation or
through it to distant sites like heart valves, the urinary tract, the biliary tract, the
lungs or the brain.
3. The patient’s skin can never be made sterile, but the amount of bacteria can be
reduced by applying on the skin antiseptics such as: Povidone iodine 10% weight
per volume equivalent to 1% available iodine, 70% alcohol, Chlorhexidene 1:200 or
mixtures of these.

4.1.5 Creating a sterile field
1. There should be a sterile area within which instruments used for the intended
procedure can be placed without danger of it being contaminated by contact with
non-sterile objects, such as the patient’s body, the HCW body, non-sterile
instruments, equipment, body fluids etc
2. A sterile field is created by covering the patient’s body and work surfaces with drapes
made of sterilized fabric or synthetic sheets. It is important for the sterile field to be
wide enough to accommodate the instruments used and for the HCW to perform his/
her tasks.
3. The amount of skin exposed should be the minimum possible.

4. It must be realized that contamination of the sterile field will cause contamination of
the instruments within it.
5. The care provider is allowed to be in contact with the sterile field if a sterile gown is
worn. If only a glove is worn then the rest of the body should not come into contact
with the sterile field.

42 Ministry of Health Malaysia