Page 78 - policy and procedure infection control

Policies and Procedures on Infection Control

5.2.3.2 Antimicrobial prophylaxis
1. Administer a prophylactic antibiotic agent only when indicated, and select
it based on its efficacy against the most common pathogens causing SSI
for a specific operation, and also adhere to MOH Antibiotic Guidelines.
2. Administer by IV route the initial dose of prophylactic antibiotic agent, timed
such that a bactericidal concentration of the drug is established in serum
and tissues when the incision is made. Maintain therapeutic levels of the
agent in serum and tissues throughout the operation and until, at most, a
few hours after the incision is closed in the operating room.
3. Before elective colorectal operations, mechanically prepare the colon by
use of enemas and cathartic agents. Administer non-absorbable oral
antimicrobial agents in divided doses on the day before the operation.
4. For high risk cesarean section, if indicated administer the prophylactic
antibiotic agent immediately the umbilical cord is clamped.

5.2.4 Intra-operative measures
5.2.4.1 Operating room (OR) environment
1. The OR should be maintained under positive pressure ventilation (2.5 Pa in
relation to corridors and adjacent areas).
2. Maintained adequate air exchanges (minimum of 15/hour, of which at least
3 should be fresh air).
3. Filter all air, re-circulated and fresh air , through the appropriate recommended
filters.
4. Optimum room temperature (around 21 C).
0
5. Keep OR room doors closed except as needed for passage of equipment,
personnel, and the patient.
6. Limit the number of personnel entering and also the movement of personnel
in the OR.
7. Consider performing implant operations in OR supplied with ultraclean air
(laminar flow).
5.2.4.2 Cleaning and disinfection of environmental surfaces

1. When visible soiling or contamination with blood or other body fluids of
surfaces or equipment occurs during an operation, use approved hospital
disinfectant to clean the affected areas before the next operation.
2. Do no perform special cleaning or closing of OR after contaminated or dirty
operation.
3. Do not use tacky mats at the entrance to the OR suite or individual ORs for
disinfection control.

4. Wet vacuum the OR floor after the last operation of the day or night with an
approved hospital disinfectant.

Ministry of Health Malaysia 67