Page 98 - policy and procedure infection control

Policies and Procedures on Infection Control

6.2 General Intensive Care Unit

Many infectious agents are present in the intensive care unit. Patients may develop infections
during their stay in the unit while healthcare workers may be infected during the course of their
duties. It is therefore important for all healthcare workers working in the intensive care units to
observe infection control measures strictly to minimise nosocomial infections.
For Standard Precautions, Transmission-based (Additional) Precautions and Hand Hygiene,
refer to Chapter 3 on Isolation Precautions.

6.2.1 Healthcare Workers and Visitors
1. All healthcare workers shall remove their white clinical coats before entering the unit.
2. There is no necessity to change footwear or use shoe covers upon entering the unit.

3. All healthcare workers shall perform hand hygiene with antiseptic soap and water or
alcohol-based hand rub upon entering and before leaving the unit.
4. Staff nurses shall change out of their uniforms and wear ICU attire/OT suits while
working in the unit. It is advisable for those who wear headscarves to change to caps
while on duty. Headscarves or ties if worn shall be neatly tucked into blouses/shirts.
5. Wearing of bangles or bracelets is not allowed during patient care. Ear studs (not
dangling earrings) and flat band rings are allowed. Wristwatches and flat band rings
must be removed when performing hand hygiene.
6. Sleeves shall be rolled up above the elbow when handling patients and equipments.
7. Healthcare workers with transmittable infections are advised not to work in the unit
until treated.
8. Visitors shall be limited to not more than two per patient at any one time.
9. Visitors shall be instructed on hand hygiene practices before and after visiting.
10. Visitors shall not be discouraged from having contact with the patients e.g. touching.
However, they shall be instructed to observe transmission-based precautions whenever
applicable.

6.2.2 Personal Protective Equipment
1. Wearing of gloves does not replace hand hygiene. Perform hand hygiene both before
wearing and after removing gloves.
2. Wear sterile gloves when performing procedures requiring a sterile field or involving
sterile areas in the body e.g. arterial cannulation, central venous cannulation, tracheal
suction, bronchoscopy, wound dressing, lumbar puncture, tracheostomy and urinary
catheterisation.
3. Wear non-sterile gloves when touching blood, saliva, body fluids or secretions,
excretions, contaminated items or surfaces, mucous membranes and non-intact skin.

Ministry of Health Malaysia 87