standard safety measures

 

1.     STANDARD SAFETY MEASURES

Definitions:

Standards: A standard is predetermined level of excellence that serves a guide for practice.

  Safety: safety is the state of being “safe “(from French saaf), the condition of being protected against physical, social, spiritual, financial, political, emotional, occupational, psychological, educational or failure, damage, error, accidents, harm or any other event high could be considered non-desirable.

 Types of safety:

 Normative safety: Normative safety is a term used to describe products or designs that meet applicable design standard.

Substantive safety:

      Substantive or objective safety means that the real-world safety history is favourable, whether or not standards are met

Standard precautions (for care providers):

“Standard precautions” are a set of basic steps care providers use to protect their patients & themselves from infection. These basic steps include:

1.     Practicing appropriate hand hygiene before and after contact with a patient, after contact with the surfaces or objects around the patient, and after removing gloves (if used).

2.     Wearing disposable gloves when the care provider may have contact with blood, faces, urine, or any other body fluids.

3.     Wearing a gown to prevent contamination of the provider’s clothing with blood or body fluids.

4.     Using a face mask, face shield, and /or goggles if splashing of blood or body fluids might occur.

5.     Cleaning of care equipment between patients.

Additional components that should be considered include:

  Care of the environmental, handling of linens and waste, sharp injury prevention, us of protective equipment during resuscitation, patient placement, safe injection practices, respiratory hygiene/cough etiquette, and use of a mask during special lumbar puncture procedures. For further guidance on these components, use CDC’s 2007 Guideline for isolation precautions.

·       Standard precaution should be used for all hands-on patient care activates in the patient’s room where the worker might have contact with blood or body fluids.

·       Hand hygiene refers to the use of soap and water or an alcohol-based hand rub to remove bacteria and viruses from the hands so they cannot be transmitted to anyone else.

·       Gloves should be won when touching or coming into contact with blood, saliva, mucus, wound drainage, faces, urine, or any other body fluids. Gloves should also be worn when cleaning possibly contaminated environmental surfaces (e.g. bedside furniture or bathrooms).

·       Gowns should be worn whenever   patient care activities might result in soiling of the provider’s clothing or uniform with blood, body fluids, or other contaminated materials. Gowns should be worn with the opening in back and the ties tied.

·        Masks and face shields or eye protection should be worn when ever a patient care activity might result in blood ,saliva, mucus, wound drainage ,feaces, urine, or any other body fluids being splashed on the face

·       In standard precaution, masks refer to surgical masks. The surgical mask protects the mouth and nose from splashed materials. The surgical mask should be worn with eye protection to avoid splashes of infected material into the eyes.

·       Goggles help protect the eyes from spatters. The goggles should fit snugly over and around the eye or over prescription eye glasses. Standard eyeglasses do not provide adequate eye  protection .

Face shield cover the eyes, nose, mouth,  and skin of the face. if you wear a face shield, you may not need a mask.

·       Your facility should have policies and procedures for handling of soiled laundry (such as bed linens and gowns),routine trash, and medical waste. Signs should be posted in the utility room as reminder of how to handle linens and waste.

·       In general, reusable gowns and linens should be transported to the laundry in bags or containers with minimal handling, and sorted and transferred to the washing machine using gloves and an apron or cover gown to prevent soiling of the worker’s hands and clothing.

Disposable equipment should not be reused.

Manufactures usually provide instructions for cleaning reusable equipment. Your facility manager should provide instructions and appropriate for cleaning equipment.

Transmission – based on precaution 

Transmission – based precaution are also known as additional infection control precaution  

In the health care transmission is (are) not completely interrupted using standard precaution alone.

Categories of transmission based on precaution

1. contact precaution

·       Contact  precautions are intended to prevent transmission of infectious agent , including epidemiologically important micro organisms , which are spread by direct or indirect contact with the patient environments.

·       Direct contact occurs when preforming patient care activities that requires touching the patients skin. Indirect contact occurs when touching potentially contaminated environmental surface or equipment in the patients environment.

For example : patients with enteric infection and diarrhoea which cannot be contained, multidrug resistant organisms (MDRO)

·       Staff wear gloves on entering the room, a gown for patient contact or contact with contaminated surface or material

·       Wash hands before and after contact with the patients and no leaving the room

·       Restrict the patient movements outside the room

·       Appropriate environment and equipment cleaning , disinfection and sterilization

Droplet precaution (droplet nuclei >5mm)

·       droplet precautions are intended to prevent transmission of pathogen spread through close respiratory or mucous membrane contact with respiratory secretion

e,g.: meningococcal meningitis diphtheria , respiratory syncytial virus

·       health care personnel must wear a mask during close contact with the infectious patient, the mask must be worn before entering into the room . while transporting the infectious patient outside, the patient must wear a mask, in order to prevent the spread of droplet infection from the infected person to the healthy person and follow respiratory hygiene . restrict the circulation of the patient wears a surgical mask if leaving the room .

Airborne precautions (droplet nuclei< 5mm):

·       airborne prevent transmission of infectious agents that remain infectious over long distances when suspended in the air ( e.g., rubella virus [measles], varicella virus [chickenpox], m tuberculosis of some disease that have multiple route of transmission (e.g., SARS), more than one transmission based precautions category may be used. Masking the patient , placing the patient in a private room (e.g., office examination room) with the door closed,  and providing higher level respirators or masks if respirators are not available for healthcare personnel will reduce the likelihood of airborne transmission

·       when transmission- based precautions are indicated , efforts must be made to counteract possible adverse effects on patients (I .e., anxiety, depression and other mood disturbances)

1.     absolute (strict ) isolation:

such isolation is required where there is a risk of infection by a highly .

E.g .: haemorrhagic fever ,vancomycin resistant.

·       Health care personnel must wash their hands to entry to and exit from the room

·       Incineration of needles , syringes.

·       Wearing personal protective measures like mask , gloves, gown , cap, eye protection for all entering the room

(a)    Biomedical waste management :

    Medical care is vital for our life and health, but the waste generated from medical activities represents a renal problems of living nature and human world. Improper management of waste generated in health care facilities causes a direct health impact on the community , the health care workers and on the environments every day , relatively large amount of potentially infectious and hazardous waste are generated in the health care hospitals and facilities around the world.