At Suburban Hospice, we take infection control very seriously in all times and circumstances. We wanted to share with you our Standard Infection Control Policy so you are aware of our practice toward keeping you and your loved one safe.

Infection Control – Standard Precautions

PURPOSE:

To reduce the risk of exposure to and transmission of infections when caring for patients.

POLICY:

Associates will adhere to the following precautions and will instruct patients and family/caregivers in infection control precautions, as appropriate to the patient’s care needs.

Note:   Patients may be given a copy of this procedure, if needed as a teaching tool. Note:   Suburban Hospice has the right to limit the practice of associates, if patient safety is in question

Definition

Under standard precautions, blood and certain body fluids of all patients are considered potentially infectious for bloodborne pathogens, such as human immunodeficiency virus (HIV), and hepatitis B virus (HBV).  Standard precautions apply to blood and other body fluids potentially containing blood or bloodborne pathogens.  These body fluids include: emesis, sputum, feces, urine, semen, vaginal secretions, cerebrospinal fluid (CSF), synovial fluid, pleural fluid, pericardial fluid, and amniotic fluid.  Standard precautions should be used with other fluids, such as nasal secretions, saliva, sweat, and tears when they contain visible blood or other potentially infectious materials and it is impossible to differentiate between body fluids.

PROCEDURE:

General Precautions

Hand Hygiene

1. Hand hygiene will be performed to prevent cross-contamination between the patient and the associate.
2. When hands are visibly dirty, contaminated with proteinaceous material, or are visibly soiled with blood or other body fluids, wash hands with soap and water.
3. When hands are not visibly soiled, use an alcohol-based hand rub for routinely decontaminating hands or soap and water.

Personal Protective Equipment

1. Gloves:

A. The use of gloves (latex or vinyl of appropriate size and quality) is important when associates have cuts, abraded skin, chapped hands, dermatitis, etc. Gloves are to be worn when:

• There is actual or potential contact with blood or other potentially infectious materials
• Contact with non-intact or abraded skin is anticipated
• Touching contaminated items or surfaces
• Performing invasive procedures
• Handling any drainage appliance
• Taking a rectal temperature
• Shaving a patient with a safety razor
• Obtaining laboratory specimens
• Patients have active bleeding
• Cleaning of body fluids and decontamination procedures
• Performing wound care
• Entering the room of, or providing care for, patients who are colonized or infected with vancomycin-resistant enterococci (VRE) or multidrug-resistant Staphylococcus aureus (MRSA)
• Handling soiled linen

B. Sterile gloves are to be worn for sterile procedures.

C. Gloves are to be changed:

• Between task and procedures on the same patient
• During changing or cleaning an incontinent patient
• After removing an old dressing
• When the integrity of the glove is in doubt

D. Gloves should never be washed or disinfected for reuse.

E. Gloves are not necessarily needed for general care or during casual contact, such as assisting with ambulation.

F. Gloves should be worn by the family/caregiver when direct contact with any body substance is anticipated (blood, urine, pus, or feces)

2. Gowns:

A. The use of gowns/bunny suits is required when splashes to the skin and/or clothing are likely or when caring for patients with epidemiologically important microorganisms, such as multi-drug resistant organisms.

B. The gowns/bunny suits will be made of or lined with fluid-proof or fluid-resistant material and will protect all areas of exposed skin.

3. Mask/Protective Eyewear:

A. Masks, protective eye wear, or face shields are required when contamination of mucous membranes, eyes, mouth, or nose is possible, such as splashes or aerosolizing of material.

B. They are not required for routine care.

C. A NIOSH-certified N95 respiratory mask must be worn when caring for patients with suspected or confirmed Mycobacterium Tuberculosis.

Sharps

1. After use, needles and other sharps will be placed directly into a puncture-proof container located in the immediate patient care area. Needles must not be recapped, bent, broken, or clipped.
2. Whenever possible, needleless protective devices will be utilized in the provision of patient care.

Laboratory Specimens

1. Laboratory specimens should be transported in a Ziploc bag or other leak-proof container.
2. The leak-proof container should be transported to the office or alternate lab site in a puncture-resistant container that is properly labeled.

Waste Disposal

1. General Waste:

A. Materials not contaminated or visible soiled with blood or other infectious waste, such as diapers, incontinence pads, non-soiled PPE, or dressing wrappers.

B. General Waste should be disposed of in the patient’s trash receptacle

2. Syringes/Sharps Disposal:

A. In the home setting, a sharps container or puncture resistant container should be used by the clinician or patient/family.  The uncapped needle will be placed directly into the disposal container.  When 3/4 full, the disposal container should be disposed of in the patient’s trash can.

Laundry

1. Handling and Changing of Linens:

Contaminated laundry should be handled as little as possible with minimal agitation.

B. Gloves and other appropriate personal protective equipment should be worn when handling soiled linen.

C. Soiled clothing and linens should be soaked as promptly as possible. Ideally, they should be machine washed in hot (160° F) soapy water.  If appropriate, (e.g., colorfast material), a cup of bleach may be added to the water.  If low temperature (less than 150° F) laundry cycles are used, chemicals suitable for low-temperature washing at proper use concentration should be used.

D. When contaminated laundry is wet and likely to soak through or leak from the bag to the container, the laundry should be transported in containers or bags that prevent leakage to the exterior.

E. Laundry and linens should be carried away from the body.

Equipment/Nondisposable Instruments

1. Bedpans/Urinals/Commodes:

A. Bedpans and urinals should be used by only one (1) patient and should be cleaned on a regular basis with household detergent.

B. Shared commodes do not require special precautions unless blood, contaminated body substance, or fluid is present. If soiled, the commode should be cleaned with a 1:10 dilution of bleach

2. Thermometers:

A. Individual thermometers are not supplied by Suburban Hospice, but may be owned by patients.

B. Electronic thermometers with disposable sheaths need no special precautions unless they become visibly soiled. When thermometers are soiled, they should be wiped with a disinfectant solution.

C. Glass thermometers used in the home should be rinsed with soap and water before and after use. If the thermometer will be used by more than one (1) family/caregiver member, it should be soaked in 70–90% ethyl alcohol for 30 minutes followed by a rinse under a stream of water in between users.

3. Medical Equipment/Supplies

A. Any nondisposable equipment or supply utilized by the clinician in the provision of care will be disinfected by thoroughly wiping down with an approved disinfectant before use with another patient. Examples would be but not limited to:

• Pulse Oximeter
• Nylon BP cuffs
• Stethoscopes

B. Any nondisposable equipment returned to organization stock will be transported in a designated dirty area in trunk and then will be placed in the dirty supply area and then thoroughly wiped down with an approved disinfectant. After proper cleaning, the equipment may be returned to stock for patient use.

C. In the event a nondisposable piece of equipment comes in contact with blood or body fluids, an approved disinfectant is used to clean it. Soiled blood pressure cuffs will be washed in hot, soapy water.

Other Considerations

1. Eating, drinking, smoking, applying makeup or lip balm, or handling contact lenses should be avoided in work areas where there is a reasonable chance of exposure.
2. Sterile technique will be employed for sterile dressing changes, IV insertion, IV site care, phlebotomy, tracheal suctioning, insertion of a urinary catheter, and whenever appropriate to prevent infection.
3. Disinfectants: HIV is inactivated rapidly after being exposed to chemical germicides. HIV can be inactivated after exposure for ten (10) minutes to any of the following:

A. Chlorine bleach (1:10 dilution)

B. Alcohol (70–95%)

 

INITIATED:      10/19

REVIEWED:     4/20

REVISED:        4/20