In all workplaces, Nurses are acutely aware of the importance of adhering to current guidelines for the prevention and control of infections. Did you know there are over 165,000 healthcare associated infections in Australian acute healthcare facilities every year? This makes healthcare associated infections the most common complication affecting patients in the hospital. The long awaited updated Australian guidelines for the prevention and Control of Infection in Healthcare (2029) has been released. The Guidelines include disinfection methods, antimicrobial resistance, replacement of peripheral intravenous catheters, use of chlorhexidine, immunisation for healthcare workers, Norovirus and the use of hospital-grade disinfectants. You can access the guidelines here>>

“Effective infection prevention and control is central to providing high quality healthcare for patients and a safe working environment for those who work in healthcare settings. These Guidelines provide evidence-based recommendations that outline the critical aspects of infection prevention and control, focusing on core principles and priority areas for action. The revised Guidelines uses new national and international evidence to strengthen the risk management approach to infection and prevention control established in the 2010 guidelines. The evidence which has informed the updated Guidelines includes international infection prevention and control guidelines, national infection prevention and control guidelines on specific topics, literature reviews and systematic reviews.”

A quick reminder regarding Standard Precautions:

“Standard precautions consist of:
• hand hygiene, as consistent with the 5 moments for hand hygiene[56] • the use of appropriate personal protective equipment
• the safe use and disposal of sharps
• routine environmental cleaning
• reprocessing of reusable medical equipment and instruments
• respiratory hygiene and cough etiquette
• aseptic technique
• waste management
• appropriate handling of linen.
Standard precautions should be used in the handling of blood (including dried blood); all other body substances, secretions and excretions (excluding sweat), regardless of  whether they contain visible blood; non-intact skin; and mucous membranes.”

Examples of recommendations contained within the guidelines include the following:

  • “The type and length of fingernails can have an impact on the effectiveness of hand hygiene. Artificial or false nails have been associated with higher levels of infectious agents, especially Gram-negative bacilli and yeasts, than natural nails[. Fingernails should, therefore, be kept short (e.g. the length of the finger pad) and clean, and artificial fingernails should not be worn. Studies have also demonstrated that chipped nail polish may support the growth of organisms on the fingernails. It is good practice to not wear nail polish, particularly as chipped nail polish may support the growth of organisms on the fingernail.
  • The consensus recommendation is to strongly discourage the wearing of watches, rings or other jewellery during health care; however, if jewellery must be worn in clinical areas it should be limited to a plain band (e.g. wedding ring) and this should be moved about on the finger during hand hygiene practices. In high-risk settings such as operating
    suites/rooms, any jewellery, even a plain band, should not be worn.
  • Gloves are single-use items. In aseptic technique, if it is necessary to touch key parts or key sites directly, sterile gloves are used to minimise the risk of contamination. Otherwise, non-sterile gloves are sufficient.
  • It is recommended that soap and water should be used for hand hygiene when hands are visibly soiled
  •  It is good practice to use a chlorine-based product such as sodium hypochlorite or a Therapeutic Goods Administration-listed hospital-grade disinfectant with specific claims in addition to standard cleaning practices to effectively manage norovirus specific outbreaks
  • Droplet precautions are intended to prevent transmission of infectious agents spread through close respiratory or mucous membrane contact with respiratory secretions. As these microorganisms do not travel over long distances, special air handling and ventilation are not required. Infectious agents for which droplet precautions are indicated include influenza, norovirus, pertussis, meningococcus.
  • Use of surgical masks to prevent droplet transmission -There is insufficient evidence to support the use of P2 respirators for reducing the risk of infections transmitted by the droplet route. Although surgical masks do not protect the
    wearer from infectious agents that are transmitted via the airborne route, surgical masks that meet Australian Standards are fluid impervious and protect the wearer from droplet contamination of the nasal or oral mucosa. The surgical mask is generally put on upon room entry, with hand hygiene practised before putting on the mask and after taking off the mask.
  • It is good practice to consider the use of early bay closures to control known or suspected norovirus outbreaks rather than ward/unit closures. Rather than closing an entire ward or unit to manage an outbreak of norovirus in a
    healthcare facility, it may be more efficient to control an outbreak through cohorting symptomatic patients in bays. If taken, this approach needs to be implemented promptly and early (within three days of the first case becoming ill) in combination with adequate infection control strategies.
  • Crockery and utensils used by patients on transmission-based precautions do not require containment and should be treated in the same manner as those used for non-infectious patients (i.e. washed in a dishwasher). Disposable crockery and utensils are not necessary.
  • . It is good practice for healthcare workers and visitors to adhere to norovirus exclusion periods. Healthcare workers should not be at work from symptom onset until 48 hours after symptom resolution. On returning to the healthcare facility, healthcare workers should adhere to appropriate hand hygiene practices.
  • For postoperative wounds use sterile saline for wound cleansing up to 2 days after surgery.”

The Nursing CPD Institute provides great information and CPD  on an array of nursing topics including communicable diseases and wound care in a range of easy learning ways including webinars and quizzes on the latest information that Nurses need to know – remember it was created by Australian Nurses for Nurses!  https://www.ncpdi.com.au

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