Hand Hygiene

• Avoid touching surfaces around the patient unless necessary.
• Hand washing with an alcohol-based hand rub is preferred if hands are not visibly soiled or after removing visible material with non-antimicrobial soap and water.
• Use antimicrobial soap and water to wash your hands if:
  • Your hands are visibly dirty, soiled, or contaminated
  • You had contact with spores from infectious organisms
• Wash hands:
  • Before contact with a patient
  • Before moving from a contaminated area of a patient to a clean area of the patient
  • After contact with blood, body fluids, secretions, excretions, mucous membranes, nonintact skin, wound dressings or contaminated items
  • After removing gloves
  • After contact with objects such as medical equipment that is around the patient
• Artificial fingernails should not be worn when caring for patients who are at high risk for infection.

Personal Protective Equipment

Personal Protective Equipment includes disposable gowns, gloves, eye, and face protection.

Gowns
• Use to prevent contamination of clothing or skin during procedures and patient care activities where contact with blood or other body fluids is anticipated
• Gowns should not be reused.
Gloves
• Use for touching nonintact skin, mucous membranes, blood, body fluids, secretions, excretions, and contaminated items
• Use a new pair of gloves with each patient.
• Change gloves if moving from a contaminated area of a patient to a clean area of the patient.
Mask, Goggles, Face Shield
• Use during procedures and patient care activities that are likely to result in splashes or sprays of blood, body fluids, secretions, or excretions
• Use during lumbar procedures that involve placement of a catheter, or injection of material into spinal or epidural space
• Personal protective equipment should be removed and thrown away before leaving the patient's room.

Needles and Other Sharps

• Accidental injuries with needles and sharps happen when performing procedures. They also occur when handling or disposing of used needles and sharps.
• To prevent needle stick injuries, used needles should not be recapped, bent or broken, or otherwise manipulated by hand.
• If recapping is required, use a one-handed scoop only.
• Place used needles, disposable syringes, scalpel blades, pipettes, and other sharp items in puncture-resistant containers marked with a biohazard symbol for disposal.
• Use safety features when available.

Safety when Injecting Medicine

• Aseptic techniques should be used with sterile injection equipment.
• Do not reuse needles, tubing, connectors, IV bags, or syringes. They should only be used on one patient.
• Use single-dose vials whenever possible and only use single-dose vials for one patient.
• If using multi-dose vials:
  • Keep them away from the immediate patient areas.
  • Needles, tubing and syringes used to access the vial must be new and sterile.

Patient Resuscitation

Use a mouthpiece, resuscitation bag, or other ventilation devices to prevent contact with mouth or oral secretions.

Environmental Control

• Frequently clean and disinfect surfaces that are patients are near and frequently touched surfaces as these surfaces can easily be contaminated
• Use appropriate cleaning solutions that are Environmental Protection Agency registered.
• Child play toys used in waiting areas should be disinfected regularly.
• Handle fabric such as used sheets and towels carefully to avoid contamination with other objects or the air.

Equipment Used in Patient Care

Precautions should be taken to prevent spread of infection from equipment that has been contaminated. Examples include:

• Removing material from instruments and cleaning the devices before sterilization
• Wearing appropriate personal protective equipment when handing patient care equipment that may have been soiled or been in contact with blood or body fluids

Patient Placement

Try to put patients who may transmit infections to others in a single room. This may be any patient who is likely to contaminate the environment or does not maintain hygiene. It may also be patients at risk for acquiring or developing adverse outcomes following infection.

Respiratory Hygiene/Cough Etiquette

In addition to patients and healthcare workers, this element is also aimed at family members and friends with undiagnosed transmissible respiratory infections. People entering a health facility with signs of illness including cough, congestion, rhinorrhea, or increased production of respiratory secretions should take special precautions. Offices and hospitals should have posted signs with instructions for patients and visitors to:

• Cover their mouth/nose when coughing or sneezing.
• Use tissues and after use, throw them away in appropriate receptacles.
• Wash hands after coughing, sneezing, or blowing nose.
• Wear masks if they are coughing or have other symptoms as soon as they walk into the facility during a season where respiratory infections are common.
• Stay at least 3 feet away from other patients if they are having symptoms.