Infection prevention and control - Royal Marsden Manual of Clinical ...

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102 Infection prevention and control Procedure guideline 3.6 (Continued) Procedure 2 Apply demister solution according to manufacturer’s instructions, if required. 3 Position item over eyes/face and secure using ear pieces or headband; adjust to fi t. 4 At the end of the procedure, remove by grasping the ear pieces or headband at the back or side of the head and lifting forward, away from the face. Do not touch the front of the goggles or face shield (see Action Figure 4 ). Postprocedure 5 Dispose of used disposable items as ‘hazardous infectious waste’, that is, into an orange waste bag, unless instructed otherwise by the infection prevention and control team. 6 Clean reusable items according to the manufacturer’s instructions, usually with detergent and water or a detergent wipe. To ensure good visibility throughout the procedure. E To ensure the item is comfortable to wear and remains in the correct position throughout the procedure. E To avoid contaminating the hands with material from the outside of the eye protection ( DH 2010b , C , E ). All waste contaminated with blood, body fl uids, excretions, secretions and infectious agents thought to pose a particular risk should be disposed of as hazardous infectious waste. Orange is the recognized colour for hazardous infectious waste that does not require incineration and may be made safe by alternative treatment ( DH 2006a , C ). To avoid cross-contamination and ensure the item is suitable for further use. E Action Figure 4 Don and remove eye protection by grasping the earpieces; do not touch the front.
Procedure guideline 3.7 Donning sterile gloves: open technique Infection prevention and control Purpose : To have a barrier between the nurse’s hands and the patient to prevent the transmission of infectious agents in either direction, and to prevent contamination of a vulnerable area or invasive device through contact with non-sterile gloves. Note that in steps 4 and 5, below, either glove can be put on fi rst. Simply exchange ‘left’ and ‘right’ in the description if you wish to put on the right-hand glove fi rst. Essential equipment ■ Sterile disposable gloves ■ All other equipment required for the procedure for which the gloves are required Preprocedure Action Rationale 1 Clean hands using soap and water or alcohol-based handrub. 2 Prepare all the equipment required for the procedure, including setting up the sterile fi eld and tipping sterile items on to it from packets if you do not have an assistant, but do not touch any sterile item before putting on gloves. Procedure 3 Open the packet containing the gloves and open out the inside packaging on a clean surface so that the fi ngers of the gloves are pointed away from you, taking care not to touch the gloves or allow them to come into contact with anything that is non-sterile (see Action Figure 3 ). 4 Hold the cuff of the left-hand glove with your right fi ngertips, at the uppermost edge where the cuff folds back on itself. Lift this edge away from the opposite edge to create an opening. Keeping them together, slide the fi ngers of the left hand into the glove, taking care not to contaminate the outside of the glove, while keeping hold of the folded edge in the other hand and pulling the glove onto the hand. Spread the fi ngers of the left hand slightly to help them enter the fi ngers of the glove (see Action Figure 4a, 4b, 4c ). 5 Open up the right-hand glove with your left hand fi ngertips by sliding them beneath the folded-back cuff. Taking care not to touch the left-hand glove or the outside of the right-hand glove, and keeping the fi ngers together, slide the fi ngers of the right hand into the right-hand glove. Again, spread your fi ngers slightly once inside the body of the glove to help them into the glove fi ngers (see Action Figures 5a , 5b ). 6 When both gloves are on, adjust the fi t by pulling on the body of the glove to get your fi ngers to the end of the glove fi ngers (see Action Figures 6a , 6b ). Hands must be cleansed before and after every patient contact or contact with patient’s equipment ( Pratt et al. 2007 , C ). To avoid contaminating gloves with non-sterile packets. E To prevent contamination of the gloves and to put them in the best position for putting them on. E To prevent contamination of the outside of the glove. E To prevent contamination of the outside of the glove. E To ensure the gloves are comfortable to wear and do not interfere with the procedure. E (Continued) 103
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Page 3 and 4: Box 3.1 Terms used when discussing
Page 5 and 6: Bacteria Bacteria are probably the
Page 7 and 8: Table 3.2 Medically signifi cant ba
Page 9 and 10: the appearance of a sponge, hence t
Page 11 and 12: many of these organisms may be less
Page 13 and 14: of regular visits to clinical areas
Page 15 and 16: Assessment and recording tools Asse
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Page 19 and 20: Procedure guideline 3.3 Putting on
Page 21 and 22: Procedure guideline 3.4 Putting on
Page 23: Procedure guideline 3.5 (Continued)
Page 27 and 28: Action Figure 5a Slide the fi ngert
Page 29 and 30: Postprocedure 11 At the end of the
Page 31 and 32: Action Figure 8d Push your hand thr
Page 33 and 34: ■ Traceability system for any reu
Page 35 and 36: Source isolation Evidence-based app
Page 37 and 38: Linen Place infected linen in a red
Page 39 and 40: Postprocedure 11 Assess the patient
Page 41 and 42: 5 If the patient has an infection r
Page 43 and 44: Prevention and management of inocul
Page 45 and 46: Box 3.3 Actions to take in the even
Page 47 and 48: Table 3.7 (Continued) Management of
Page 49 and 50: DH/HPA ( 2008 ) Clostridium diffi c

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