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

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104 Infection prevention and control Procedure guideline 3.7 (Continued) Postprocedure 7 Remove the gloves when the procedure is completed, taking care not to contaminate the hands or the environment from the outside of the gloves. 8 First, remove the fi rst glove by fi rmly holding the outside of the glove wrist and pulling off the glove in such a way as to turn it inside out. 9 Then remove the second glove by slipping the fi ngers of the ungloved hand inside the wrist of the glove and pulling it off whilst at the same time turning it inside out. 10 Dispose of used gloves as ‘hazardous infectious waste’, that is, into an orange waste bag, unless instructed otherwise by the infection prevention and control team. The outside of the glove is likely to be contaminated. E Whilst removing the fi rst glove, the second gloved hand continues to be protected. By turning the glove inside out during removal, any contamination is contained inside the glove. E By putting the fi ngers inside the glove, the fi ngers will not be in contact with the potentially contaminated outer surface of the glove. 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 ). 11 After removing the gloves, decontaminate your hands. Hands may have become contaminated ( Pratt et al. 2007 , C ). Action Figure 3 Open the packet containing the gloves onto a clean surface and open out the inside packaging so that the fi ngers of the gloves point away from you. Action Figure 4b Keep hold of the folded edge and pull the glove onto your hand. Action Figure 4a Hold the cuff of the fi rst glove with the opposite hand and slide the fi ngertips of the other hand (that the glove is to go on) into the opening. Action Figure 4c Spread your fi ngers slightly to help them enter the fi ngers of the glove.
Action Figure 5a Slide the fi ngertips of your gloved hand beneath the folded cuff of the second glove. Action Figure 6a Pull the glove onto your hand, again spreading your fi ngers slightly to help them enter the fi ngers of the glove. Infection prevention and control Action Figure 5b Slide the fi ngertips of your ungloved hand into the opening of the second glove. Action Figure 6b When both gloves are on, adjust the fi t. Procedure guideline 3.8 Donning a sterile gown and gloves: closed technique Note 1 : These procedures will normally require participants to also wear a mask and eye protection. Note 2 : An assistant is required to open sterile gloves and tie the back of the gown. Essential equipment ■ Sterile disposable gloves ■ Sterile disposable or reusable gown Preprocedure Action Rationale 1 Prepare the area where gowning and gloving will take place. Open the gown pack with clean hands. Do not touch the inside of the package. To ensure that there is adequate room to don gown and gloves and to avoid contaminating either. E (Continued) 105
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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 and 24: Procedure guideline 3.5 (Continued)
Page 25: Procedure guideline 3.7 Donning ste
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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