Jordan Ellis
Cross-contamination is the physical movement or transfer of harmful bacteria from one person, object, or place to another. This can happen in any setting, including hospitals, where the risk of infection is greater when undergoing a medical procedure. To avoid cross-infection in hospitals, it is important to adhere to infection prevention and control practices. These practices are outlined by the CDC and include recommendations such as education and training of healthcare personnel on infection prevention, injection and medication safety, and proper sterilization techniques. Additionally, good clinical practices, such as avoiding the passing of unsheathed needles between personnel and restricting the use of fingers during anesthesia administration, are crucial. Patients can also play a role in preventing cross-infection by practicing good hand hygiene, covering their mouth and nose when coughing or sneezing, and staying away from others when sick.
| Characteristics | Values |
|---|---|
| Hand hygiene | Wash hands regularly to prevent the spread of infectious diseases |
| Personal hygiene | Take a daily shower or bath to eliminate bacteria and prevent cross-infection |
| Mouth care | Brush teeth at least twice a day to maintain oral health and prevent infections |
| Cover mouth and nose | Use a tissue or elbow/hands to prevent the spread of infection through sneezes and coughs |
| Stay home when sick | Avoid contact with others to prevent the spread of infection |
| Vaccinations | Keep vaccinations up to date to prevent infectious diseases |
| Sterilization techniques | Use proper sterilization techniques to prevent cross-contamination |
| PPE removal | Remove PPE in a specific order and perform hand hygiene to avoid contamination |
| Needle handling | Avoid passing unsheathed needles and recapping needles with one hand to prevent injuries and infection |
| Instrument cleaning | Use mechanical cleaning over manual cleaning to decrease the risk of percutaneous injuries and exposure to blood |
| Antimicrobial stewardship | Limit inappropriate use of antimicrobials and select appropriate treatments to manage infections effectively |
| Surveillance and control | Implement an active system of surveillance and efficient infection control to minimize the spread of antimicrobial-resistant organisms |
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What You'll Learn
Wash hands regularly and maintain good mouth care
Washing your hands regularly is one of the most important practices for reducing the transmission of infections in healthcare settings. This is true for healthcare workers, patients, and visitors alike. Hands can be a primary source of pathogenic spread, so it is essential to wash your hands frequently and properly.
The correct technique for handwashing is as follows: First, stand in front of the sink, ensuring that your hands and uniform do not touch the sink surfaces. Then, turn on the warm water and wet your hands and wrists thoroughly. Keep your hands and forearms lower than your elbows to prevent cross-contamination from water running back. Next, use liquid soap if possible and apply a small amount to your hands. Rub your hands together until a lather forms, ensuring that you cover all surfaces of your hands and fingers, including the area around and under your fingernails. Continue rubbing your hands for at least 15 seconds. Rinse your hands well under running water and dry them with a paper towel. Finally, use the paper towel to turn off the faucet and to open the door if needed.
In healthcare settings, alcohol-based hand sanitizers are often preferred over soap and water as they are more effective at killing potentially deadly germs, cause less irritation and dryness to the skin, and are easier to use during the course of care. However, handwashing with soap and water is necessary in certain situations, such as when there has been potential exposure to specific pathogens like Clostridium difficile, Norovirus, or Bacillus anthracis.
In addition to handwashing, maintaining good mouth care is crucial for preventing cross-infection in hospitals. Dental settings, in particular, pose a high risk of cross-contamination due to the generation of aerosols during certain procedures, which can spread microbial particles through the air. To prevent this, dental professionals should follow guidelines such as avoiding aerosol-producing procedures when possible, using isolated rooms with negative suction and high particulate air filtration systems, and adhering to proper personal protective equipment (PPE) protocols. Regular cleaning, disinfection, and sterilisation of dental equipment are also essential to reducing the risk of cross-contamination.
Good oral hygiene practices, such as regular brushing and flossing, can also help to reduce the risk of infection in the mouth. Additionally, maintaining a healthy mouth pH and avoiding sugary foods and drinks can create an environment that is less conducive to the growth of harmful bacteria.
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Cover your mouth and nose when coughing or sneezing
Covering your mouth and nose when coughing or sneezing is an important step in preventing the spread of respiratory illnesses, including influenza, respiratory syncytial virus (RSV), pertussis (whooping cough), and COVID-19. By containing the droplets released during coughing or sneezing, you can help prevent the transmission of these illnesses to others.
The CDC recommends covering your coughs and sneezes with a tissue or your elbow. This simple act can create a physical barrier, blocking the expulsion of respiratory droplets that may contain harmful pathogens. It is important to dispose of the tissue immediately after use and to avoid touching your eyes, nose, or mouth with unwashed hands.
Washing your hands immediately after coughing, sneezing, or blowing your nose is crucial. Hand hygiene is one of the most effective ways to prevent the spread of germs and to protect yourself and others from illness. Wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, use an alcohol-based hand sanitizer containing at least 60% alcohol.
In healthcare settings, infection prevention and control practices are essential to providing safe and high-quality patient care. Healthcare personnel (HCP) are advised to follow CDC guidelines, which include practices such as hand hygiene, injection safety, and education and training on infection prevention. By adhering to these practices, HCP can minimise the risk of cross-infection and help ensure patient safety.
Covering your mouth and nose when coughing or sneezing, combined with proper hand hygiene, is a simple yet powerful measure to prevent the spread of respiratory illnesses in hospitals and other healthcare facilities. These basic infection control practices are applicable across all healthcare settings and play a crucial role in maintaining a safe environment for patients, visitors, and healthcare workers alike.
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Use and dispose of tissues correctly
Using tissues correctly is an important way to prevent the spread of infection in a hospital setting. When coughing or sneezing, it is important to cover your mouth and nose with a tissue to prevent the spread of infection to others. Be sure to keep tissues readily available at all times, including at home, at work, and in your pocket. After coughing or sneezing, throw away the used tissue immediately and then wash your hands. If you do not have a tissue, cover your mouth and nose with the bend of your elbow or your hands. If you use your hands, be sure to wash them immediately afterward.
It is also important to dispose of tissues correctly. Used tissues should be thrown away in a bin with a lid and lined with a plastic bag. The bin should be emptied regularly and the plastic bag should be tied off before being placed in an outside bin. Hands should be washed after handling used tissues or the bin.
In a hospital setting, it is particularly important to use and dispose of tissues correctly to prevent the spread of infection. This includes ensuring that tissues are readily available for patients, visitors, and staff, and that bins are regularly emptied and cleaned. Educating patients and visitors on the correct use and disposal of tissues is also key to preventing the spread of infection.
In addition to using and disposing of tissues correctly, other measures can be taken to prevent the spread of infection in a hospital setting, including regular handwashing, the use of personal protective equipment (PPE), and maintaining good hygiene practices, such as showering or bathing daily.
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Implement the correct use of PPE
The correct use of PPE (personal protective equipment) is a critical component of infection prevention and control practices in healthcare settings. Here are some detailed instructions for implementing the correct use of PPE to prevent cross-infection in hospitals:
Education and Training:
It is essential that all healthcare personnel (HCP) who interact with patients or infectious materials are educated and trained in the correct use of PPE. This includes understanding the types of PPE available, how to don (put on) and doff (take off) PPE appropriately, and the specific situations or procedures that require the use of PPE.
Types of PPE:
The types of PPE used in hospitals can include gloves, masks, respirators, face shields or eye protection, gowns or aprons, and headcovers. Each type of PPE serves a specific purpose in protecting different parts of the body from exposure to pathogens.
Donning (Putting on) PPE:
Before donning PPE, HCP should perform hand hygiene, such as washing hands with soap and water or using an alcohol-based hand sanitizer. When putting on PPE, it is important to do so in a designated area, away from patients or potentially contaminated areas. The order of donning PPE is crucial: first, put on a mask or respirator, ensuring a proper seal; second, put on eye protection or a face shield; third, put on a clean, non-sterile gown, ensuring it covers the torso and arms; fourth, put on gloves, ensuring they fit properly and there are no tears or defects.
Using PPE During Procedures:
During procedures or interactions with patients, it is vital to maintain the integrity of the PPE. Avoid touching or adjusting the PPE unnecessarily. If any piece of PPE becomes contaminated or soiled, replace it as soon as possible, following the established protocols.
Doffing (Removing) PPE:
The process of removing PPE is just as important as putting it on. Hand hygiene is crucial before and after removing any PPE item. Remove PPE in a specific order to minimize the risk of contamination: first, remove gloves, being careful not to touch the outside of the gloves and wash hands if they become contaminated; second, remove the gown or apron by breaking the neck strap and touching only the inside of the garment; third, remove the mask or respirator without touching its external surface; fourth, remove eye protection without touching the outer surfaces; and finally, perform hand hygiene again.
Disposal of PPE:
Proper disposal of PPE is essential to prevent the spread of infection. All PPE items should be disposed of in appropriate waste containers, following the hospital's waste management guidelines.
By implementing these practices and providing ongoing education and training to healthcare personnel, hospitals can effectively utilize PPE to prevent cross-infection and protect both patients and healthcare workers.
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Avoid passing unsheathed needles between hospital personnel
Needlestick injuries are a common occupational hazard for healthcare workers. The use of needles is unavoidable in healthcare settings, and despite universal precaution guidelines and safety-conscious needle designs, needlestick injuries continue to occur, albeit at a lower rate than in the past. In the operating room, needlestick injuries are not uncommon, and in the US alone, there are estimated to be nearly 600,000 such injuries annually, half of which go unreported.
Healthcare professionals at the highest risk of needlestick injuries include surgeons, emergency room workers, laboratory professionals, and nurses. However, housekeeping personnel and those who clean the sharps containers are also at high risk. The risk of needlestick injuries is always a concern, and while HIV was the major concern in the early 1980s, today the concern is primarily hepatitis B and hepatitis C.
To prevent needlestick injuries, it is important to follow safe handling practices for sharps, which include needles, scalpels, and other tools that puncture or cut the skin. Before using a sharp object, ensure that all necessary items, such as alcohol swabs, gauze, and bandages, are within reach, and be aware of the location and capacity of the sharps disposal container. Some needles have protective devices, such as needle shields or sheaths, that can be activated after use to enable safe handling and reduce the risk of exposure to blood or body fluids. It is crucial to understand how these devices work before using them.
To avoid passing unsheathed needles between hospital personnel, established protocols should be followed. For example, in the operating room, there should be clear procedures for how sharp instruments and needles are passed between the nurse and surgeon. After use, needles should be placed in sharps containers that are easily accessible and at eye level. If a needle is protruding from the container, do not push it in with your hands. Instead, call for assistance or use tongs to safely push the needle back into the container. These practices can help reduce the risk of infections among healthcare workers and provide safe and high-quality patient care.
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Frequently asked questions
Cross-infection is the physical movement or transfer of harmful bacteria from one person, object, or place to another. This can happen in any setting, including hospitals.
The risks of cross-infection in hospitals include the spread of infections, such as superbugs like Mycobacterium abscessus, and the development of antimicrobial resistance. Infections can lead to significant patient illnesses and deaths, prolonged hospital stays, and increased costs for patients.
Some general ways to prevent cross-infection in hospitals include adhering to infection control practices, such as hand hygiene, respiratory etiquette (covering coughs and sneezes), and staying home when sick. It is also important to keep vaccinations up to date and practice good personal hygiene, such as taking daily showers or baths and maintaining mouth care.
Specific strategies include the use of personal protective equipment (PPE), proper sterilization techniques, and infection control practices specific to the healthcare setting, such as dental offices or intensive care units. Protocols for minimizing percutaneous injuries and exposure to blood are also important.
Healthcare personnel play a crucial role in preventing cross-infection by adhering to infection control guidelines, receiving education and training on infection prevention, and following standard and transmission-based precautions when treating patients. They should also be mindful of the importance of infection control in all aspects of their work.
