Prevention and management of infection in healthcare settings
The practices that form the basic measures to prevent transmission of infectious diseases within health care environments are divided into standard and transmission-based precautions.
When a disease agent is unknown, a symptom-based approach will reduce the risk of transmission to the health care worker and to other patients. For example, if a patient presents with vomiting or diarrhoea or respiratory symptoms (coughing, sneezing and fever) then the appropriate precautions should be implemented immediately, rather than waiting for a definitive diagnosis.
The use of standard precautions for all patients is the primary strategy for minimising the transmission of infections in health care settings.It is essential that standard precautions are applied at all times when caring for any patient regardless of their infectious disease status. This is becoming more important as the prevalence of unidentified carriage of multidrug-resistant organism (MRO) in community settings increases.
The practices that form part of standard precautions include:
- hand hygiene according to the "5 moments" for hand hygiene
- appropriate use of personal protective equipment according to risk of body fluid exposure
- use of aseptic technique where required
- appropriate reprocessing of re-useable instruments and equipment
- safe handling and disposal of sharps and potentially infectious material
- safe handling of waste and linen
- environmental controls including cleaning and spills management.
Transmission-based precautions are applied in addition to standard precautions for patients suspected or confirmed to be infected with specific organisms of concern. The additional precautions required to manage these infections varies according to the route of transmission (airborne, droplet or contact).
The specific additional precautions may involve the use of:
- isolation facilities (single room)
- additional respiratory protection, such as the use of high filtration P2 OR N95 respirators
- disposable gowns, gloves and eye protection on entry to the room.
Details of these requirements are found in local facility procedure manuals, state guidelines for management of multi-resistant organisms and the Australian guidelines for the prevention and control of infection in healthcare.
A useful summary of infectious diseases and their modes of transmission and the specific precautions required can be found in the document Infection Control Management of Infectious Diseases (PDF 467KB).
SA Health has developed specific advice on:
- infection prevention and control of cystic fibrosis (PDF 312KB)
- management of gastroenteritis outbreaks (PDF 272KB)
- influenza for healthcare professionals
- flu/gastro posters and resources
SA Health has also developed a training tool for the Australian Government titled "The safe use of personal protective equipment" primarily for use in a pandemic situation, but the principles and information contained in the DVD is applicable to all situations where transmission-based precautions are required. A PPE donning and doffing poster and brochure are also available.
The Australian Commission for Safety and Quality in Health Care also has a number of generic resources available from their website, such as a set of standardised signage on standard and transmission-based precautions.
SA Health's Infection Control Service also provides educational opportunities for staff with responsibility for infection prevention and control in their facility.
For further information on the prevention and management of infections in the healthcare settings, contact the SA Health's Infection Control Service.