Wound Care Bacaan Penuh ( bersaiz 5.5 MB)

Policies and Procedures on Infection Control Ministry of Health Malaysia 49 Physical facility Touch contamination during preparation and administration Formula preparation Adding water or other substances, or using procedures that increases handling of formulas or administration systems increases the potential for contamination. A d m i n i s t r a t i o n a n d prolonged hang time Regardless of administration system, all tube-feeding formulas have risk of microbial growth. Prolonged hang time is associated with unacceptable microbial levels. Causes of Contamination Preventive Measures 1. There should be a room equipped with the necessary facilities for the preparation of enteral feeds following aseptic technique for the whole hospital and proper delivery system to the wards. 2. The preparation area should be clean and hand washing facilities must be made available. 1. Practice hand hygiene before handling formula or administration system. 2. Use disposable gloves. 3. Sanitise all equipments and surfaces used for formula preparation 4. When using decanted formula, sanitise the container before opening. 5. Avoid touching any part of container or the administration system that will come into contact with the formula e.g: the container feeding port, piercing pin on the feeding set. 1. Use commercial formulas and avoid blenderised foods. 2. Avoid adding water, colorants, medications or other substances directly to formula. 3. Use clean technique to add medication to the feeding tube if cannot be given by other route. 4. Use full strength formula. For GI intolerance, reduce administration rate instead of diluting the formula. 5. Reduce handling by using closed feeding system. 6. Label product, date and time of preparation on the container. 1. Limit hang time of refilled formula to 24 hours. 2. Limit hang time of decanted formula to 8 – 12 hours. 3. When using decanted formula, allow feeding to empty completely and rinse before adding fresh formula. 4. Avoid topping up freshly prepared formula until all the previous formula in feeding bag is completely administered. 5. Flush feeding tube with sterile boiled water. 6. Change feeding set every 24 hours. Policies and Procedures on Infection Control Ministry of Health Malaysia 50 Unsafe storage and transportation Even low-level contamination can grow logarithmically in nutrient-rich solutions at warm temperatures. Reuse of feeding sets Touch contamination during setup and cross infection in hospitals occurs mainly via hand. Causes of Contamination Preventive Measures 1. Keep prepared formula at suitable temperature until ready for use. Freshly prepared formula is a better option. 2. Cover, label and refrigerate unused, opened and reconstituted formula. Discard after 48 hours if unused. 3. Do not allow refrigerated formulas to sit at room temperature for more than 20 minutes before feeding. 4. Do not freeze or over heat the formula. 5. Do not reheat with microwave oven. 1. Prolong use of feeding systems causes significant contamination. 2. Discard feeding sets and containers according to instructions. 1. Practice hand hygiene before handling feeding systems. Using clean, disposable gloves may be beneficial 2. Avoid touching any portion of the feeding system that will come into contact with formula. E.g., the container feeding port, piercing pin on the feeding set. 3. Reduce handling by using pre-filled containers. 4. Reduce the number of times that a delivery system must be disconnected. 5. Use clean technique when refilling or changing feeding containers. 6. Assemble feeding systems on a clean, dry, disinfected surface not on the patient’s bed