Introduction INFECTION CONTROL IN SPECIFIC HEALTHCARE SETTING

Policies and Procedures on Infection Control Ministry of Health Malaysia 83

6.1.4 Handwashing

• Adherence to good hand hygiene is mandatory. • Rings, watches, and bracelets should not be worn while providing patient care. All jewelry should be removed before hand hygiene as this interferes with effective handwashing. Cuts and abrasions should be covered with waterproof dressings. • All personnel will perform a 2-3 minute scrub with an antiseptic soap prior to beginning patient care in the nursery and upon re-entering the nursery care area. This scrub should include all areas of the hands and arms to the elbows. 4 chlorhexidine is the recommended handwashing preparation. • Alcoholic Chlorhexidine 4 as a fast acting skin rub disinfectant may replace handwashing especially in situations where there is no visible contamination of the hands and decontamination is needed urgently. • The handrub solution must come into contact with all surfaces of the hand. The hands must be rubbed together vigorously, paying particular attention to the tips of the fingers, the thumbs and the areas between the fingers, and until the solution has evaporated and the hands are dry. • Hands that are visibly soiled or potentially grossly contaminated with dirt or organic material must be washed with liquid soap and water first. • A 10-15 second wash will be performed before and after patient contact or after contaminating the hands. • Hands must be washed after gloves are removed. • Other healthcare workers involved with neonatal care, including radiographers, physiotherapists and occupational therapists must observed strict hand hygiene before and after attending to these neonates.

6.1.5 Newborn Isolation

• Most infections in newborns do not require special isolation precautions. General newborn care measures will prevent transmission of most infections between newborns. • For most infections, where air control is not necessary, an isolation area can be defined in the nursery or NICU . • Infants suspected or diagnosed with infections transmitted by contact or droplets i.e., rubella, mumps, pertussis, and RSV may require special precautions. A distance of at least three feet should separate infected infants from other patients. • Cohorting of infants may be used at times of nosocomial outbreaks. All patients with multiresistant organism infection should be clearly identified. • There are no special restrictions for admission of infants born outside the hospital. They should be treated the same as infants born in the hospital. Infants suspected or diagnosed with certain infections i.e., varicella, measles, TB require special precautions. Infants of mothers with perinatal varicella or measles should also be isolated. Isolation needs are determined by the mode of transmission of the pathogen involved, the number of infected or colonized newborns, and the care required by those newborns. The use of a negative pressure room can be considered where appropriate.