Post-operative care measures Non-critical items - instruments or objects that come in contact with intact

Policies and Procedures on Infection Control Ministry of Health Malaysia 71

5.3.3 Prevention of Postoperative Pneumonia

The following patients are high risk for developing postoperative pneumonia: i. Age 60 years ii. History of chronic lung disease or smoking iii. On steroids for chronic conditions iv. History of chronic alcohol consumption v. Impaired sensorium vi. History of cerebrovascular accident with residual neurologic deficit vii. General anaesthesia viii. Upper abdominal or thoracic surgery ix. Emergency surgery xi. Obesity 1. Patients at risk should receive pre and postoperative instructions on deep breathing exercises and incentive spirometry. 2. Encourage all postoperative patients to take deep breaths and ambulate them as soon as possible postoperatively, unless medically contraindicated. 3. Provide adequate postoperative analgesia to facilitate effective coughing and deep breathing.

5.3.4 Sterilization or disinfection and maintenance of respiratory equipment and devices

1. For sterilization or disinfection of respiratory equipment, refer policy and procedure of nosocomial infection in general intensive care unit. 2. Do not routinely sterilize or disinfect the internal machinery of mechanical ventilators 3. Do not routinely change the ventilator breathing circuit on the basis of duration of use. Change the ventilator breathing circuit when visibly soiled. 4. Drain and discard periodically any condensate in the circuit. Take precautions not to allow the condensate to drain towards the patient. 5. Use sterile water to fill bubble-through humidifiers. 6. Do not routinely change more frequently than every 48 hours an HME that is in use on a patient. Change when it malfunctions mechanically or becomes visibly soiled. 7. Change the oxygen delivery system tubing, nasal prongs or mask that is in use on one patient when it malfunctions or becomes visibly contaminated or between uses on different patients. 8. Clean, disinfect, rinse with sterile water and dry nebulizers between treatments on the same patient. Replace nebulizers with those that have undergone sterilization or high-level disinfection between uses on different patients.