Policies and Procedures on Infection Control
Ministry of Health Malaysia
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7. Once supplies are opened they should not be left unattended. Sterile set-ups should
not be covered for future use. 8.
Non sterile person should not reach over the sterile field. Sterile persons should not reach over non sterile areas.
9. Fabric or paper wrapped sterile items which are dropped on the floor should be
considered non sterile and should not be used. 10. Once the patient has entered the theatre where sterile supplies have been opened,
those supplies may only be used on that particular patient. These supplies should be discarded in the event of cancellation.
11. Large bundles of packages should be opened on a flat surface and not while holding it in the hand.
12. Opened sterile bottles should be used for only one patient. The entire contents of bottle should be dispensed or the remainder discarded.
13. Care should be taken when pouring solutions to avoid splashing. The scrub nurse should hold the edge of the table so that circulating nurse need not reach over the
sterile field to pour. The solution should be poured in a slow steady stream.
6.3.16 Maintaining the Sterile Field
1. Precautions should be taken to prevent moisture contamination and subsequent
strike-through by using water resistant materials. 2.
The scrub team should remain close to and face the sterile field. Movement is only from sterile to sterile areas. When changing positions the scrub personnel will pass
front to front or back to back. They should avoid changing levels, they either sit or stand. Talking should be kept to a minimum. Scrub personnel should not lean on
sterile areas.
3. The unscrubbed team should remain at least one foot 30cm from the sterile field.
Movement is from non sterile to non sterile area. They should not pass between sterile areas.
4. Breaks in aseptic technique should be monitored, documented and corrective action
taken as soon as possible. 5.
A sterile field is maintained by: •
Placing only sterile items within the sterile field. •
Opening, dispensing, or transferring sterile items without contaminating them. •
Considering items located below the level of the draped client to be non sterile. •
Not allowing sterile personnel to reach across non sterile areas or vice versa or to touch non sterile items.
• Recognizing and maintaining the service provider’s sterile area.
• When gowned this area extends from chest to the level of the sterile field; sleeves
are sterile from 5 cm above the elbow to the cuff. The neckline, shoulders, and back are considered to be non sterile areas of the gown.
Policies and Procedures on Infection Control
Ministry of Health Malaysia
99
• Recognizing that the edges of a package containing a sterile item are considered
non sterile; •
Recognizing that a sterile barrier that has been penetrated wet, cut or torn is considered contaminated;
• Being conscious of where your body is at all times and moving within or around
the sterile field in a way that maintains sterility; •
Not placing sterile items near open windows or doors.
6.3.17 Management of infectious cases that requires additional precaution. e.g.TB, MRO. 1.
Pre-operative Management
• Appropriate personal protective equipments should be worn when managing
hazardous procedures.. •
All infectious cases should be listed last, unless emergency situation. Terminal cleansing will have to be done after this. Patient to be sent straight from ward to
the operation room. •
All personnel involved should be informed regarding the infectious case. •
Proper specific disposable and protective attire to be used by all personnel. •
Personnel involved should be kept to the minimal.. •
Only specifically required equipment should be kept in the operation room.
2. Intra operative
• Induction of patient to be done on operation table in the theater. Disposables
items should be use wherever possible.. •
Gentle handling during draping is required to minimize aerosol contamination of environment.
• Additional protective face shield should be worn during the procedure to protect
splashes. •
Any operating attire to be changed as soon as possible when soiled during the procedure.
• All the clinical waste should be thrown onto the clinical waste bin,and sharps to
be disposed into sharp bin by the person handling the sharp.
3. Post operative
• Surgical instruments should be sent to CSSD as soon as possible.
• Whenever it is not possible to do so after office hours –soak in disinfectant for 30
min, pick up to rinse and pack for CSSD cm, the blood should be wiped off the instruments and rinsed with water and soaked with high–level disinfectant adhering
to manufacturer’s recommendations and then sent to CSSD. to confirm with CSSD section- stuck
• All laboratory specimens must be in clean secure containers and placed into the
biohazard specimen plastic bag before being send to pathology.
