Quality control Procedure for post-mortem examination of known or suspected CJD

Policies and Procedures on Infection Control Ministry of Health Malaysia 126

3. Treatment room

i. Common treatment room

Common treatment room should be used with caution as this will risk contaminating the surrounding environment and dressing materials stored within the vicinity. Change of dressing is best done by the patient’s bedside. ii. Hydrotherapy room Hydrotherapy and its related equipments should be disinfected with high-level disinfection in between patients. It is difficult to disinfect the pipelines, drains or tanks as these aquatic environments will be continuously inoculated by organisms from patients and the caregivers.

4. Plants and flowers

Plants and flowers should not be allowed in the Burn unit as they harbor gram negative organisms such Pseudomonas species and fungi. These organisms may colonize the burn wound and many are intrinsically resistant to multiple antibiotics. 5. Toys Pediatric patient with burns should be restricted to non porous and washable toys only. This should be designated to individual patient use only, and thoroughly disinfect after use or before giving to another patient.

6.8.4 Patient Care Items and Equipments

All equipments and surfaces such as beds, side rails, tables, wheelchairs and trolleys should be adequately decontaminated Refer MOH guidelines for disinfection.

1. Non invasive items

• Non critical items such as blood pressure cuffs, oxygen mask, nasal prongs, tubing, stethoscopes, bedpans, wheelchair, infusion pumps if used on areas without dry, occlusive dressings, may need high-level disinfection. • These items should be restricted to an individual patient treated in the isolation room.

2. Invasive items

• This refers to the care of endotracheal tracheostomy tube,intravascular catheter and continuous bladder catheterization. Intravascular catheter should be placed through unburned skin, preferably at a sufficient distance from the wound to prevent contamination at the insertion site. If insertion of catheters is placed within or near the burn wound, appropriate dressing is required to cover the site of insertion. Prevention of UTI includes removal of the catheter as soon as it is no longer required for monitoring of urine output, maintaining a closed urinary drainage system, and performance of urinary catheter care. Policies and Procedures on Infection Control Ministry of Health Malaysia 127

6.8.5 Care Givers For Patient In The Burn Unit 1.

Care givers working short hours in the Burn unit This refers to doctors, paramedics, therapist, nutritionist and technical staff who are handling patients or equipments in the burn unit for short hours. Requirement: • Wear shoe cover or slippers provided before entering the unit. • Remove white coat before entering the unit • Hand hygiene before and after attending each patient. • Use disposable glove, surgical mask and disposable gown during handling of each patient. • Strict aseptic technique when performing procedure or change of dressing. • Follow contact precaution technique when entering the isolation room.

2. Full time Care givers

• Change to burn unit attire if available. • Wear shoe cover or slippers provided before entering the unit. • Comply to Hand hygiene.. • Use disposable glove, surgical mask and disposable gown during handling of each patient. • Strict aseptic technique when performing procedure or change of dressing. • Follow contact precaution technique when entering the isolation room. • Remove burn unit attire before leaving the unit. • Parentguardian accompanying their child should be supervised when handling patient. They should follow the contact precaution technique if their child is nursed in the isolation room.

6.8.6 Visitors

1. Only one visitor per patient is allowed at one time. 2. Wear disposable gown, shoe cover or slippers provided before entering the unit. 3. Hand hygiene should be supervised by the ward staff. 4. Physical contact should be limited especially for patient treated in the isolation room.

6.8.7 Care of the Burn Wound

1. Bathe patient daily in the hydrotherapy room. Exceptions are given to very ill patient; patient post wound debridement and skin grafting, or dressings that don’t require daily changes