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.
Policies and Procedures on Infection Control
Ministry of Health Malaysia
100
• Any contamination to the outside of containers should be cleaned with sodium
hypochlorite 1:100. Ensure the containers are tightly sealed to avoid spillage. •
Any linen used in operating room will be placed in alginate red linen bag to be treated and laundered in hot water.
• The room and all equipment should be decontaminated with solution sodium
hypochlorite 1:100 and leave to dry. The room can be reused once it’s dry.
6.3.18. Waste and Linen
1. Waste should always be disposed of with minimal handling because there is a risk
of blood-borne pathogen transmission. 2.
Body fluids should be disposed of in the sluice by staff with appropriate protective clothing such as gloves, aprons, and eye protection.
3. Used linen should be contained in hampers or in soiled laundry bags at the point of
use. Linen that is saturated with body fluids should be placed in fluid proof bags. 4.
Other contaminated waste should be handled and disposed of according to the facility’s medical waste process.
6.3.19. Cleaning of the Operation theatre
There should be a simple, clear, cleaning policy that can be adhered to easily. The cleaning equipment for the operating room must be dedicated and kept separate from the
outer zone.
1. Initial cleaning at the beginning of the day
• Clean floors and all horizontal surfaces operating procedure tables, examination
couches, chairs, trolley tops or Mayo stands, lamps, counters, and office furniture with a cloth dampened with water to remove dust and lint that may have
accumulated over night.
2. Concurrent cleaning between cases
• Clean operatingprocedure tables, examination couches, trolley tops or Mayo
stands, lamps, counters, and any other potentially contaminated surfaces in operating theatres and procedure rooms with a cloth dampened with a disinfectant
solution.
• Immediately clean spills of blood or other body fluids with a chlorine solution.
Clean visibly soiled areas of the floor, walls, or ceiling with a mop or cloth dampened with a disinfectant solution.
• Discard waste when plastic bags of waste containers that are 23 full. Discard
safety sharps disposal boxes, when they are 23 full. •
Do not perform special cleaning or closing of the operating theatres after contaminated or dirty operations. revise as in SSI section
• Thorough, routine cleaning is sufficient to provide a safe environment for subsequent
cases given the high frequency of air changes in the well designed OT.
