Mod3 Infection Control in Healthcare Settings

Legal and Legislative Framework

• The Policy Directive integrates with several laws including:
  • Health Practitioner Regulation National Law Act 2009 (NSW)
  • Public Health Act 2010 (NSW)
  • Food Act 2003 (NSW)
  • Privacy Act 1988 (Commonwealth)
  • Health Records and Information Privacy Act 2002 (NSW)
  • Therapeutic Goods Act 1989 (Commonwealth)
  • Public Health Regulation 2022 (NSW)
  • Work Health and Safety Act 2011 (NSW)
  • Protection of the Environment Operations Act 1997 (NSW)
• The Health Practitioner Regulation (NSW) Regulation 2016 outlines standards for infection prevention for various healthcare practitioners including medical professionals and nurses.
• Dental practitioners must adhere to the Australian Health Practitioner Regulation Agency (Ahpra) Shared Code of Conduct regarding infection control.

Clinical Governance Requirements

• Each NSW Health Organisation needs an executive sponsor for their infection control program.
• Organizations must create procedures for:
  • Health worker communication and reporting of communicable disease risks.
  • Mitigating transmission risks of communicable diseases.
  • Managing human resource issues, including redeployment and return to work.

Respiratory Protection Program

• Health workers providing care for patients on airborne precautions must have a respiratory protection program in place.
• Follow the CEC Respiratory Protection Program Manual for specific guidelines.

Risk Identification Requirements

• Individual infection risk assessment is vital for determining potential infection sources among patients, visitors, and caregivers.
• Specialised healthcare areas require high-quality air delivery:
  • Operating rooms, intensive care units, and similar areas must maintain dedicated return air paths.
• Effective ventilation systems are essential for controlling the spread of infectious diseases.
• Consultation with stakeholders is necessary for temporary structures in clinical areas to avoid airflow risks.

Environmental and Engineering Controls

• Healthcare facilities must meet strict standards as per the Australasian Health Facility Guidelines.
• The efficacy of portable air filtration devices remains inconclusive; usage should be limited to specific deficient situations.
• Proper protocols around the management and safe use of air filtration devices are essential.

Personal Protective Equipment (PPE) Compliance

• The Infection Prevention and Control Practice Handbook outlines PPE selection and usage.
• Evaluate environmental sustainability impacts while implementing PPE.
• Health workers must not introduce unapproved PPE into healthcare facilities.

Infection Control and Monitoring

• Gloves are mandatory for any potential exposure to body substances; they must be worn on both hands.
• Sterile gloves are required for any contact with key sites.
• Ongoing compliance monitoring and feedback are necessary for adherence to infection control standards.

Multidrug-Resistant Organisms (MRO) Screening

• Targeted MRO screening plans must be established in acute-care settings based on:
  • Local MRO prevalence and patient admission reasons.
  • Functional risk of the patient's unit and likelihood of MRO carriage.
• Screening results inform ongoing infection prevention strategies and actions.

Revision History

• PD2023_025 approved in September 2023, updating references to the COVID-19 Infection Prevention and Control Manual and Respiratory Protection Program Manual.
• PD2017_013 was a composite update of several infection control policies including hand hygiene and multi-resistant organism prevention.

Key Definitions

• Body Substance: Emphasizes precautions against contact with solid tissues and various body fluids excluding intact skin, hair, and sweat.
• Cleaning: Involves removing visible soil from surfaces using water and detergents or enzymatic products.

Clinical Governance

• Establishes a framework for accountability across all organizational levels to enhance service quality and ensure patient care standards.

Infection Prevention and Control

• A disease cluster is defined by a high incidence of a specific microorganism in close timing and location, necessitating organized monitoring.
• Colonisation refers to organisms detected at specific sites without signs of infection, highlighting the importance of communication about communicable diseases among health workers.

Respiratory Protection Program

• Mandatory respiratory protection for health workers caring for patients with airborne pathogens.
• NSW Health Organizations must adopt guidelines from the CEC Respiratory Protection Program Manual.

Risk Assessment

• Infection risk is evaluated through patient assessments to identify potential infection sources, leading to prioritized intervention measures.
• Facial protection required for procedures involving possible exposure to body substances, maintaining mucous membrane safety.

Personal Protective Equipment (PPE)

• Surgical Masks: Essential for protecting against splashes and droplets and must be worn during procedures involving potential exposure.
• Masks must be based on risk level assessment and should be utilized throughout any relevant exposure or task duration.

Waste Management Protocols

• Clinical waste must be disposed of properly in clinical waste streams, while sharps are to be discarded in designated sharps bins.
• Non-clinical waste has to be directed to general waste or specific recycling if applicable.

Respiratory Hygiene and Cough Etiquette

• Individuals with acute respiratory symptoms are required access to hand hygiene products and masks in NSW Health Organizations.
• Health workers exhibiting respiratory infection symptoms should not attend work, following local or state protocols for potential respiratory infections.