Adhiparasakthi Dental College IPC Manual 2023 PDF

ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 1 Version: 03 Issue:01...

ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 1 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6 1.0. PURPOSE: 1.1. To prevent/minimize the risk of infection in dental settings. 1.2. To promote awareness for each dental personnel in the importance of standard precautions. 1.3. To provide a framework for the education of dental healthcare personnel in the infection prevention and control. 2.0. SCOPE: 2.1. Hospital Wide 3.0. ABBREVIATION: 3.1. NABH : National Accreditation Board for Hospitals and Health care providers. 4.0. REFERENCE: 4.1. NABH: Accreditation Standards for Dental Health Care Services Provider, 3rd edition April 2023/IPC 4.2. IPC – 1 : The DHSP has a comprehensive and co-ordinated Infection Control (IC) Programme aimed at preventing, reducing/eliminating risks to patients, visitors, care providers and the community 4.3. IPC -2 : The DHSP provides adequate and appropriate resources for infection prevention and control. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 2 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6 4.4. IPC - 3: The DHSP implements the infection prevention and control programme in clinical areas. 4.5. IPC – 4: The DHSP implements the infection prevention and control programme in non- clinical areas. 4.6. IPC – 5: The organization performs surveillance to collect and monitor infection prevention and control data. 4.7. IPC -6: Infection prevention measures includes sterilization and disinfection of instruments, equipments and devices. 5.0.HOSPITAL INFECTION CONTROL COMMITTEE:  Chairperson: Correspondent  Infection Control officer: Professor& Head Oral Pathology  Infection Control Nurse  Quality Manager  NABH Co-ordinator  Members from: Department of Oral Surgery Department of Periodontics PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 3 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6 Department of Endodontics Department of Oral Medicine Department of Prosthodontics Department of Oral Pathology 5.1 Objectives of the committee:  To minimize the risk of infection to patients, staff and visitors.  To identify the roles and responsibilities of key personnel involved in the prevention and control of infection.  To maintain surveillance over hospital acquired infections.  To develop a system for identifying, reporting, analyzing, investigating and controlling hospital acquired infections.  To review and update hospital infection control policies and procedures from time to time.  To help to provide employee health education regarding matters related to hospital acquired infections. 5.2 Meetings The infection control committee meets once in 3 months and otherwise as necessary. Documentation of meetings and recommendations are kept with the Quality Manager / Infection control nurse and will be reported to the Head of the Institution. The ICN (Infection Control Nurse)/ Matron PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 4 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6 Conduct inspection rounds frequently/Daily. Registers are maintained by Infection Control Nurse / Quality Manager. 6. RESPONSIBILITY OF INFECTION CONTROL CORE TEAM: 6.1. Team Members: The infection control team consists of the following members:  Oral surgeon  Infection Control Nurse  Pathologist  Quality Manager / NABH Coordinator  All Department Representatives  Housekeeping In charge 6.2. Responsibilities of the Infection Control Team:  Advise staff on all aspects of infection control and maintain a safe environment for patients and staff.  Advise management of high risk patients.  Provide a manual of policies and procedures for aseptic, isolation techniques.  Provide relevant information on infection and take corrective measures. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 5 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6  Assist in training of all new employees as to the importance of infection control and the relevant policies and procedures.  Have written procedures for maintenance of cleanliness.  Surveillance of infection, data analyses, and implementation of corrective steps. This is based on reviews of lab reports, reports from nursing in-charge etc. (Fumigation)  Waste management  Supervision of isolated patients.  Monitors employee health programme.  Addresses all requirements of infection control and employee health as specified by NABH, state and local laws. 6.2.1. Role of infection control officer  The ICO overall coordinate the committee team.  Formulation and review of antimicrobial policy guidelines in conjunction with various specialties and infection control committee.  Monitor the decisions of the infection control committee.  To organize infection control training programme for various categories of staff.  To carry out surveillance activity. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 6 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6 6.2.2. Role of the Pathologist  The Pathologist shall be responsible for:  Carrying out random surveillance, when necessary by applying methods of random surveillance for checking sterilization, disinfection and environment.  To carry out the infection control activity as per policy as decided by the infection control team or committee.  To carry out education programme in infection control practices, in conjunction with other departments and areas of patients care. 6.2.3. Infection Control Nurse (ICN): Role of infection control nurse:  The duties of the ICN are primarily associated with ensuring the practice of infection control measures by nursing and housekeeping staff.  Identifying problems and implementing solutions. In addition the ICN conducts Infection control rounds and maintains the checklist.  ICN is also involved in education of paramedical staff including nurses and housekeeping staff.  The necessary data related to surveillance of infection is collected by ICN. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 7 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6 6.2.4. Role of Nursing In charge:  Maintaining the hygiene in the hospital. She shall have a very thorough knowledge of the hospital hygiene Programs and ensure that it is properly implemented  Keep extremely close watch on the aseptic techniques, hand washing, equipments used for diagnosis or treatment and also visitors. POLICY: 7. Employee health programme: 7.1.Employee health education: An in-service training session related to patient safety issues, standard precautions, biomedical waste management, hand hygiene practices will be conducted for staffs of all categories once in a year by the infection control officer. All infections including cutaneous and or other diagnosed communicable diseases e.g hepatitis, mumps, rubella, measles, chicken pox, diarrhea, productive cough more than three weeks, rashes etc., are to be reported by staff to their immediate supervisor at which time appropriate action to protect the patients in the hospital will be taken. All staff are informed that they should report exposure to potentially infectious blood or body fluid to their immediate supervisor who in turn informs the Infection Control Nurse or Quality Manager in the absence of ICN. Action is taken after assessment of risk at each situation. Work restrictions may be imposed in situations which PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 8 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6 call for such action. Personnel shall adhere to policies and practices to minimize the potential spread of diseases and or infection. 8. Infection control committee in community outbreaks: Infection control committee co-ordinates with external agencies which includes biomedical waste disposal and pest control activities to manage community outbreaks. Training session are being conducted to the staffs involved in biomedical waste segregation and pest control activities. 9. Infection prevention and control programme assessment and review: The infection prevention and control programme shall be assessed, reviewed and updated regularly based on newer literature on infection prevention, outbreak prevention mechanisms, infection trends and also based on the outcome of the audit processes conducted using WHO and CDC guidelines. 10. Management of patients with high risk: 10.1. High Risk Patients Those patients who are prone to suffer from blood and blood borne related congenital or acquired infections, and High risk communicable disease patient. 10.2. Policy:  The hospital shall offer special care taken as per the following laws and acts to those who are considered as high risk group such as blood and blood borne related congenital or acquired PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : APDH/NABH/IPC/ Issue Date: Page 9 Version: 03 Issue:01 01/02/03/04/05/0 03/05/2023 of 44 6 infections such as HIV, Hepatitis , HSV positive patients and high risk communicable disease patient.  Staff shall be trained to care for high risk group and awareness about high risk group shall be provided to all care providers.  Patients identified as high risk will be treated via AAA approach (Advice, Analgesia, Antibiotics) in the first instance but there will be occasions where this approach is not suitable and dental treatment is required in case of emergency. 10.3. Procedure: Care Of High risk Patients  Patients demographic data will be registered in medical record department. All new patients and patients without appointment will be received in Oral Medicine department after registration at medical record department.  Detailed case documentation will be recorded in Oral medicine department, case history & review of system will be documented.  After analyzing the patient’s medical status, suspected high risk patients will be sent for suitable investigations.  Patients diagnosed or confirmed with high risk group will be shifted to Isolation room and further procedures will be carried out in Isolation room.  The patient must wear a face mask at all times (other than when actually receiving their treatment) and be asked to use handwashing facilities before and after their appointment.  The practice must be mindful of the areas, the patient has come into contact with, during their visit and ensure stringent cleaning of surfaces once the patient has left the premises. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 10 of 01/02/03/04/05/0 03/05/2023 44 6  The practice must ensure the patient’s appointment is the last of the day, with no patient cross- over and minimal staff contact at the practice (i.e. the treating doctor and nurse only where possible). Recommended PPE must be worn by all staff at the practice.  The instruments used for those patients will be segregated separately, those instruments will be sent to CSSD separately. Maximum if possible disposable instruments are used for such patients.  For all group of High risk patients Red flag symbol identification will be reflected in HIS and Red color coded signage label is sticked in UHID card as "SAFETY FIRST".  Consultant will be called to isolation room to carry out treatment procedure for high risk patients. Separate register is maintained in Isolation room to document the treatment procedure details of the patients. 11. Spill Management:  In hospital spillage of body fluids can occur at any time due to sample breaks in the laboratory area or during transportation, or because there is excessive bleeding during the procedure. Body fluid spillage poses risk to the staff, visitors and patients who are extremely susceptible to infection. It is therefore essential for the hospital to have the right material and well trained staff to deal with spill immediately. 11.1. Spill management kit  Gloves x 2 pairs  Apron  Mask  Shoe cover or plastic bag to cover the shoes PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 11 of 01/02/03/04/05/0 03/05/2023 44 6  Absorbent material like tissue paper or blotting paper  Sodium hypochlorite 1% (Disinfectant)  Waste collection yellow bag  Sign Board  Cleaning equipment – bucket, mop, cloths, can be obtained from housekeeping and must be washed and disinfected appropriately after use. 11.2. Minor 30 ml:  Keep sign Board  Inform the housekeeping staff  Wear PPE kit  Keep required biomedical Waste Bin cover (Yellow)  Mark the spill area  Cover the area with absorbent paper  Pour freshly prepared 1% Sodium Hypochlorite Solution  For minor Spill Wait for 10 min  For Major Spill Wait for 20-30 min  Discard absorbent paper into Yellow cover  Clean the area with approved floor cleaner  Discard the PPE in proper biomedical waste cover and wash hands  Inform the incident to Infection Control Nurse  Document in Continuous Quality Improvement Form (Incident Report) PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 12 of 01/02/03/04/05/0 03/05/2023 44 6 All the spill kits must be readily available with all departments especially where risk of spill is more, like laboratory, sample collection room, wards etc. 11.3. Display of spill management protocols Spill management protocols need to be displayed at prominent locations in the hospital. Displayed protocols serve as a ready reference for the staff for management of spills. IEC materials displayed at point of use (POU). 11.4. Training of staff on spill management All the staff in hospitals needs to be trained in spill management protocols of the hospital. 12. Fund and resources for the infection prevention and control program: A sufficient budget will be allocated by the institution to carry out infection control and prevention activities. The budget includes the coverage of values required for procuring necessary equipment and resources to be used in clinical and non-clinical areas of the institution and also includes funding for training programme, health check-ups, pre and post exposure prophylactic vaccinations, ensuring compliance with the standards. The institution also provides sufficient infrastructure and resource supplies including hand hygiene facilities, hand wash, hand rubs, soap, personal protective equipment, biomedical waste bags and bins, disinfectant solutions, equipments and materials needed for sterilization process. Proper maintenance and replenishment of these supplies will be done regularly. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 13 of 01/02/03/04/05/0 03/05/2023 44 6 13. Staff health programme: 13.1. Staff Health Evaluation A pre-employment medical checkup is performed at the time of joining services for all staff. An annual medical checkup will be done for all staff of the hospital. Records are maintained by the HR Department. Vaccination for Hepatitis B, TT is given whenever necessary to the staff in the departments of nursing, lab services, housekeeping, maintenance, technicians and consultants who are not vaccinated. 13.2. Vaccination: HEPATITIS B VACCINE: This vaccination is given to all employees who are directly into health care Vaccination Record: A vaccination tracker is being maintained by the HR Department for all employees. 14. Resources: 14.1. Hand hygiene facilities in patient care areas: Large washbasins, tap, soap, hand rub, hand wash with dispensers, facility of drying hand without contamination are available in every patient care area and the instructions for hand hygiene compliances are displayed in every handwashing/scrubbing area respectively. The hand hygiene compliances are monitored regularly according to the WHO hand hygiene observation forms. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 14 of 01/02/03/04/05/0 03/05/2023 44 6 14.2. Personal protective equipment resources: The personal protective equipment includes gloves, protective eye wear, mask, apron, gown, shoe covers and cap/hair cover. All the health care workers are instructed to wear PPE appropriately to the risks involved and also removed as soon as the procedures associated with the risk are over. 15. Isolation rooms and barrier facilities: Patients with high risk are referred to isolation rooms located in OMFS department. Consultant will be called to isolation room to carry out treatment procedure for high risk patients. Separate register is maintained in Isolation room to document the treatment procedure details of the patients. Barrier facilities are available for radiological purpose. 16. Standard precautions (As per CDC Guidelines for Dental Settings) 16.1. The standard precautions should be applied to apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is delivered. 16.2. These practices are designed to both protect DHCP and prevent DHCP from spreading infections among patients. 16.3. Standard Precautions include: 16.3.1. Hand Hygiene 16.3.2. Use of personal protective e q u i p m e n t (e.g., gloves, masks, eyewear). 16.3.3. Respiratory hygiene/cough etiquette. 16.3.4. Sharps safety. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 15 of 01/02/03/04/05/0 03/05/2023 44 6 16.3.5. Safe injection practices. 16.4. Standard precautions should be applied to contact with: 16.4.1. Blood; all body fluids, secretions, and excretions (except sweat), regardless of whether they contain blood; 16.4.2. Non-intact skin; 16.4.3. Mucous membranes. 16.4.4. Saliva has always been considered a potentially infectious material in dental infection control. 16.4.5. Education and training are critical elements of standard precautions, because they help DHSP make appropriate decisions and comply with recommended practices. 16.4.6. When Standard Precautions alone cannot prevent transmission, they are supplemented with Transmission-Based Precautions. This second tier of infection prevention is used when patients have diseases that can spread through contact, droplet or airborne routes (and are always used in addition to Standard Precautions) PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 16 of 01/02/03/04/05/0 03/05/2023 44 6 16.3.1 HAND HYGIENE PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 17 of 01/02/03/04/05/0 03/05/2023 44 6 PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 18 of 01/02/03/04/05/0 03/05/2023 44 6 Five Moments of Hand Hygiene PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 19 of 01/02/03/04/05/0 03/05/2023 44 6 16.3.2 SEQUENCE FOR PUTTING ON PERSONAL PROTECTIVE EQUIPMENT (PPE) PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 20 of 01/02/03/04/05/0 03/05/2023 44 6 HOW TO SAFELY REMOVE PERSONAL PROTECTIVE EQUIPMENT (PPE) PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 21 of 01/02/03/04/05/0 03/05/2023 44 6 16.3.3 Cover your Cough PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 22 of 01/02/03/04/05/0 03/05/2023 44 6 16.3.4 SHARPS SAFETY Recapping a needle by hand. Do not do this. This shows the one-handed scoop technique, a safe way to recap a needle PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 23 of 01/02/03/04/05/0 03/05/2023 44 6 16.3.5 Safe Injection Practices Safe Injection Practices refers to the proper use and handling of supplies for administering injections and infusions. These practices are intended to prevent transmission of infectious diseas es between one patient and another, or between a patient and healthcare personnel during preparation and administration of parenteral medications. Unsafe injection practices that have resulted in disease transmission have most commonly included: o Using the same syringe to administer medication to more than one patient, even if the needle was changed or the injection was administered through an intervening length of intravenous (IV) tubing. o Accessing a medication vial or bag with a syringe that has already been used to administer medication to a patient, then reusing contents from that vial or bag for another patient. o Using medications p a c k a g e d a s single-dose or single-use for more than one patient. o Failing to use aseptic technique when preparing and administering injections. Dental practitioners should adhere to the following injection practices that are critical for patient safety: o Prepare injections using aseptic technique in a clean area. o Disinfect the rubber septum on a medication vial with alcohol before piercing. o Do not use needles or syringes for more than one patient (this includes manufactured prefilled syringes and other devices such as insulin pens). o Medication containers (single and multi dose vials, ampules, and bags) are entered with PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 24 of 01/02/03/04/05/0 03/05/2023 44 6 a new needle and new syringe, even when obtaining additional doses for the same patient. o Use single-dose vials for parenteral medications when possible. o Do not use single-dose (single-use) medication vials, ampules, and bags or bottles of intravenous solution for more than one patient. o Do not combine the leftover contents of single-use vials for later use. o The following recommendations should be applied if multi-dose vials are used: o Dedicate multi-dose vials to a single patient whenever possible. o If multi-dose vials will be used for more than one patient, they should be restricted to a centralized medication area and should not enter the immediate patient treatment area (e.g., dental operatory) to prevent inadvertent contamination. o If a multi-dose vial enters the immediate patient treatment area, it should be dedicated for single-patient use and discarded immediately after use. o Date multi-dose vials when first opened and discard within 28 days, unless the manufacturer specifies a shorter or longer date for that opened vial. o Do not use fluid infusion or administration sets (e.g., IV bags, tubings, connections) for more than one patient. 17. Managing exposure to potentially infectious body fluids: a. Categories of exposure:  Needle stick injuries  Non- intact skin exposure PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 25 of 01/02/03/04/05/0 03/05/2023 44 6  Mucosal exposure e.g. Splash into eye  (Immediate action to be taken) 17.1. Needles stick injury: DOs : Wash immediately with water and soap for 10 minutes. Report to immediate supervisor / staff in-charge. Inform hospital infection control nurse. Collect blood sample of Healthcare Providers immediately after exposure for HIV. HBsAg and HCV testing, Consent should be obtained for HIV testing. Fill up the incident / accident report form. Further follow up is by infection control nurse. Seek medical attention for any febrile illness that occurs within 12 weeks of exposure. Report to emergency and start prophylaxis within 1 hour if the blood report is positive. DONTs : Do not ignore. Do not place pricked finger into mouth. Do not squeeze from wound. PREPARED BY VERIFIED BY APPROVED BY INFECTION CONTROL OFFICER PRINCIPAL CORRESPONDENT  ADHIPARASAKTHI DENTAL COLLEGE AND HOSPITAL PROCESS MANUAL – INFECTION PREVENTION & CONTROL Doc No : Page APDH/NABH/IPC/ Issue Date: Version: 03 Issue:01 26 of 01/02/03/04/05/0 03/05/2023 44 6 Do not use bleach / alcohol / betadine / iodine. 17. 2. Non intact skin exposure:  Wash for 10 minutes with soap solution and water.  Report to supervisor.  Fill in the incident form 17.3. Mucosal exposure e.g. splash into eyes Eye irrigation procedure to be carried out in the lab services. The eyelid should be held open by another person wearing sterile gloves. Do not use soap and water or disinfectant. 17.4. Management: If index patient is known, patient is checked for HIV/ HBsAg antibodies. Injured health care worker is checked for anti HBs antibody and HIV after obtaining consent. Guidelines are appended to this manual. For HBV infection: In case, patient is positive, if health care worker has adequate anti HBs titre ->100MIU- only reassurance need be given. If titre is