MMSR Manual 2021-Standard 8 (Infection control and Housekeeping).pdf

Standard 8 INFECTION CONTROL AND HOUSEKEEPING Attachments: FIGURE 8-1 Tetanus Vaccine Report FIGURE 8-2Cleaning of Blood Spills FIGURE 8-3 Floor sink FIGURE 8-4 Housekeeping Equip & Supplies 137  FIGURE 8-3 Floor sink 138 ...

Standard 8 INFECTION CONTROL AND HOUSEKEEPING Attachments: FIGURE 8-1 Tetanus Vaccine Report FIGURE 8-2Cleaning of Blood Spills FIGURE 8-3 Floor sink FIGURE 8-4 Housekeeping Equip & Supplies 137  FIGURE 8-3 Floor sink 138  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code Yes No NA 8.0 INFECTION CONTROL AND HOUSEKEEPING 1. VACCINATION PROGRAM CC/HCP The HCP shall ensure that their medical facilities have a vaccination program in place HCP as follows: 1. There is a vaccination program for all open wound injuries and is implemented. 2. Administered vaccines are appropriately logged in a book or database. Refer to Figure 8-1 3. As per MOH regulations, all staff before site assignment, shall be screened and CC/HCP immunized as follows: a. Chest X-ray. b. Tuberculosis skin test (tuberculin or PPD test). c. Hepatitis B (HBV) and Hepatitis C (HCV). d. Human Immunodeficiency Virus (HIV). e. There is evidence that screening and immunization were completed. f. Chest X-ray. 2. INFECTION CONTROL 1. The HCP shall ensure that staff knows and complies with the following standard HCP precautions: g. Hand washing. h. Gloves. i. Mask. j. Handling sharps. k. Disposal of contaminated waste. l. Cleaning of spills. m. Patient placement (isolation). 139  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code Yes No NA 8.0 INFECTION CONTROL AND HOUSEKEEPING 2. The HCP shall ensure that personal protective equipment (PPE) is always HCP available. At a minimum this includes, but is not limited to: a. Disposable Surgical masks. b. Gloves. c. Goggles and Face shield d. Gowns. e. Plastic aprons. f. Safety shoes. h. N95 mask, different sizes as per fit test recommendations 3. The HCP ensures that sterilization is not performed by soaking in liquids, HCP boiling and/or steaming. This is not an acceptable practice. 4. STERILIZERS are not present at the remote industrial medical facilities. The HCP shall ensure that all CSS supplies (instruments & packs) in their medical HCP facilities are disposable. At a minimum these include, but are not limited to: a. Dressing packs. b. Suture pack. c. Forceps. d. Tongue depressors. e. Dressing scissors (individual pack). Move #5 to the left5. Clinical areas have sinks (wash basins) available with the CC following: a. Hot and cold water. b. Antiseptic liquid soap. c. Wall mounted single paper towel dispensers. d. Trash bins. 6. The HCP shall ensure that their medical facilities have approved HCP alcohol-based hand-rub. 7. Staff knows and is able to demonstrate appropriate hand sanitizing/ Hand HCP washing 140  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code Yes No NA 8.0 INFECTION CONTROL AND HOUSEKEEPING 8. Hand washing technique as per established hand washing policy. HCP 9. Examination tables are protected with disposable cover sheets or paper rolls. HCP 10.The HCP shall ensure that their medical facilities have appropriate bactericidal HCP available and that it is used to disinfect hard surfaces. 11.Disposable linen stored in a protected clean area. HCP 12.Soiled linen placed (deposited) into covered, leak proof bags, as per HCP established criteria. 13.There are adequate puncture resistant, leak-proof sharp containers in all HCP clinical areas, as follows: a. All clinical areas have sharp containers. b. Sharp containers are wall-mounted. c. Replaced when they are three quarters (¾) full. 14.There is no recapping of needles. If used needles are recapped, the scoop HCP method is used. 15.Healthcare providers are able to verbalize what to do in the event of a needle HCP stick/sharps injury. 16.Housekeepers are able to verbalize what to do in the event of a needle HCP stick/sharps injury. 17. The HCP shall ensure that their medical facilities have a system in place for the safe management (identification, segregation, collection, storage, HCP transportation, treatment and disposal) of infectious wastes/ biomedical waste, as follows: a. System is in compliance with Infection Control (IC) guidelines and is in accordance with MOH regulations. b. Staff is familiar with and is able to verbalize the disposal protocol (i.e., all sharps boxes are securely taped shut, double boxed and transported to an approved agent for disposal). 18.The HCP shall ensure that their medical facilities have adequate color- HCP coded foot-operated waste bins, as follows: 141  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code Yes No NA 8.0 INFECTION CONTROL AND HOUSEKEEPING a. For regular waste. b. For infectious waste. c. Bins are labeled. 19.Laboratory specimens are handled, stored and transported in accordance HCP with established policy/protocol. 20. The HCP shall ensure that their medical facility have blood spill kits HCP available. For cleaning of blood spills and contents. Refer to Figure 8-2 21.There is evidence that personnel responsible for cleaning and HCP disinfecting blood and body fluids spills are adequate trained. 22. The HCP & CC shall ensure that their medical facilities have two (2) HCP/ CC dedicated refrigerators available, as follows: a. Medication refrigerator is used for medications only. HCP b. Refrigerator is used for staff’s food only. HCP c. Temperature is maintained between 2-8 degrees Celsius HCP d. (36-46 degrees Fahrenheit). e. There is a thermometer available in each refrigerator. HCP f. Refrigerator’s temperature is recorded twice a day in a log sheet. Log is HCP available upon request. g. Refrigerators are cleaned inside and out on a regular basis, and when HCP applicable, defrosted as needed. 3. JANITORIAL SERVICES 1. The CC shall ensure that their medical facilities have a dedicated part-time (at least 4 hours in morning shift and 1-2 hours in evening shift) for one CC Nurse operated Clinic or full day shift for large Nurse Clinic. Full-time janitor available every shift for Level A and B clinics. 2. The HCP and CC shall ensure that their medical facilities are cleaned inside HCP/CC and outside to acceptable healthcare standards. 3. The CC & HCP shall ensure that their medical facilities’ janitor receives training/orientation in medical housekeeping. On-site orientation performed HCP/CC by a nurse and/or a senior janitor is acceptable. Evidence of the orientation period/ training completion available upon request. 142  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code Yes No NA 8.0 INFECTION CONTROL AND HOUSEKEEPING 4. The CC & HCP shall ensure that their medical facilities’ janitor attended an HCP/CC infection control training/ class. 5. The CC & HCP shall ensure that their medical facilities’ janitor is appro- priately immunized prior to medical facility assignment. Evidence of immunization is HCP/CC available upon request. 6. The HCP shall ensure that their medical facilities’ janitor closet is clean and tidy. HCP For Floor sink sample Refer to Figure 8-3 7. The HCP shall ensure that their medical facilities’ cleaning agents and HCP disinfectants are appropriately labeled and stored. 8. The HCP shall ensure that their medical facilities’ color coded mops are cleaned HCP and disinfected on a daily basis. Evidence is available. 9. The HCP shall ensure that their medical facilities’ janitors use separate cleaning HCP equipment for toilet areas. This shall be in evidence. 10.The HCP shall ensure that their medical facilities according to their size and needs have sufficient housekeeping equipment and supplies. At a minimum these HCP include, but are not limited to: Refer to Figure 8-4. 11.The CC & HCP shall ensure that there is a regular (twice daily and as HCP/CC necessary) removal of trash from all clinical areas. 12.The HCP shall ensure that their medical facilities have a procedure for cleaning HCP blood spills and that it is posted. This shall be in evidence 13.Janitor and other staff know/verbalize the blood spill cleaning proce- dures and HCP/CC cleaning fluid dilution ratios, as per guidelines. 14.The CC & HCP shall ensure that their medical facilities’ are cleaned on a daily basis, cleaning is in evidence. At a minimum cleaning includes, but is not limited HCP/CC to: a. Damp dusting. b. Polishing floors and/or furniture as applicable. c. Vacuuming. d. Mopping of floor. e. Cleaning toilet areas. 143 Figure 8-1 Tetanus Vaccine Report Medical Facility: Date Given Patient Name Company ID Batch/Lot No. Nurse Signature ID No. 144 Figure 8-2 Cleaning of Blood Spills Spills of blood can occur in your medical facility. So, it is essential to keep in mind that it is not possible to identify patients with Hepatitis B virus (HBV) and/or Human Immunodeficiency Virus (HIV). Therefore, all blood and blood borne pathogens “shall be considered infectious.” A Blood Spill Kit shall be placed in all areas where blood spills are likely to occur, including medical facilities in remote areas. Each Spill Kit shall have the following items and supplies: One two-compartment plastic pail (dual bucket). Disposable shoe covers. Disposable safety glasses or plastic goggles. Disposable mask. Disposable gloves. Two (2) trigger sprayers or peri-bottles, labeled #1 and #2. One (1) measuring glass. Container of detergent/disinfectant mixed to correct ratio. Container of 5.25% sodium hypochlorite (Clorox). One (1) roll paper towel or disposable cleaning cloths (J-cloths). One (1) roll color-coded plastic bags for disposable of infectious waste. One “WET FLOOR” sign. One (1) laminated copy of these instructions. Cleaning Procedure: 1. Place “WET FLOOR” sign near to the spill. 2. Wear disposable gloves and mask. 3. If splashing is anticipated, protective eye wear, such as disposable goggles should be worn. Wear disposable coverall/gown if soiling of clothes is likely. 4. If there is a chance that shoes could become contaminated, wear shoe covers. 5. Prepare the disinfectant/detergent solution according to the following prescribed ratio: a. One 1 ounce of Beaucoup solution per one (1) gallon of sweet water. b. One 1 ounce of Clorox solution per nine (9) ounces of sweet water. Note: 145 For other chemical dilution ratios, see page 97. 6. Arrange the required color coded (yellow) bio-hazardous plastic waste bags, so they are ready to receive contaminated waste. 7. Use disposable paper towels to soak up and remove all spilled blood or body fluid. Place soiled disposable paper towels in the color coded (yellow) bio-hazardous bag. Repeat until all spilled blood or body fluid has been removed. 8. Spray or apply adequate approved disinfectant solution (Beaucoup) on the spillage area. Clean the area with fresh paper towels, being sure to remove all visible blood or body fluid. Dry with fresh paper towels. Place soiled disposable paper towels in the color coded (yellow) bio-hazardous waste bag. Spray or apply adequate Clorox solution on the spill area, ensuring that the entire spillage area is covered with Clorox solution. Allow a two minute contact time and then wipe the area thoroughly with disposable paper towels. Dry with fresh paper towels. Place soiled disposable paper towels in the color coded (yellow) bio-hazardous bag. 9. Wait for the area to completely dry before removing the WET FLOOR sign. 10. Clean and disinfect the trigger spray bottles and other non-disposable items, as these items are considered potentially contaminated. 11. On completion of the task, place all disposable protective garments, such as gloves, shoe covers, goggles and mask in the yellow plastic bag. Wash hands thoroughly using antiseptic soap, such as Scrub stat. 12. Replenish all disposable items in the spill kit and ensure it is ready for future use. Spills/Splashing of Walls: 1. Wear disposable gloves and mask. 2. If splashing is anticipated, protective eye wear (goggles) should be worn. Wear gown if soiling of clothes is likely. 3. Wear shoe covers if there is a chance of shoes becoming contaminated. 4. Prepare the disinfectant/detergent solution according to prescribed ratio. a. One 1 ounce of Beaucoup solution per one (1) gallon of sweet water. b. One 1 ounce of Clorox solution per nine (9) ounces of sweet water. 5. Arrange the required color coded (yellow) bio-hazardous plastic waste bags, so they are ready to receive contaminated waste. 6. Use disposable paper towels to soak up and remove all of the spilled blood or body fluid. Place soiled disposable paper towels in the color coded (yellow) bio-hazardous waste bag. 7. Spray or apply adequate SAMSO approved disinfectant solution (Beaucoup) on the spillage area. Clean the area with fresh paper towels, being sure to remove all visible blood or body fluid. Dry with fresh paper towels. Place soiled disposable paper towels in the color coded (yellow) bio-hazardous waste bag. 8. Spray or apply adequate Clorox solution on the spill area, ensuring that the entire spillage area is covered with Clorox solution. Allow a two minute contact time and then wipe the area thoroughly with disposable paper towels. Dry with fresh paper towels. Place soiled disposable paper towels in the color coded (yellow) bio-hazardous waste bag. 9. If it is found absolutely necessary to use a yellow scouring pad, this scouring pad should then be treated as infectious waste. 10. Double bag the scouring pad in yellow color plastic bag for disposal. 11. Clean and disinfect the trigger spray bottles and other non-disposable items, as these items are considered to be potentially contaminated. 12. On completion of the task, place all disposable protective garments, such as gloves, shoe covers, goggles and mask in the yellow plastic bag. Wash hands thoroughly using antiseptic soap, such as scrub stat. 13. Replenish all disposable items in the spill kit and ensure it is ready for future use. 146 Chemical Dilution Ratios Beaucoup Phenolic Germicidal Detergent One (1) ounce (30 milliliter) of Beaucoup per 1 gallon (3.7 liters) of sweet water. 147 Figure 8-4 Housekeeping Equipment and Supplies Minimum Requirement The quantity of each listed below depends on the medical facility category and utilization rate. Description Check (√) Remarks Mops, two (2) different colors. Trolley with dual mop bucket and wringer/portable bucket with wringer for small clinic. J cloth. Sodium hypochlorite (Clorox bleach). Antiseptic scrub for sinks (hibi-scrub/ hro-scrub 4). Trigger spray bottle. Detergent, upgrade or similar, e.g., beaucoup for patient area. Plastic bags for rubbish, color coded for infectious waste. Paper towels for sinks and spills. Paper towel dispenser. Wet Floor sign. Blood Spill Kit. Floor polish. Window cleaner. Furniture polish. General multi-cleaner with bleach for sinks, etc. Toilet bowl and urinal cleaner. Soap, liquid and dispenser. Waste bin, pedal type with lid for clinical waste. Waste basket, general purpose. Hand brush and dust pan. Gloves rubber, heavy duty. Hand sanitizer, ethyl alcohol 70% base, Sani-gel or Septo-gel. Housekeeping Equipment and Supplies Minimum Requirement 148