Infection prevention and control systems
Evidence-based systems are used to mitigate the risk of infection. These systems account for individual risk factors for infection, as well as the risks associated with the clinical intervention and the clinical setting in which care is provided. A precautionary approach is warranted when evidence is emerging or rapidly evolving.
Patients, consumers and members of the workforce with suspected or confirmed infection are identified promptly, and appropriate action is taken. This includes persons with risk factors for transmitting or acquiring infection or colonisation with an organism of local, national or global significance.
The health service organisation is clean and hygienic and has well-maintained and configured engineering systems for the delivery of effective models of care.
Infection control is a health and safety issue. All people working in the health service organisation are responsible for providing a safe environment for consumers and the workforce. Infection prevention and control programs should be in place, in conjunction with use of the hierarchy of controls, to reduce transmission of infections so far as is reasonably practicable.
Infectious agents transmitted during provision of health care come primarily from human sources, including patients, members of the health workforce and visitors. Successful infection prevention and control measures involve implementing work practices that prevent the transmission of infectious agents using a two-tiered approach: standard precautions and transmission-based precautions.
Standard precautions are basic infection prevention and control strategies that apply to everyone, regardless of their perceived or confirmed infectious status. Strategies include hand hygiene, personal protective equipment, cleaning, and appropriate handling and disposal of sharps. These are a first-line approach to infection prevention and control in health service organisations and are routinely applied as an essential strategy for minimising the spread of infections. Standard precautions minimise the risk of transmission of infectious agents from one person or place to another, even in high-risk situations, and render and maintain objects and areas as free as possible from infectious agents.
Transmission-based precautions are specific interventions to interrupt the mode of transmission of infectious agents. They are used to control infection risk with patients who are suspected or confirmed to be infected with agents transmitted by contact, droplet or airborne routes. Transmission-based precautions are recommended as extra work practices in situations when standard precautions alone may be insufficient to prevent transmission. Transmission-based precautions are also used during outbreaks to help contain the outbreak and prevent further infection. Transmission-based precautions should be tailored to the infectious agent involved and its mode of transmission – this may involve a combination of practices.
Hand hygiene is an essential infection prevention and control strategy. The current National Hand Hygiene Initiative promotes a multimodal approach to improving hand hygiene. That includes:
- The use alcohol-based hand rub at the point-of-care
- Ensuring uniform hand hygiene and infection prevention and control education
- Monitoring hand hygiene compliance and performance feedback
- Using hand hygiene programs that ensure culture change.
Aseptic technique, use of invasive medical devices, workforce immunisation and screening for vaccine-preventable diseases, and environmental cleaning are also important elements of infection prevention and control systems. Health service organisation management is responsible for overseeing the systems and processes to maintain a clean, hygienic environment, including maintenance and upgrading of buildings and equipment; environmental cleaning of the buildings and infrastructure; evaluation of the infection risks for new products or equipment; and linen handling and management.
For further information on implementing systems for standard and transmission-based precautions, refer to the Australian Guidelines for the Prevention and Control of Infection in Healthcare.