Basing Infection Control Protocol on Disease Transmission Realities
Creating and adhering to an infection control protocol is essential to mitigating the risk of infection in any healthcare space, but despite the fact that healthcare-associated infections (HAIs) are possible anywhere, there’s no single solution. In some cases, basic disease transmission prevention may not be enough, and more tailored protocols are required. So how you do determine what to include in an infection control protocol?
In the case of a disease outbreak or abnormally high risk levels of infection for a particular disease, specific protocols for the infecting organism may be required. For example, respiratory hygiene/cough etiquette, which is now considered a standard disease prevention practice, was initially developed in response to SARS (severe acute respiratory syndrome) outbreaks.
In case of risk of airborne infections, the World Health Organization recommends a three-pronged approach: administrative control, which includes education of healthcare workers and patients, environmental control, which includes appropriate ventilation and air sanitation measures, and personal respiratory protection measures such as sterile face masks and minimized interaction between affected and vulnerable staff and patients.
Contact transmission precautions focus on two areas: patient placement and movement, and sterile environments. Patients infected with a disease that is transmitted through contact should be isolated from vulnerable populations, and be placed in a single patient space if available. Movement and transportation should be limited unless medically necessary. In addition, any care implements should be either disposable or dedicated to a single patient, and particular care and priority should be given to cleaning and sanitizing patient care spaces.
For droplet-transmitted infectious organisms, control the source by having the patient wear a sterile face mask that is changed regularly and disposed of safely. Limit patient movement and do not place them in the same care space as a vulnerable individual. Healthcare staff should use personal protective equipment (PPE) as needed.
Different locations can be at greater risk than others of transmission of certain diseases. For instance, outbreaks can originate in one location, then spread throughout the country and globe via travel or trade. A recent example is the rapid spread of and resulting panic over the Ebola outbreak from 2014-2016. In addition to dispatching researchers and healthcare workers to source countries in Africa, the CDC implemented an infection control protocol in the US that included widespread education and awareness efforts, as well as procedures to isolate and treat infected patients as quickly as possible. With a focus on large population areas and low-income communities where treatment is sought less frequently and disease can spread quickly, the CDC aimed to prevent a large-scale outbreak in the United States.
In the case of certain diseases, some populations are more vulnerable than others. Much of the US population is familiar with the prevention procedures for influenza, including hand washing, respiratory hygiene and cough etiquette, and receiving an annual vaccine, but in healthcare facilities that treat children and the elderly, preventing the spread of influenza is particularly important. While the disease may not be a major concern for healthy adults, influenza can be deadly to children, seniors, and individuals with compromised immune systems. Be sure to consider risks unique to different populations treated in your healthcare facility when developing an infection control protocol.
It’s important to keep in mind that the best infection control protocols incorporate all the relevant factors, not just one or the other. Because conditions in healthcare facilities can change rapidly, it’s best to evaluate the situation regularly, take note of changes, and update the protocol as needed. With both baseline and situation-based protocols for disease transmission prevention in place, you can create a safer environment for healthcare workers and patients alike.