The Australian healthcare system is currently navigating its biggest crisis in modern history - perhaps ever - with the current COVID-19 threat.

Healthcare-associated infections are already the most common complication affecting patients in hospitals around the country. The high infection spread rate associated with the virus that causes COVID-19 is posing significant challenges for hospital staff.

As Coronavirus restrictions begin to ease within the general population, healthcare infection control procedures remain as important as ever. Both for protecting patients, and also the staff who care for them.

Transmission based precautions

Given the multiple routes of transmission, there are three precautions hospitals must uphold.

Contact precautions

Used to control infection transmission that occurs through direct or indirect contact within the immediate environment, such as care equipment. Contact transmission is the most common cause of infection spread.

Droplet precautions

Droplets from the respiratory tract of a patient with COVID-19 can spread to other people in the vicinity when that patient coughs or sneezes. The maximum distance for droplet transmission is estimated to be approximately 1 metre around the infected patient.

Airborne precautions

These are used to prevent and control infection transmission for droplets hanging around in the air after being expelled from the respiratory tract of an infected patient. It’s estimated that the virus can last 3 hours while airborne.

Infection control procedures in hospitals must include:

Risk assessment

Patients must be promptly assessed for infection risk upon arrival, and also throughout their inpatient stay. Patients with symptoms of COVID-19 should be segregated as soon as possible.

Hand hygiene

Hand hygiene is a critical element of standard infection control, and essential to reduce the transmission of this Coronavirus and other pathogens.

All staff, patients, and visitors should decontaminate their hands using alcohol-based disinfectant immediately before and after every episode of patient care or close contact.

Cough hygiene

Patients, staff, and visitors should be encouraged to use tissues over the nose and mouth when sneezing, coughing, or blowing their nose. Foot-operated waste bins should be available for immediate disposal of tissues after use.

Personal Protective Equipment (PPE)

Staff need to be adequately protected against the risks associated with the procedure being undertaken. All staff should be trained in how to properly use all PPE they may need to wear, including disposable aprons, disposable gloves, and eye protection.

Safe management of linen

Linen is already categorised as ‘infectious’ in hospitals. It’s important that strict handling measures remain in place to combat the spread of the infection. These measures include using disposable gloves and aprons when handling used linen, and transporting it in a manner that prevents exposure to their own person, as well as the surrounding environment.

When handling linen, staff should not shake or sort it after removal, or place it on the floor or any other surfaces (such as tables). Instead, it should be placed in a water-soluble bag and secured, then placed into the closest laundry receptacle.

Staff uniforms

Appropriate use measures including PPE aim to protect staff uniforms from contamination. Hospitals and other healthcare facilities should provide changing rooms where their staff can change in and out of their uniforms each shift.

Hospital laundry services should be used to launder staff uniforms using the same precautions as they would other infectious linen. If there is no laundry facility available on-site, staff should be provided with a disposable plastic bag to take their uniforms home in to launder. Uniforms should be laundered separately from their other household linen or clothes, and at the maximum temperature the fabric can tolerate. Then it should be tumble dried instead of hung on a line.

Environment

Along with the other measures above, patient rooms, cohort areas, and clinical rooms must be decontaminated daily. Frequently touched surfaces within these spaces, such as toilets, door handles, medical equipment, bed tables, and bed rails should be cleaned at least twice daily, as well as immediately after they have come into contact with a body fluid or secretion.

Staff management

It’s imperative that staff experiencing flu-like symptoms do not come to work. As a general principle, all employers should discuss with employees who are at risk or are pregnant the need to be deployed away from areas with a high COVID-19 risk.

Equipment maintenance

Healthcare equipment such as beds, wheelchairs, walking aids, mattresses, bariatric equipment and other high-touch equipment must be thoroughly disinfected before and after use.

At Keystone Healthcare, we offer a cleaning and maintenance service for all our healthcare safety equipment. Our team pick up and transport equipment to our facility in Victoria which houses medical-grade washing and drying equipment, a repairs and servicing workshop and our logistics facilities.

Keystone also has a Hygiene Washer that can be installed in a facility that allows for hard surfaced equipment to be washed and sanitised, for example, wheel chairs, walking aids and other equipment.