Prevention of Cross Contamination

## Preventing of Cross Contamination

Hospitals make a great effort to protect their patients and
staff from contamination by using several safety precautions such as isolation,
sterilization, disinfection, aseptic techniques, hand washing and disposables,
patient care equipment and proper air circulation.

## Isolation

When there is unidentifiable breakout of a disease, the
infected patient is put into a private room. Isolation is usually reserved for
patients with serious infections such as haemorrhagic fever and diphtheria. This
is the most serious precaution taken to prevent further spread of infection throughout
the hospital. If this measure is not taken, the highly contagious patient will
contaminate objects, surfaces, other patients and staff. In cases where
patients are infected with infections such as pertussis, meningitis,
rhinovirus, and adenovirus infections healthcare workers are asked to wear a
mask, goggles and gown upon entering the isolated room. This protective gear
will further protect the staff from contact with the patients’ bodily fluids (Mehta
et al, 2014, p.157).

## Sterilization

Sterilization is another very important process to reduce the
spread of nosocomial infections.Sterilization is most effective when implemented after
thoroughly cleaning, which includes removing all dirt, debris and film. This
step is imperative because these things can protect bacteria and fungi. On the
bright side of things, cleaning and sterilization can remove more than 90% of
microorganisms *(Hospital Hygiene*,
1992, p. 152).  Sterilization can be achieved using two
methods, heat and chemicals. The heat method will dry out the microorganisms
and the likelihood of any surviving is one percent.Chemical sterilization is achieved using gas such as ethylene oxide, this
method will disinfect and sterilize the object. Unfortunately, the downside to this
technique is the high cost *(Hospital*
Hygiene, *1992* *p. 153).*

## **Disinfection**

Disinfectant is another important method used in a hospital to
control spread of infection on surfaces and objects. There are three different
levels of disinfects that can be utilize depending upon the substance/ surface
that needs to be disinfected. Please note disinfectants should never  be used on humans because it’s too toxic for
the human tissues. The three levels of disinfection are high-level
disinfection, intermediate disinfection, and low-level disinfection. High-level
disinfect will destroy all microorganisms including spores. Intermediate- level
disinfectants inactive vegetative spores, bacteria and most viruses, and
low-level disinfectants kill most bacteria, some viruses and fungi but not
bacterial spores *(Hospital*
Hygiene, *1992* *p. 154).*

## Aspectic Technique

An aseptic technique is another method used to reduce the
spread of infection on skin and wounds. Aseptic are generally safe to use on
the skin and wounds without disrupting the normal flora.  Examples of asepsis substances are alcohol,
hydrogen peroxide, and chlorhexidine these are all effective, safe to use and
budget friendly to the hospital *(Hospital*
Hygiene, *1992, p. 154).*

## Handwashing

Hand washing is the number one key technique used to reduce the spread of nosocomial infections. According
to World Health Organization recommends that staff should follow the 5 Guidelines
in Hand Washing:

(1)   Before touching a patient to protect the patient from
harmful germs carried on your hands

(2)   Before aseptic procedures to protect the patient against
harmful germs, including the patient’s own germs.

(3)   After body fluid exposure/risk to protect  harmful patient’s germs

(4)    After touching the patient  and to protect yourself and the health care environment from the harmful patient’s germs

(5)   After
touching the patient’s surrounding to protect yourself and the health care
environment from the harmful patient’s germs.Hand washing before and after making
contact with patient is imperative to reduce cross contamination. Also, proper hand washing with a sufficient amount of soap and water can remove 90% of germs. (*Hospital Hygiene,* 1992, p. 155). The use of antimicrobial soap can greater increase this number. Furthermore, it is a common practice for health care workers to wash their hands extensively with antibacterial detergent for 5 to 10 minutes and disinfect with chlorhexidine or alcohol before entering a surgical room or participating in a surgical procedure. (Mehta et al, 2014, p.156).

## Disposables

It is almost impossible to avoid coming in contact with a
contaminated object or surfaces however, following the hospitals “standard
precautions or universal precautions” can help decrease contamination and
ultimately reduce the number of nosocomial infections. In a hospital
disposables are very important and act as a barrier to avoid the spread of
infection.It is also imperative to understand
the different material that should discard and the materials that can be
reused. A glove is a good example of a disposable. It is a standard precaution to wear gloves
before making contact with patients’ mucous membrane and non intact skin.  Experts agreed that it’s imperative that health care worker do not use the
same glove on the infected body part to an uninfected body part (Mehta et al,
2014, p.151).  The same glove should
never be worn when coming in contact with another patient. When complete gloves
should be thrown out immediately and hands should be thoroughly washed again.

## Patient Care Equipment

Reusable items, such as patient care equipment should be
thoroughly cleaned, disinfected and sterilized to avoid spreading infection
(Mehta et al, 2014 p. 156).  Patient care
equipment that has been soiled with blood, body fluids, secretions or excretions should be handled with care to prevent skin and mucous membrane exposure. Reusable items should be used by one patient only until after it’s sterilized to avoid transfer of microorganisms. It is very important not to share patient care equipment until it has been cleaned and sterilized; sharing of equipment puts patients at risk for cross contamination (Brown, 2011, p. 65).

## Air Circulation

In recent years, microbiologist have
partnered with building engineers to study infection control in building designs,
facilities management and modeling airflow “Engineers have given great insight
to the transmission of hospital acquired infections” (Beggs, Knibbs, Johnson
& Morawska, 2015,p.467 ). Through lots of research and testing it was
discovered that the hospitals air condition and ductwork systems is heavily
contaminated with nosocomial pathogens, in particular fungal pathogens. Large
ductwork such as in a hospital consequently accumulates a lot of these deposits
therefore making them extremely contaminated. Ductwork colonizes a substantial
amount of fungal contaminants putting immunocompromised patients at high risk
of infection. Bacterial and fungal air contaminations in hospitals have an
important role in development of hospital infections. Approximately 10% of the
nosocomial infections in both immune-compromised and healthy people are caused
by airborne bacteria (Abdollahi & Mahmoudzadeh, 2012, p.178).

In
the United Kingdom, American Institute of Architects strongly discouraged recirculation
of air in their hospitals because of the high risk of  fungal contaminations whereas in the United
States, recirculation of air is permitted, however the air  goes through a filtering process before it is
disbursed throughout the hospital.  The
cleaning of air ventilation systems can certainly reduce the risk of
contamination, but will not completely eliminate it. To clean the system
properly, it is suggested to “use the mechanical brushing, the most efficient
method to remove surface dust from 75% to 94%” (Beggs et al, 2015, p. 468).  Several factors contribute to fungal air
contamination in healthcare centers, such as ineffective aseptic procedures,
inappropriate air conditioning system, open windows, and doors. Abdollahi & Mahmoudzadeh (2012)
hypothesized that “lowering the levels of these pathogens in the air would
result in providing an environment that would help decrease the risk of
nosocomial infection” (p.178).