| 1. Hand hygiene (personal cleanliness) |
To mechanically remove soil and debris from the skin and reduce the number of transient microorganisms. |
Hand hygiene (World Health Organization 2012):
Before touching a patient. Before clean and aseptic procedure. After body fluid exposure risk. After touching a patient and at the end of a shift.
Alcohol-based hand rub technique (Harrogate and District NHS Foundation Trust 2016):
Ensure you are ‘bare below the elbows’. Apply enough antiseptic hand rub (about a teaspoonful) to cover the entire surface of hands and fingers. Ensure the solution covers the wrist surfaces. Rub the solution vigorously into hands, especially between fingers and under nails until the solution gets dried (about 20–30 s).
|
| 2. Personal hygiene (personal cleanliness) |
To reduce the number of microorganisms that may be present in their bodies and those that may harbour in their jewellery. |
Rules of personal hygiene (Lister & Inamdar 2013; Netherlands Development Organisation 2014):
Shower, bath or wash thoroughly every day. Keep hair and nails short, clean and neat. Cover open cuts and wounds. Brush your teeth at least twice daily and use a breath refresher as needed throughout your shift. Always wear clean clothes. Always remove jewellery during a radiological procedure.
|
| 3. Personal protective gear and the use of appropriate equipment (personal cleanliness) |
To protect themselves, fellow healthcare workers and patients from microorganisms from contaminating hands, eyes, clothing, hair and shoes. |
Inspection, cleaning and maintenance of personal protective equipment (PPE) (Australia Workforce Health 2015):
Inspect the PPE for signs of damage prior to use. Clean/decontaminate all reusable PPE. Avoid using cleaning agents that are likely to scratch surfaces of PPE. Store PPE in clean, sealed containers such as plastic tubs with lids. Ensure that the PPE is kept clean in between usages. Remove damaged PPE from use.
|
| 4. Safe handling of sharps and sharp containers (health of houses) |
To avoid occupational exposure to microorganisms that may be found in the blood and other body fluids which may occur because of needle stick (sharp) injuries. |
Safe use of sharps (Loveday et al. 2014):
Do not recap bent or disassemble used needles, managing sharps and sharp containers (Kenya Ministry of Public Health and Sanitation & Ministry of Medical Services 2010):
Position the sharp end of instruments away from self and others. Dispose of used sharps immediately in designated puncture and leak-proof containers labelled with a biohazard symbol. If injured by sharps, contact your supervisor immediately. Put sharps containers as close to the point of use as possible and practical, at a convenient height and ideally within arm’s length. Label sharps containers clearly with a biohazard symbol so that people will not unknowingly use them as garbage or trash containers. Keep sharps containers in the area where sharps are being used. Do not place sharp containers where people might accidentally put their hands on them. Do not fill sharps containers above the three-quarters full mark. Seal the container when it is three-quarters full and do not reopen it. Never reopen, empty or reuse a sharps container after closing and sealing it.
|
| 5. Decontamination and cleaning (cleanliness of rooms) |
To prevent potentially harmful microorganisms reaching a susceptible host in sufficient numbers to cause infection. |
Decontamination (Kenya Ministry of Public Health and Sanitation & Ministry of Medical Services 2010):
Decontaminate large surfaces or instruments that might have come into contact with blood and body fluids. Wipe them with a cloth soaked in the chlorine solution. Immediately after use, place all instruments in an approved disinfectant such as chlorine solution for 10 min. Remove instruments from chlorine solution after 10 min and immediately rinse them with cool water to remove residual chlorine before thoroughly cleaning them. Once instruments and other items have been decontaminated, cleaned and sterilised or high-level disinfected. Dry the instruments thoroughly.
|
| 6. Housekeeping (cleanliness of rooms) |
To reduce the number of microorganisms that may come into contact with staff, patients, visitors and the community in order to provide a clean and pleasant atmosphere for patients and staff. |
Dusting (Kenya Ministry of Public Health and Sanitation & Ministry of Medical Services 2010):
Wet cleaning cloths or mops with cleaning solution contained in a basin or bucket. Avoid dry dusting; dust cloths and mops should never be shaken to avoid the spread of microorganisms. Avoid raising dust. Perform dusting in a systematic way, using a starting point as a reference to ensure that all surfaces are reached.
Chairs, lamps, tables, table tops, chest stands, hand rails and counters (Kenya Ministry of Public Health and Sanitation & Ministry of Medical Services 2010):
Wipe daily and whenever visible soiled with a damp cloth, containing disinfectant cleaning solution. Use a disinfectant when contamination is present (e.g. blood or other body fluid spills).
|
| 7. Routine infection control practices (cleanliness of rooms) |
To minimise the risk for transmission of infection among patients and personnel in the radiology departments. |
Routine infection control practices (Ehrlich & Coakes 2017; Tugwell & Maddison 2011; UNC Health Care 2016):
Clean all radiologic equipment on a routine basis (e.g. weekly), whether soiled or not soiled. All radiographic accessories labelled for single use should not be reused. Clean or decontaminate reusable radiographic accessories to remove all visible matter/debris prior to placing accessories in the central processing and distribution container in readiness for sterilisation. Between each patient that has undergone examination, thoroughly clean X-ray tables, vertical stands and any other items that come into contact with patients. Clean and disinfect portable radiographic equipment before and after entering the room of a patient or ward. Dust daily the overhead tube, spot film devices, image intensifiers and television monitors. Dust weekly the overhead tracks for ceiling-mounted equipment using a vacuum cleaner. Wash weekly control stands and spot film devices with disinfectant. Clean lead rubber gloves and aprons weekly using disinfectant, dilute bleach or a germicide cloth. Clean, wash and disinfect anatomical markers with gel weekly and use only once per patient. Cover all portable X-ray cassettes and grids with a disposal, clear plastic cassette cover to prevent contamination. Clean all anatomical markers, positioning pads and sponge pads with an approved disinfectant after each patient/radiographic procedure. Always provide a patient with clean attire (e.g. a clean hospital gown) for all radiological examinations that require the use of a gown.
|
