TABLE 3.

Guidelines for infection prevention and control in the physician’s office, 2004 http://www2.worksafebc.com/PDFs/Healthcare/Backgrounder_drs_infection_control_guidelines.pdf

Routine Infection Control Practices

Routine infection control practices are to be used with all patients, at all times, regardless of presumed infections status or diagnosis. Routine Infection Control Practices include: •The separation of infected, contagious patients including those with respiratory symptoms from uninfected patients. •Hand cleaning should occur before and after every patient contact. Wash hands with soap and warm water for 15 to 30 seconds. Waterless (alcohol-based) hand antiseptics are also effective. Soap and water should be used if hands are visibly soiled. •Gloves should be used as an additional measure, not as a substitute for hand washing. •Personal protective equipment, such as gowns, masks and eye protection should be worn during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions or excretions. •Mouthpieces and resuscitation bags should be available for performing CPR. •Safe handling and disposal of needles and other sharp devices. •Appropriate sterilization and disinfection of reusable equipment and office surfaces (counters, furniture) must be routine. †Outpatient settings include, but are not limited to, ambulatory care clinics, physicians’ offices, walk in clinics and community health centres.

Preventing Transmission

Preventing the transmission of infectious diseases spread by either airborne or droplet routes poses a significant challenge in the outpatient setting. Special arrangements for patients with a suspected respiratory infection can reduce this risk. These include: •Screening patients at the time the office visit is scheduled. •Making efforts to see these patients at the end of the day. •Quickly triaging these patients out of common waiting areas. •Closing the door of the examining room and limiting access to the patient by visitors and staff members who are not immune to the suspected disease.

Preventing the transmission of infectious diseases spread by direct contact such as antibiotic resistant organisms (e.g. MRSA, VRE) require special attention to decrease the likelihood of spread. Patients may harbour resistant bacteria as part of their respiratory or gastrointestinal tract flora for an extended period. Precautions include: •Disinfecting surfaces and equipment that have been in direct contact with the patients immediately after a visit. •Patients known to be carriers of these organisms should have this indicated in their medical record in order to facilitate recognition on subsequent visits.