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Infection control in coronavirus departments
The medical staf working in the coronavirus departments are at the highest risk for getting COVID-19, especially after the number of infections among doctors, nurses, and other teams working in those departments has spiked. They are like soldiers in a battle fghting this deadly and rapidly spreading virus.
There are infection control programs and international protocols in place that require the application of precautionary measures to limit the spread of infection within the hospital. The focus on these programs has increased recently in the coronavirus departments, especially since respiratory infection is the second most common hospital infection and the frst most common infection within ICUs.
To prevent infection, standard precautions are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confrmed infection status of the patient, in any setting where healthcare is delivered. These practices are designed to both protect DHCP and prevent DHCP from spreading infections among patients. Standard Precautions include hand hygiene, use of personal protective equipment (e.g., gloves, masks, eyewear), respiratory hygiene / cough etiquette, sharps safety (engineering and work practice controls), safe injection practices (i.e., aseptic technique for parenteral medications), sterile instruments and devices as well as clean and disinfected environmental surfaces.
The hospital environment, whether rooms or corridors, should be sterilized to prevent virus transmission, and here we must emphasize the need to sterilize doorknobs, elevator buttons and ofce surfaces because they are the primary driver for infection.
Handwashing is the frst step
Infection control programs focus primarily on the hands, as they are the primary source of transmission of infection and germs, which requires washing them in the best way recommended by the World Health Organization. Cleaning, sterilizing and disinfecting hands before and after dealing with the patient, especially when taking samples, is the frst procedure to stop and prevent the risk of cross-infection, HAND HYGIENE IS ONE OF THE MOST IMPORTANT MEASURES THAT PREVENT THE SPREAD OF INFECTION IN HOSPITALS, AND IT IS A GENERAL TERM THAT INCLUDES WASHING HANDS WITH SOAP AND WATER, USING DISINFECTANTS BY RUBBING THEM WITH ALCOHOL AND DISINFECTING THEM IN PREPARATION FOR SURGICAL PROCEDURES.
and it is crucial for everyone working in the health facility to follow it, as it has been shown that washing hands contributes to reducing infection cases in hospitals by up to 50 percent. The importance of hand hygiene urged the World Health Organization to celebrate Hand Hygiene Day given its role in preventing the transmission of infections.
Medical teams and healthcare providers follow the seven handwashing steps in order not to neglect any area during handwashing and ensure that their hands have been thoroughly cleaned and sterilized. But handwashing in hospitals must be done in a specifc technique that guarantees getting rid of germs, and this technique is as follows: 1. Wet hands with water and apply single shot of soap 2. Rub hands palm to palm 3. Rub back of each hand with the palm of other the hand with fngers interlaced 4. Rub palm to palm with fngers interlaced 5. Rub with backs of fngers to opposing palms with fngers interlocked 6. Rub each thumb clasped in opposite hand using rotational movement 7. Rub tips of fngers in the opposite palm in a circular motion 8. Rub each wrist with the opposite hand 9. Rinse hands with water & dry thoroughly
Healthcare workers must follow a stricter handwashing process as recommended by WHO: • Before touching a patient, • Before clean/aseptic procedures, • After body fuid exposure/risk, • After touching a patient, and • After touching the patient surroundings
Knowing how to wash your hands properly is an important step in preventing the spread of infections in the workplace, home or schools. Also important is knowing when to wash your hands. Here are the key times when handwashing should be conducted: • At the end of each work/school period • Before each break • Before eating or preparing food • After going to the restroom • Whenever hands are dirty or contaminated
Medical waste
The COVID-19 outbreak has increased medical waste all across the world and it has also led to a huge amount of face masks and medical waste. In particular, another aspect of the spread of COVID-19 is improper solid waste management. If waste is not managed properly, it may lead to the spread of the virus. Consequently, the number of confrmed cases has rapidly increased and the amount of medical waste associated with COVID-19 has also signifcantly increased. According to the World Health Organization (WHO), infectious waste is defned as waste contaminated with blood and other bodily fuids, cultures and stocks of infectious agents from laboratory work, or waste from patients with infections. But WHO interim guidelines suggest all healthcare waste produced during patient care, including those with confrmed COVID-19 infection, is considered as infectious medical ACCORDING TO THE WORLD HEALTH ORGANIZATION (WHO), INFECTIOUS WASTE IS DEFINED AS WASTE CONTAMINATED WITH BLOOD AND OTHER BODILY FLUIDS, CULTURES AND STOCKS OF INFECTIOUS AGENTS FROM LABORATORY WORK, OR WASTE FROM PATIENTS WITH INFECTIONS.
waste, but the waste generated in waiting areas of healthcare facilities can be classifed as non-hazardous and disposed of by municipal waste services.
The Centers for Disease Control and Prevention (CDC) claims medical waste coming from healthcare facilities treating COVID-19 patients is no diferent than waste coming from facilities without COVID-19 patients, and management of medical waste should be performed in accordance with routine procedures.
The black bags inside the health facilities are used for the disposal of non-hazardous and recyclable medical waste, while the red bags are used for hazardous waste, as there are thousands of gloves, masks, protective jackets and medical syringes used on a daily basis.
Surfaces and windows are also cleaned with dilute chlorine, and waste locations lying on the ground are sterilized, after collecting the bags containing medical waste.
Medical waste includes materials that transmit infection such as syringes, needles, scalpels, and blades, chemicals used in laboratory formulations, disinfectants, mercury in thermometers and batteries, as well as pharmaceutical preparations such as used and expired drugs and vaccines. Medical waste and waste provide a fertile environment for the growth of the most vicious microbes, viruses, and fungi that can be transmitted to workers through inhalation, touch and other methods of exposure.
Waste with high contents of heavy metals should normally be treated in specifc recycling/ treatment facilities. Alternatively, as for chemical waste, it may be encapsulated. Waste with high contents of heavy metals, in particular mercury or cadmium, should never be incinerated.
Therefore, it is essential to safely dispose of medical waste contaminated with COVID-19 in order not to pose a threat to the persons dealing with it. According to the WHO, waste and by-products cover a diverse range of materials including infectious waste or waste contaminated with blood and other bodily fuids, cultures and stocks of infectious agents from laboratory work, or waste from patients with infections (e.g. swabs, bandages and disposable medical devices); pathological waste: human tissues, organs or fuids, body parts and contaminated animal carcasses; sharps waste: syringes, needles, disposable scalpels and blades, etc.; chemical waste: for example solvents and reagents used for laboratory preparations, disinfectants, sterilants and heavy metals contained in medical devices (e.g. mercury in broken thermometers) and batteries; pharmaceutical waste: expired, unused and contaminated drugs and vaccines; cytotoxic waste, radioactive waste and non-hazardous or general waste: waste that does not pose any particular biological, chemical, radioactive or physical hazard. With the COVID-19 outbreak, the use of medical materials has increased dramatically. The World Health Organization warned of the dangers of using these materials repeatedly, especially through contact with patients and working in infected environments.
The waste usually includes microscopic bacteria that transmit the infection to patients, medical personnel and the general public. Therefore, workers in waste management are subject to strict controls in terms of wearing protective suits, masks and gloves to prevent them from catching deadly germs or viruses. MEDICAL WASTE INCLUDES MATERIALS THAT TRANSMIT INFECTION SUCH AS SYRINGES, NEEDLES, SCALPELS, AND BLADES, CHEMICALS USED IN LABORATORY FORMULATIONS, DISINFECTANTS, MERCURY IN THERMOMETERS AND BATTERIES, AS WELL AS PHARMACEUTICAL PREPARATIONS SUCH AS USED AND EXPIRED DRUGS AND VACCINES.
