Policy:
- Infection Control Policy for Cardiac Catheterization>
OBJECTIVE:
To prevent the spread of acquired infections in hospitals
before and after cardiac catheterization.
Procedures: -
First before starting heart catheterization: -
1-Preparation of the patient:
a) The catheter should be delayed if
possible in case of any type of infection in cases of non-emergency heart
catheterization.
b) The blood glucose level of the
patient is determined, and the patient's vital signs are measured and recorded
c) A patient's shower with the
antiseptic, such as betadine, is recommended for the night before the catheter.
d The hospital shall be kept in front
of the catheter for a short period whenever possible
2 - Do not remove hair only if it
interferes with the place of insertion of the catheter. It is possible to use
razors or surgical scalpel to remove hair and hair is removed shortly before
the catheter with a clipper machine.
3 - Clean
the skin immediately before the catheter using: 2% chlorhexidine or betadine
10% or 70% alcohol and leave to dry or more than two minutes.
4 - Do
not prefer to give a preventive antibiotic in general but given cephazolin in the following cases:
- Immune-Deficient
Patients. - Patients with artificial
heart valves.
- Patients
expected to be infected for their wounds.
5. Special
Sabo should be worn before entering the catheter room
6. Head
cap, surgical masks and cardiac catheterization suits should be worn in the
changing room
7. The
room and bed of cardiac catheterization should
be cleaned and disinfected between patients.
8. Hand
washing is performed surgically as described in the hand washing policy
9. Sterile
towels should be available to dry the hands
10. The
sterile gaon is worn before starting the catheter
11. The
nurse should wash their hands before preparing the instruments
12. The
nurse should use the non-touch technique during preparing the instruments
13. Do
not leave the instruments opened before preparing the catheter.
14. Open
the instruments immediately before starting the catheter
Second: - During the catheterization: -
1. The
tissue of the patient's body should not be damaged
2. avoid
the patient from bleeding during catheterization as much as possible
3. Do
not contaminate the place of insertion of the catheter during the
catheterization.
4. Vital
signs of the patient should be observed during catheterization
5. In
case of percutaneous coronary intervention PCI after 6 hours delay after
diagnostic catheter we use the opposite side.
6. Waste
should be separated at the source at work, so that contaminated waste in the
red bag, paper, wrappers, thermal paper, syringes and similar items shall be
disposed of in the black bag, sharp instruments and syringes in the safety box.
Third: - After the catheterization
1. impermeable
plastic dressing should not be used because they increase the risk of infection
and instead use sterile gauze or semipermeable translucent dressing. Sterile
gauze is preferred in:
- Sweaty
patients and if the place of the
catheter is bleeding or oozing.
2- The
dressing must be changed if there is contamination or there is wetness.
3. Check
for signs of infection every 72 hours or when the patient complains.
4- The
place is cleaned every three days with betadine 10% or 2% chlorhexidine.
5- The
catheter is removed as often as possible, if there is no need for it.
6. The
dressing is removed when the catheter is removed as long as the wound is closed
and there are no secretions.
7. It
is strictly forbidden to use chemical disinfectants or formalin to sterilize
any surgical instrument, but by autoclave.
8. The
floor, anesthesia equipment and patient bed should be cleaned and disinfected after
catheterization and before another patient enters
9. the
surfaces cleaned and disinfected to receive another patient
10. Do
not move with catheter's wear outside the catheter roam.
11. Do
not move with the mask and head caps outside the catheter compartment
Cleaning the catheter room:
1. The
catheter should always be kept clean, dry and free from dust
2. The
floors are cleaned with chlorine 5000 ppm and left to dry after the catheter is
finished directly and between the patient.
3. The
floor, anesthesia equipment and patient bed should be cleaned after
catheterization and before another patient enters
4. The
types of waste are separated at the source as above
5. Blood
spills and body fluids should be cleaned as follows:
.
The blood spills
are removed immediately with a single-use towel, then disposed of in the
hazardous waste container. Then cleaned with soap and water and then dried. The
disinfection is done with 5000 ppm (2 tablets per liter).
7. The
ceilings and walls must be cleaned from top to down. All appliances are removed
and then cleaned again before entering the catheter room once a week or at any
time during the dirty process.
Note:
The infected cases enter in the last of the menu except they
are lifesaving
Responsible for implementation:
• Head
of Department of Cardiac Catheterization Laboratory
• Nurse
responsible for cardiac catheterization room
• Responsible
Cardiac catheterization
• Work-based
surgeon
• Doctors
in the catheterization laboratory in all categories for implementation each in
its own right
• Nursing
in the catheterization laboratory in all categories for each implementation in
its own jurisdiction
• Cardiac
catheter department workers
Accessory models: None
Review:
• Periodic
every three years
• An
emergency in the event of any event that requires change or modification of the
policy
References:
National Infection Control Handbook 2016
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