R3.9.TB DOTS Policy-Infection Control

RHU BINDOY TB DOTS
POLICIES AND PROCEDURES ON INFECTION CONTROL
source:
 WHO Policy on TB Infection Control in Health-Care Facilities, Congregate Settings and
Households, WHO 2009.
TB infection control is a combination of measures aimed at minimizing the risk of TB

transmission within populations. The foundation of infection control is early and rapid
diagnosis, and proper management of TB patients. (WHO). TB infection control should be
part of overall infection prevention and control. Bindoy RHU TB DOTS facility routinely
applied standard precautions when providing care for all patients.
Standard precautions:
• Wash hands:
 Immediately upon arriving at work
 Before and after handling each client
 After touching anything that may be contaminated
 Before putting on gloves for clinical procedures
 After removing gloves
 After using the toilet
 Before leaving work
• Always wear gloves when:

 One expects that his/her hands will come in contact with the client’s blood, other
body fluids or tissue
 One’s hand may come in contact with medical waste
In addition, the following infection control measures is observed:
MANAGERIAL CONTROL
Activities:
- Infection Control Team conduct orientation of Health Staff on infection

control plan and procedures
ADMINISTRATIVE COTROL:
Triage
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RHU BINDOY TB DOTS
- Place large notices at the entryway at eye-level, stating that one must
immediately inform staff of current cough lasting for two weeks or more
- Display notices explaining the Bindoy RHU prioritizes patients with current
cough that lasted for two (2) weeks or more over others in the waiting area
queue and makes use of designated separate (waiting) areas.
SEPARATION:
- Separate presumptive TB and diagnosed infectious TB patients in
designated partition of the general waiting area near open windows
- Separate diagnosed MDR-TB patients from other patients by giving them a
specific time slot for visiting the health center
TB Screening of Staff
- Get screened at least annually through chest x-ray
ENVIRONMENTAL CONTROL
Natural Ventilation:
- Ensure that doors and windows on opposing walls are kept open during
consultation hours in all consultation areas
Mixed-mode Ventilation:
- Install ceiling fans in the waiting area behind nurse/ midwife in hours in all
consultation areas
PERSONAL RESPIRATORY PROTECTION
- Purchase and provision of N95 mask for all staff every 6 months.
- Provision of surgical facemask to all presumptive TB patient.
• Follow these steps in giving injections:
 Wash injection site with soap and water if the area is visibly dirty
 Swab that area with antiseptic (alcohol solution) in a circular motion starting from
the intended injection site going outward
 Allow alcohol to dry
 Inform client that you are about to inject.
• Needles should not be recapped. Used needles should be placed in a punctured-proof

container
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RHU BINDOY TB DOTS
• Process used instruments accordingly. The steps are as follows:
 Decontamination – All used instruments and linens soiled with blood and
body fluids shall be decontaminated first with a 5% disinfecting solution for
10 minutes before they are washed with soap and water.
 Cleaning – rinse and wash the instruments with detergent and water.
 Sterilization or high-level disinfection:
- autoclave – 106kPa 121⁰C for 20 minutes (unwrapped) or 30 minutes

(wrapped)
- dry heat - 170⁰C for 60 minutes
- Chemical – soak for 20 minutes
For STERILIZATION: All instruments use for TB DOTS shall be sterilized

by autoclave.
Sterile Supplies
No sterile supplies will be stored on a counter or other open surface.
All supplies sterilized within the clinic will be labelled with date of sterilization and expiration date.
Sterile supplies will be inspected every two weeks. Out of date supplies will be removed, rewrapped and
sterilized again. A schedule for regular inspection will be posted and the staff member inspecting the
supplies will initial it.
No outdated sterile supplies will be used.
 Use or store.
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RHU BINDOY TB DOTS
PROCEDURES IN IDENTIFYING AND ADDRESSING THE RISKS OF CONTAMINATION OF

STAFF AND PATIENTS FROM SOURCES OF INFECTIOUS DISEASE
If the staff and patients face the risks of contamination from the source of infectious
disease, protection should be worn, if feasible under the circumstances. In cases of suspected
airborne diseases or diseases transmitted via droplets, suspect should be provided masks,
instructed to follow proper hygiene etiquette such as coughing into elbows, and transfer to
their allotted waiting area (holding area).
When an individual or staff exposed to an infectious disease, the following should be

done:
 Record the essential information on the means by which infection took place
and thereby assist in future preventive measures
 Any unprotected skin surfaces that come into contact with body fluids from an
infected individual shall immediately washed with soap and water.
 Self- quarantine, observe signs and symptoms
 Practice good public health hygiene such as wearing an appropriate mask,
covering their mouth using elbow when coughing or sneezing, washing and
sanitizing potentially contaminated or commonly used items, washing hands,
practice social distancing.
In cases of staff with needle stick injury from a potentially infectious patient,
 the injured area should be thoroughly washed with soap and water
 assess and observed the site
 refer to MHO for further management
 Informed the head of the facility/ infection control team
 Ask to submit an incident report.

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RHU BINDOY TB DOTS

POLICIES AND PROCEDURES ON INFECTION CONTROL

TB infection control is a combination of measures aimed at minimizing the risk of TB

• Always wear gloves when:

In addition, the following infection control measures is observed:

- Infection Control Team conduct orientation of Health Staff on infection

• Follow these steps in giving injections:

• Needles should not be recapped. Used needles should be placed in a punctured-proof

• Process used instruments accordingly. The steps are as follows:

- autoclave – 106kPa 121⁰C for 20 minutes (unwrapped) or 30 minutes

- dry heat - 170⁰C for 60 minutes

- Chemical – soak for 20 minutes

For STERILIZATION: All instruments use for TB DOTS shall be sterilized

PROCEDURES IN IDENTIFYING AND ADDRESSING THE RISKS OF CONTAMINATION OF

When an individual or staff exposed to an infectious disease, the following should be

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