health care workers, family, friends and co-workers of patients. These practices can prevent up to 30 percent of health care associated infections when there is a clear understanding of the principles of disease transmission.

Infection control measures are established to isolate infectious agents and to interrupt their transmission. Inappropriate and "overprotective precautions'' are detrimental to this goal.

Infection control guidelines for health care offices: 1: Hand washing is the cornerstone of infection control. It is generally considered the single most important procedure that can be performed to interrupt the transmission of infectious agents. Proper hand washing removes the transient microbial contamination acquired by contact with infected or colonised patients or environmental sources. Hands should always be washed before and after direct patient contact.

2: Handling specimens. Gloves should always be worn when handling blood and body fluid specimens. Gowns should only be worn when clothing may be soiled with blood and body fluids. Specimens should be transported to the lab in sealed plastic bags to prevent spillage and handling.

3: Maintain the environment. Good cleaning practices are important not only for reducing the microbial load on environmental surfaces but for aesthetics.

Horizontal surfaces, exam tables, countertops, chairs, faucet handles, etc., should be physically cleaned with a disinfectant that is effective in killing various bacteria and viruses.

Air vents should be damp dusted as needed. Blood and other body fluids should be wiped up immediately. Remember to wear gloves and use disposable towels.

The surface should be washed and disinfected.

4: Disposal of trash and sharps. Care should be taken to prevent injuries from used needles, scalpels, and other sharps contaminated with potentially infectious material. Needles should not be recapped, remove from syringes, bent, broken, or otherwise manipulated by hand.

All sharps should be discarded into rigid, puncture proof containers. Locate these containers close to the site where these needles will be most often used. The containers should be locked away when not in use.

5: Cleaning, then disinfecting and sterilising of equipment. All equipment requires cleaning. Items used for single patient use or are disposable, should not be used again. Items which are in contact with mucous membranes should be disinfected by soaking for a recommended time in a chemical agent that has been proven to be effective in killing various pathogens.

6: Employee wellness. This is important not only for the health care worker, but for the patient. Regular screening for TB has been recommended by the CDC, Rubella screening is valuable in a paediatric and obstetrical setting. HCWs should make sure they are up to date with their Hepatitis B and tetanus vaccinations.

7: Immunisations for children and immune suppressed persons are an important part of interruption of disease transmission. HCWs should ensure that all children have completed their course of immunisations. It is now recommended that persons with HIV and AIDS should be immunised for Hepatitis B, Haemophilus influenza type B, pneumococcal meningitis and influenza. This has been in effect since 1993.

Remember, every patient has a right to health care provided in a timely and equal manner, and these rights should not be abridged in the name of infection control. Patients have a right to privacy and individual human dignity.

Confidentiality must be maintained at all times by all people involved in the care of the patient. Family, friends, co-workers, etc., should not be informed of a patient's diagnosis without his/her consent.

For further information you may call 236-0224 ext 237.

HEALTH AND SOCIAL ISSUES HTH