Key Infection Control Practices in Inpatient and Outpatient Medical Care Settings

  1. Establish and maintain infection control policies and procedures
    • Implement written policies and procedures according to published guidelines.
    • Ensure staff members are familiar with policies and procedures and review regularly.
    • Update written policies and procedures regularly.
  2. Properly use and handle needles, cannulae and syringes
    • Whenever possible, use sharps with engineered sharps injury protections (i.e., nonneedle sharp or needle devices with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident). Do not disable or circumvent the safety feature on devices.
    • Needles, cannulae and syringes are:
      • Sterile, single-use items; any use will result in these items being contaminated.
      • Contaminated once used to enter or connect to any component of a patient's intravenous infusion set.
    • Medication from a syringe must not be administered to multiple patients even if the needle on the syringe is changed.
    • Dispose of all needles and syringes immediately into a leakproof, puncture-resistant, closable container.
    • Develop policies and procedures to prevent sharps injuries among staff and review regularly.
  3. Properly handle medications and solutions
    • Designate separate areas for preparation and disposing medications.
    • Minimize use of multidose vials; use single-dose vials for parenteral medications whenever possible.
    • If multidose vials must be used:
      • Always use aseptic technique.
      • A new needle/cannula and a new syringe must be used to access the multidose vial.
      • Do not keep the vials in the immediate patient treatment area.
    • Do not administer medications from single-dose vials or ampules to multiple patients or combine leftover contents for later.
    • Do not use bags or bottles of intravenous solution as a common source of medication or fluid for multiple patients.
    • Use infusion sets (i.e., intravenous bags, tubing and connectors) for one patient only and dispose appropriately after use.
  4. Strictly adhere to aseptic technique
    • Ensure all staff members perform proper hand hygiene before and after gloving, between patients, and whenever hands are soiled.
    • Avoid cross contamination with soiled gloves.
    • Provide adequate soap/water, disposable paper towels, and waterless alcohol-based hand rubs throughout the facility.
  5. Properly reprocess medical equipment
    • Follow manufacturer's recommendations for proper cleaning, disinfection, and sterilization of all reusable equipment.
    • Designate staff responsible for maintaining proper reprocessing procedures.
    • Ensure designated staff members are properly trained in reprocessing each piece of equipment.
    • Never reprocess equipment designated for single use.
    • Maintain a log of all equipment reprocessing.
  6. Fulfill all federal and state requirements for infection control training
    • All healthcare personnel must complete bloodborne pathogen control training regularly.
    • All licensed healthcare professionals in New York State (physicians, physician assistants, special assistants, registered professional nurses, licensed practical nurses, podiatrists, optometrists, dentists, and dental hygienists) are required to receive training on infection control and barrier precautions every four years through a NYS-approved provider.
    • Documentation of appropriate training must be maintained both by the course provider and course participant.

Bibliography: Infection Control

[Please note: The following references and websites have been updated since the original Commissioner letter distributed in 2008]

Bibiliography: Healthcare-Acquired Hepatitis

Websites

The following websites will assist you in developing or updating your infection control policies and procedures.

Association for the Advancement of Medical Instrumentation (AAMI):

Centers for Disease Control and Prevention (CDC):

Occupational Safety and Health Administration (OSHA):

New York State Department of Health: