HAND HYGIENE When? After removing gloves After contact with body substances Before and after each patient Before eating, drinking or smoking After going to the toilet How? 1. Wet hands with running water 2. Place soap in palms 3. Rub hands together to make a lather 4. Scrub hands vigorously for 20 seconds 5. Dry hands with a disposable towel 6. Turn off tap using the disposable towel Using hand rubs 1. Place alcohol-based hand rub in palms 2. Apply to all surfaces of hands 3. Rub hands together until dry Resource 1 Australian Veterinary Association Guidelines for Veterinary Personal Biosecurity
GOWN SEQUENCE FOR PUTTING ON PPE Fully cover torso from neck to knees, arms to end of wrists, and wrap around the back Fasten at the back of neck and waist MASK Secure ties or elastic bands at middle of head and neck PROTECTIVE EYEWEAR OR FACE SHIELD Place over face and eyes and adjust to fit GLOVES SEQUENCE FOR REMOVING PPE Outside of glove is contaminated! Grasp outside of glove with opposite gloved hand; peel off Hold removed glove in gloved hand Slide fingers of ungloved hand under remaining glove at wrist Peel glove off over first glove Discard gloves in waste container Perform hand hygiene PROTECTIVE EYEWEAR OR FACE SHIELD Outside of eye protection or face shield is contaminated! To remove, handle by head band or ear pieces Place in designated receptacle for reprocessing or in waste container GOWN Gown front and sleeves are contaminated! Unfasten ties Pull away from neck and shoulders, touching inside of gown only Turn gown inside out Fold or roll into a bundle and discard GLOVES Extend to cover wrist of isolation gown Note that for surgical procedures and dentistry, the sequence for putting on PPE differs. In these situations, masks and protective eyewear are applied first prior to hand preparation. Gown and gloves are then put on. MASK Front of mask is contaminated DO NOT TOUCH! Grasp bottom, then top ties or elastics and remove Discard in waste container Perform hand hygiene immediately after removing all PPE Resource 2 Australian Veterinary Association Guidelines for Veterinary Personal Biosecurity. Source: Australian guidelines for the prevention and control of infection in healthcare, adapted from http://www.cdc.gov/hicpac/2007ip/2007isolationprecautions.html, and used with permission.
GLOVES Gloves should be worn for any contact with body substances or objects contaminated by body substances. Gloves are NOT a substitute for proper hand hygiene. Change gloves and wash hands Dirty area Clean area when moving from dirty to clean areas on the same animal Dirty procedure Clean procedure when moving from dirty to clean procedures on the same animal after contact with blood or body substances between individual animals before touching equipment such as computer keyboards during patient care if gloves become torn or damaged. Resource 3 Australian Veterinary Association Guidelines for Veterinary Personal Biosecurity
Vehicle and site visit checklist For low risk site visits, veterinary personnel should routinely protect themselves with clean overalls and boots, and disinfect on entering and leaving premises. Veterinary vehicles used for site visits should carry all the following supplies for use in both high and low risk activities. Clean outerwear such as overalls, hat and washable boots Box of surgical gloves Surgical mask Respirator Water for washing hands and boots Alcohol-based hand rub Sharps container High risk site visit checklist (Resource 5 of Australian Veterinary Association Guidelines for Veterinary Personal Biosecurity) Resource 4 Australian Veterinary Association Guidelines for Veterinary Personal Biosecurity
When attending sites where the risk has been assessed as very high, follow this checklist to implement high level biosecurity protection. High risk site visit checklist 1. Identify clean, dirty and transition zones. 2. Set up decontamination equipment in transition area Lay out ground sheet (if you have one) Dirty side: bucket of disinfectant for footbath, second bucket or spray bottle of disinfectant, scrubbing brush and 2 x plastic bags with ties for waste Clean side: bucket or spray bottle of disinfectant and 2 x plastic bags with ties for PPE disposal 3. Put on PPE while in clean zone: Wash hands with soap and dry Put on overalls with legs outside boots Put on respirator. Check fit Put on eye protection. Ensure it sits snugly over respirator Put on gloves, double gloved, with outer pair snugly over overall sleeves 4. Enter dirty zone, conduct examination, sampling or post mortem. Double bag samples. Wipe each packaging layer with disinfectant. 5. Remove gross contamination while still in the dirty zone Use hose or tub of water and clean boots, overalls and gloves 6. Return to the transition area Dirty side: put waste in plastic bag, disinfect, put in second bag and disinfect again then place in clean zone. Disinfect boots and wash/spray hands, equipment and samples with disinfectant Clean side: remove outer gloves and wash/spray inner gloves with disinfectant. Remove overalls and boots, remove eye protection then remove respirator once any dust has settled. Put PPE in plastic bag. Remove inner gloves, put in plastic bag with other PPE and tie. Disinfect plastic bag then put in second plastic bag and disinfect again. Wash hands with soap and dry Resource 5 Australian Veterinary Association Guidelines for Veterinary Personal Biosecurity This diagram is reproduced with permission from Guidelines for veterinarians handling potential Hendra virus infection in horses Version 4 (2010) published by Biosecurity Queensland http://www.dpi.qld.gov.au/4790_2900.htm.
PPE for dental and obstetric procedures These precautions should be taken by all people working nearby such as monitoring anaesthesia. Dental Protective outerwear Gloves Mask or respirator Face shield or goggles Obstetrics Impermeable outerwear Gloves Shoulder length sleeves if necessary Mask or respirator Face shield or goggles Resource 6 Australian Veterinary Association Guidelines for Veterinary Personal Biosecurity This diagram is reproduced with permission from Guidelines for veterinarians handling potential Hendra virus infection in horses Version 4 (2010) published by Biosecurity Queensland http://www.dpi.qld.gov.au/4790_2900.htm