Oncology Unit

by Mr. Rosauro P. Benito

1. ROCHI PARAON BENITO, RN MSN
Junior Assistant Manager
MANILA DOCTORS HOSPITAL

2. Basic Infection
Control Guidelines in
the Chemotherapeutic
Unit

3. “ The Facilities
are encourage
to personalized
the plan to
make it more
relevant to your
setting

4. Aspects of care
that are beyond
the scope of this
plan.
This is intended
to address
facility-specific
issues or other
aspects of care
such as:

5. Infection prevention
issues that are unique
to blood and bone
marrow transplant
Occupational health
requirement, including
recommended PPE
for handling
antineoplastic and
hazardous drugs

6. Appropriate preparation
and handling, (like
reconstitution, mixing,
diluting, compounding) of
sterile medication including
antineoplastic agent.
Clinical recommendation
and guidance on
appropriate antimicrobial
prescribing practices, and
the assessment of
neutropenia risk in patients
undergoing chemotherapy

7. A patient with diagnosis underlying cancer is at particular
risk of infection related to a multitude of factors:
1.Immunosupresion from the underlying disease
2.Treatment . Eg. Chemotherapy, radiation or stem
transplantation
3.Breach in the continuity of skin and mucosal barrier
related to central venous catheter.
4.Therapy –associated mucositis

8. Prevention and control of HAI’S in
inpatient with neoplastic
disease is one of the most
important contributor to the
overall success of treatment in
this population

9. Fundamental Principles
of Infection Prevention
and Control
1. Standard Precaution
A.hand hygiene
Hand hygiene techniques
5 moments of hand
hygiene

10. Defined Technique for Hand Washing
The hands are moistened and 3-5 ml formulation is applied to cupped hands.
The hands are then rubbed together 5 times as follows:
Palm to palm
Right palm over dorsum
and vice versa
Palm to palm; Fingers
interlaced
Back of fingers to opposing
palms, fingers interlocked
Rotational rubbing of right
clasped in left palm and
vice versa
Rotational rubbing, backwards
and forwards with clasped fingers
of right hand in left palm and vice
versa

11. When to do Hand Hygiene in the Healthcare setting?

12. B. Personal Protective
Equipment
Gloves
Gown
Mask / respirator
Hair cap / bonnette
Goggles
Face mask
Fundamental Principles of
Infection Prevention and
Control

13. C. Patient placement
D. Injection safety
Disposal of sharps
Fundamental Principles of
Infection Prevention and
Control

14. E. Medication handling and
storage
 medication storage
 medication preparation
area
 Medication delivery
 Medication disposal
Central Venous Catheters
Removing Implant Port
Fundamental Principles of Infection
Prevention and Control

15. antimicrobial drugs –anti
microbial prophylaxis
Fundamental Principles of Infection
Prevention and Control

16. F. Cleaning and Disinfection of
Devices and Environmental
surfaces
Air handling system –use of
HEPA FILTER
Unidirectional (formerly
called laminar flow)
Use of N95 respirator
Air exchanges and
pressurization
Fundamental Principles of
Infection Prevention and
Control

17. Environmental Hygiene as
Applied in Environmental
Care
Proper and thorough environmental
hygiene in the hospital is critical in
the prevention of Healthcare
Associated infections
It encompasses vigorous surface
cleaning and disinfection of highly
touched surfaces in the healthcare
setting as well as decontamination
of medical devices used in patient
care procedures according to
evidence based practices and
recommended guidelines from
CDC.

18. Environmental Measures
Clean and disinfect surfaces
and equipment that maybe
contaminated with
pathogens, including those
that are in close proximity to
the patient (e.g bed rails,
over bed tables) and
frequently touched surfaces
in the patient care
environment (e.g door knobs,
surfaces in and surrounding
toilets in patient’s room) on a
more frequent schedule
compared to that minimal
touched surfaces.

19. Contaminated surfaces increase cross-
transmission ~
The Inanimate Environment
Can Facilitate Transmission
~ Contaminated surfaces increase cross-
transmission ~
Abstract: The Risk of Hand and Glove Contamination after Contact
with a VRE (+) Patient Environment. Hayden M, ICAAC, 2001,
Chicago, IL.

20. Monitor cleaning
performance to
ensure consistent
cleaning and
disinfection of
surfaces in close
proximity to the
patient and those
likely to be touched
by the patient and
HCW

21. Obtain environmental
cultures (e.g surfaces,
shared medical
equipment) when there
is an epidemiologic
evidence that an
environment source is
associated with on
going transmission of
the targeted MDRO

22. Vacate units for
environmental
assessment and
intensive
cleaning to
eliminate
environmental
reservoir.

23. 11. Transmission –
Based Precaution
A.Contact Precaution
B.Droplets Precaution
C.Airborne
Precaution

24. 2. Education and
Training
All facility staff including
contract personnel( e.g.
Environmental service
workers from outside
agency)are educated and
trained
Proper selection and use of
PPE
Job-or task-specific
infection prevention
practices

25. Personnel providing
training have demonstrated
and maintained
competency in providing
instruction
Training provided at
orientation, repeated at
least annually and anytime
policies and procedures are
updated
2. Education and
Training

26. 3. Surveillance reporting
A.Hospital Acquired
Infection
B.Disease reporting

27. 4. Central Venous
Catheters
A.General Maintenance
and Access
Procedure
B.Peripherally Inserted
Central Catheters
(PICCs)
C.Implanted Ports

28. Prevention is
PRIMARY!!!
Protect patients…
protect healthcare personnel…
promote quality healthcare!!!!

29. THANK YOU……