28/01/2023
Policies and Procedures in ICU (Intensive Care Unit)
PURPOSE: To define policies guiding care of patient in the Intensive Care Unit
POLICY:
1) Intensive care admission and / or discharge shall be decided by treating doctor/In charge, ICU. Each patient shall be under the care of a nurse, always maintaining the patient to nurse ratio of 2:1. Intensive care areas shall follow infection control practices as per procedure. (Ref: Infection control manual). Intensive care units shall follow the quality assurance programme.
2) Visitors shall not be allowed in high dependency areas, except in special situations wherein restricted entry of one or two close relatives shall be permitted during visiting hours only.
3) As and when there is a shortage of beds, patients those who are normal will be shifted to the wards and priority will be given to the emergency patients.
4) One empty bed shall be kept reserved for all the time for receiving emergency patients of IGIMS who need ICU admission.
5) Quality assurance system is implemented and followed in ICU’s.
6) Cleaning of floors, work stations, etc. to be done with Bionil disinfectant.
Infection Control Practices
Infection control practices can be grouped in two categories
(1) standard precautions;
(2) additional (transmission-based) precautions.
Transmission of infections in health care facilities can be prevented and controlled through the application of basic infection control precautions which can be grouped into standard precautions, which must be applied to all patients at all times, regardless of diagnosis or infectious status, and additional (transmission-based) precautions which are specific to modes of transmission (airborne, droplet and contact).
Standard Precautions
Treating all patients in the health care facility with the same basic level of “standard” precautions involves work practices that are essential to provide a high level of protection to patients, health care workers and visitors. These include the following:
§ Hand washing and antisepsis (hand hygiene);
§ Use of personal protective equipment when handling blood, body substances, excretions and secretions;
§ Appropriate handling of patient care equipment and soiled linen;
§ Prevention of needlestick/sharp injuries;
§ Environmental cleaning and spills-management; and
§ Appropriate handling of waste.
Hand washing and Antisepsis (hand hygiene)
Appropriate hand hygiene can minimise micro-organisms acquired on the hands during daily duties and when there is contact with blood, body fluids, secretions, excretions and known and unknown contaminated equipment or surfaces (for further details see Annex 1).Wash or decontaminate hands:
· After handling any blood, body fluids, secretions, excretions and contaminated items;
· Between contact with different patients;
· Between tasks and procedures on the same patient to prevent cross contamination between different body sites;
· Immediately after removing gloves; and
· Using a plain soap, antimicrobial agent, such as an alcoholic handrub or waterless antiseptic agent. The hospital setting is a good setting for communication about personal hygiene, such as informing visitors and the general public about hygiene rules such as washing hands.
Use of Personal Protective Equipment
Using personal protective equipment provides a physical barrier between micro-organisms and the wearer. It offers protection by helping to prevent microorganisms from:
· Contaminating hands, eyes, clothing, hair and shoes;
· Being transmitted to other patients and staff (for further information about personal protective equipment see Annex 2). Personal protective equipment includes:
· gloves;
· protective eye wear (goggles);
· mask;
· apron;
· gown;
· boots/shoe covers; and
· cap/hair cover.
