Guide to Infection Prevention and Control in Personal Service Settings, 3Rd Edition
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Guide to Infection Prevention and Control in Personal Service Settings, 3rd edition First Revision: July 2019 Public Health Ontario Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. Public Health Ontario links public health practitioners, frontline health workers and researchers to the best scientific intelligence and knowledge from around the world. Public Health Ontario provides expert scientific and technical support to government, local public health units and health care providers relating to the following: communicable and infectious diseases infection prevention and control environmental and occupational health emergency preparedness health promotion, chronic disease and injury prevention public health laboratory services Public Health Ontario's work also includes surveillance, epidemiology, research, professional development and knowledge services. For more information, visit publichealthontario.ca. How to cite this document: Ontario Agency for Health Protection and Promotion (Public Health Ontario). Guide to infection prevention and control in personal service settings. 3rd ed., 1st revision. Toronto, ON: Queen’s Printer for Ontario; 2019. ©Queen’s Printer for Ontario, 2019 Public Health Ontario acknowledges the financial support of the Ontario Government. Previously published as: Ontario. Ministry of Health and Long-Term Care. Infection prevention and control best practices for personal services settings. 2nd ed. Toronto, ON: Queen’s Printer for Ontario; 2009. Publication history: 1st edition: 1998 (Ministry of Health and Long-term Care) 2nd edition: 2009 (Ministry of Health and Long-term Care) 3rd edition: November 2018 1st Revision: July 2019 Guide to Infection Prevention and Control in Personal Service Settings i Summary of Revisions First published: November 2018 The evidence in this document is current to November, 2018. Changes in this revision are summarized in the table below. Summary of changes in 1st revision: Date of Implementation Description of Major Changes Page(s) Removed requirement for single-use disposable blades to be Jun-19 97 sterile (e.g., shaving razors, callus blades) Reclassification of level of reprocessing required for reusable 100, 103, Jun-19 handles/holders for blades (e.g., scalpels, shaving razors, 104 callus blades) Guide to Infection Prevention and Control in Personal Service Settings ii Acknowledgements We gratefully acknowledge the assistance of the following organizations and individuals in updating and reviewing the 2018 A Guide to Infection Prevention and Control in Personal Service Settings. Public Health Ontario Sandra Callery Sam MacFarlane Director, Program IPAC Specialist, Infection Prevention and Control Infection Prevention and Control Claudine D’Souza Emily Nadolny Nurse Consultant, Research Coordinator, Infection Prevention and Control Infection Prevention and Control Laura Farrell Pat Piaskowski Program IPAC Specialist, Specialist/Writer, Infection Prevention and Control Infection Prevention and Control Isabelle Guerreiro David Ryding Program IPAC Specialist, Program IPAC Specialist, Infection Prevention and Control Infection Prevention and Control Colin MacDougall Grace Volkening Research Coordinator, Program IPAC Specialist, Infection Prevention and Control Infection Prevention and Control Ministry of Health and Long-Term Care Caroline Marshall Duri Song Strategy and Policy Advisor, Policy Analyst, Infectious Disease Policy and Programs Infectious Disease Policy and Programs Danielle Reimer Janu Sritharan Programs and Policy Advisor, Senior Policy and Program Advisor, Infectious Infectious Disease Policy and Programs Infectious Disease Policy and Programs Public Health Units Cecilia Alterman Christian Lapensee Manager Control of Infectious Public Health Inspector, Diseases/Infection Control, Ottawa Public Health Toronto Public Health Katherine Mayer Public Health Inspector, Simcoe Muskoka District Health Unit Guide to Infection Prevention and Control in Personal Service Settings iii Christina Milani Joanne Ristov Public Health Inspector, Public Health Inspector, Grey Bruce Health Unit Wellington-Dufferin-Guelph Public Health Roxana Nassiri Annie Seto-Choo Public Health Inspector, Public Health Inspector, Huron County Health Unit York Region Public Health Selina Nazim Jenee Wallace Manager Infection Prevention and Control, Public Health Inspector, York Region Public Health Simcoe Muskoka District Health Unit Katherine Paphitis Public Health Inspector, Wellington-Dufferin-Guelph Public Health The following Public Health Ontario staff also contributed to the development of this document: Helen Bedkowski Brandy Kirchen Manager Programs and Resources, Network Assistant, Infection Prevention and Control Infection Prevention and Control Barbara Catt Mabel Lim Manager IPAC Response and System Support, Infection Prevention and Control Specialist, Infection Prevention and Control Infection Prevention and Control Donna Moore Dr. Maureen Cividino Infectious Disease Physician, Infection Prevention and Control Specialist, Infection Prevention and Control Infection Prevention and Control Tim Cronsberry Francine Paquette Infection Prevention and Control Specialist, Manager IPAC Regional Support, Infection Prevention and Control Infection Prevention and Control Danijela Draganic Lori Schatzler Product Development Specialist, Infection Prevention and Control Specialist, Infection Prevention and Control Infection Prevention and Control Marianne Walker Dr. Gary Garber Chief, Network Assistant, Infection Prevention and Control Infection Prevention and Control Julie Hui-Chih Wu Lucia Zdeb Research Coordinator, Senior Communication Advisor, Knowledge Services Infection Prevention and Control Guide to Infection Prevention and Control in Personal Service Settings iv Disclaimer This document was developed by Public Health Ontario (PHO). PHO provides scientific and technical advice to Ontario’s government, public health organizations and health care providers. PHO’s work is guided by the current best available evidence at the time of publication. The application and use of this document is the responsibility of the user. PHO assumes no liability resulting from any such application or use. This document may be reproduced without permission for non-commercial purposes only and provided that appropriate credit is given to PHO. No changes and/or modifications may be made to this document without express written permission from PHO. Guide to Infection Prevention and Control in Personal Service Settings iv Contents Preamble ....................................................................................................................................................... 1 About This Document ............................................................................................................................... 1 IPAC Practices in PSS ................................................................................................................................. 2 1. Chain of Transmission ........................................................................................................................... 3 1.1 Infectious Agent ............................................................................................................................ 4 1.2 Reservoir ....................................................................................................................................... 5 1.3 Portal of Exit .................................................................................................................................. 5 1.4 Mode of Transmission ................................................................................................................... 5 1.4.1 Contact Transmission ................................................................................................................. 5 1.4.2 Droplet Transmission ................................................................................................................. 7 1.4.3 Vehicle-Borne Transmission ....................................................................................................... 7 1.5 Portal of Entry ............................................................................................................................... 8 1.6 Susceptible Host ............................................................................................................................ 8 2. Routine Practices .................................................................................................................................. 9 2.1 Risk Assessment ............................................................................................................................ 9 2.2 Hand Hygiene .............................................................................................................................. 10 2.2.1 Hand Rubbing Using ABHR ....................................................................................................... 11 2.2.2 Hand Washing Using Soap and Water ..................................................................................... 12 2.2.3 Other Hand Hygiene Products.................................................................................................. 13 2.2.4 Hand Care ................................................................................................................................