Temperature Measurement - Infection prevention and Work Health and Safety

Recommendations for practice

Section

Recommendation

Grade

5.

Clinicians should undertake a risk assessment to identity the risk of contamination and mucosal or conjunctival splash injuries when taking a patient’s temperature; and personal protective equipment (including goggles/face shield/gloves and gown/apron) as per NSW 2007 Infection control policy should be worn accordingly.

National and NSW Policy

6.

Clinicians must adhere to the five moments of hand hygiene.

Hand hygiene policy

7.

To reduce the risk of microbial transmission, ICUs should consider having either

an electronic thermometer at each bed area, or disposable single-use thermometers.

Consensus

8.

To reduce the risk of microbial transmission where patients are considered stable but are isolated, ICUs might consider the use of disposable single-use thermometers.

Consensus

9.

Electronic thermometers must be cleaned between patients. This includes where equipment is shared between bed areas and when a patient is discharged.

Consensus

10.

Clinicians should refer to state or local indwelling urinary catheter management guidelines to minimise CAUTI .

Consensus

The evidence review for these recommendations was current to May 2012. Clinicians are advised to check the literature as research may have been published that change these recommendations

Hand hygiene

The NSW Health Hand Hygiene Policy (PD2010_058) states that all staff must perform hand hygiene as per the Five Moments for Hand Hygiene; Hand hygiene must occur before touching the patient; prior to a procedure; after a procedure or body fluid exposure risk; after touching a patient; after touching a patient’s surroundings. Hand hygiene can be performed using appropriate soap solutions and water or alcohol-based hand rub (ABHR). Soap and water must be used when hands are visibly soiled.

Before touching a patient, before a procedure, after procedure, after touching a patient, after touching a patient's surroundings

Based on the 'My 5 moments for Hand Hygiene', © World Health Organization 2009. All rights reserved.

NSW Ministry of Health policies

Prevention of infection is an important aspect of any clinical practice guideline. Users are directed to the following policy directives covering infection control. Local policy must also be consulted.

  1. Infection Control Policy (PD2007_036)
  2. Infection Control Policy: prevention & management of multi-resistant organisms (MRO) (PD2007_084)
  3. Hand Hygiene Policy PD2010_058
  4. Australian Guidelines for the Prevention and Control of Infection in Health Care

Personal protective equipment

The Australian Guidelines for the Prevention and Control of Infection in Health Care and the NSW Infection Control Policy (PD2007_036) state that all procedures that generate or have the potential to generate secretions or excretions require that either a face shield or a mask with protective goggles be worn.

Workplace health and safety

Prevention of work injury is an important aspect of any clinical practice guideline. Users are directed to the following policy directives covering work health and safety. Local policy must also be consulted.

The NSW Work Health and Safety Act 2011 states that organisations must eliminate the health and safety risks to workers where at all possible. When it is not possible to eliminate risks, the risk must be minimised as far as reasonably practicable. Organisations must provide appropriate PPE for use by staff. Staff have a responsibility to use that PPE according to policy.

The worker has an obligation under the NSW Work Health and Safety Act 2011 to;

  1. take all reasonable care for their own safety
  2. take care that their acts or omissions do not adversely affect the health and safety of other persons
  3. Comply with any reasonable instruction they are given.

Grading of recommendation taxonomy

Grade of recommendation

Description

A

Body of evidence can be trusted to guide evidence

B

Body of evidence can be trusted to guide practice in most situations

C

Body of evidence provides some support for recommendation/s but care should be taken in its application

D

Body of evidence is weak and recommendation must be applied with caution

Consensus

Consensus was set as a median of ≥ 7

Grades A–D are based on NHMRC grades (22)

References

  1. NHMRC. NHMRC additional levels of evidence and grades for recommendations for developers of guidelines:PILOT PROGRAM 2005 - 2007. Australian Government; 2005.

Disclaimer

The information on this page is general in nature and cannot reflect individual patient variation. It reflects Australian intensive care practice, which may differ from that in other countries. It is intended as a supplement to the more specific information provided by the doctors and nurses caring for your loved one. ICNSW attests to the accuracy of the information contained here but takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.