Infection prevention Ė Essential steps for infection prevention in VIA screening or triage
- Wash your hands thoroughly with soap and water, following the steps recommended by the World Health Organization.
- Wipe your hands with a clean towel or air-dry. Avoid using shared towels, to prevent contamination.
- Wear sterile gloves on both hands before starting the procedure.
- Perform handwashing before and after examining each woman.
- Make sure to always wear gloves before making contact with any secretions, body fluids, or blood.
- Change gloves after completing each examination, to prevent cross-contamination.
- Arrange the sterile or HLD instruments for VIA on the instrument tray.
- During the examination, maintain a unidirectional flow of instruments and consumables:
- Pick up sterile instruments from the VIA instrument tray.
- Examine the woman on the examination table.
- Place the used instruments in a separate bowl or container with 0.5% chlorine solution.
- Place the used cotton swabs and gloves in a separate bowl or waste disposal container.
- Soak the used instruments and other items in 0.5% chlorine solution for 10 minutes. (It is important to remove the instruments from the chlorine solution after 10 minutes, to prevent corrosion and discolouration.)
- Remove the instruments from the chlorine solution and place them in detergent solution.
- Clean the instruments gently by scrubbing them with a soft brush to remove any organic material, tissue, and blood. Particular care should be given to the curved inner edges, joints, and screws of self-retaining specula, where organic material may remain adherent along with the microorganisms trapped inside.
- Rinse all instruments thoroughly with clean water to remove any detergent residues.
- Sterilize the instruments by using high-pressure saturated steam (autoclaving), by using dry heat, or by soaking the instruments in chemicals such as 2Ė4% glutaraldehyde or 8% formaldehyde. If chemical sterilization is used, rinse all instruments with sterile water before use.
- If performing HLD by boiling:
- Submerge the cleaned instruments in water in a covered pot or sterilizer.
- Heat the water to a rolling boil, and keep the instruments in boiling water for 20 minutes.
- Do not add any instruments after the water starts boiling.
- If performing HLD by chemicals:
- Soak the cleaned instruments in 0.1% chlorine solution or in 2% glutaraldehyde solution for 20 minutes.
- Rinse the instruments thoroughly with sterile water before use.
- Dispose of all items contaminated with blood and body fluids, including cotton balls, cotton swabs, and gauze, in properly marked leak-proof containers or plastic bags. Other waste materials generated from the cleaning of clinic premises and disinfection activities should also be discarded in the container or bag.
- Send the leak-proof container or bag for incineration or appropriate disposal. (Arrange for daily collection of wastes from screening clinics.)
- Decontaminate all objects (e.g. focusing lights) and surfaces (e.g. the examination table) that have come into contact with body fluids and secretions, by wiping them with 0.5% chlorine solution or 90% ethyl alcohol.
- Immerse both gloved hands in 0.5% chlorine solution briefly, and remove the gloves by turning them inside out.
- Decontaminate the used gloves by soaking them in 0.5% chlorine solution for 10 minutes.
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