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Preventable Measures for Nosocomial Conjunctivitis in the Wilmer Institute

Introduction

The following policy and procedures are implemented to prevent transmission of conjunctivitis within the Wilmer Institute and are intended to prevent the spread of infection to patients and personnel in the Institute. Condition Yellow is one caution which specifies infection control measures for the baseline, non-epidemic occurrence of conjunctivitis. Condition Red is a situation in which the Institute is on full alert during a suspected outbreak of viral conjunctivitis or keratoconjunctivitis. In this setting, patients are regularly presenting themselves to the Institute for evaluation of conjunctivitis and the likelihood of transmitting viral conjunctivitis to other non-infected individuals is extremely high.

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Procedures

Condition Yellow
Patient Management: Any patient noted to have signs and symptoms of conjunctivitis is referred to a Red Eye room. If nosocomial conjunctivitis is suspected, the case is logged and reported to HEIC.

Hand Hygiene: Each employee must cleanse with approved antimicrobial prodcuts before and after each patient, including each time gloves are removed after patient contact. Hands are to be dried with clean paper towels.

Instrument Disinfection: Instruments may transmit adenovirus and other possible agents. These include the Goldmann tonometer tip, pneumotonometer tip, contact, diagnostic, and treatment lenses, pinhole/occluder, and/or any instrument contaminated with eye secretions.

*See full policy for proper instrument disinfection procedures*

Medication Distribution: Discard and replace multidose dilating and other diagnostic eye drops at least monthly and whenever contamination of the dropper tip is suspected.

Employee Furloughs: Relieve employees (after ophthalmologic evaluation) with possible viral conjunctivitis for 3 days. At day three, they should undergo a repeat evaluation. If symptoms of viral conjunctivitis or positive culture for adenovirus continue, employees will be relieved from duty for 2 weeks.

Condition Red
Patient Management: A healthcare worker will screen all patients as they register. Any patient with a red eye/s will be routed to a separate registration desk and the Red Eye Room.

Hand Hygiene: Each employee must cleanse with approved antimicrobial products before and after each patient, including each time gloves are removed after patient contact. Hands are to be dried with clean paper towels.

Instrument Disinfection: Avoid all forms of tonometry during Condition Red unless medically indicated. Do not use Pneumotonometers during Condition Red. If the physician or technician uses pneumotonometry, they must disinfect all surfaces of the instrument by wiping with an approved germicide after each patient use. Three times a day, wipe all instrument surfaces in contact with patients/personnel.

*See full policy for proper instrument disinfection procedures*

Medication Distribution: Discard all multidose dilating and other diagnostic eye drops. Substitute bottles of the smallest available volume if single dose bottles are not available.

Employee Furloughs: As in Condition Yellow, relieve employees (after ophthalmologic evaluation) with possible viral conjunctivitis for 3 days. At day three, they should undergo a repeat evaluation. If symptoms of viral conjunctivitis or positive culture for adenovirus continue, employees will be relieved from duty for 2 weeks.

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