Hygiene and contagious diseases – protective equipment, isolation and NIR

Hand hygiene is already a fixed part of your everyday but when a citizen has a contagious disease you need to know more: when do you use which protective equipment and what does isolation mean in practice? The rules are based on the national infection hygiene guidelines called NIR.

The State Serum Institute (SSI) publishes and updates the National Infection Hygiene Guidelines (NIR) used in hospitals, municipalities, and the primary care sector throughout Denmark. The guidelines cover among other things hand hygiene, use of protective equipment, and cleaning, and are continuously updated by the Central Unit for Infection Hygiene.

According to NIR, hand hygiene must be performed before clean tasks and before food handling, after unclean tasks, before and after contact with the citizen or their immediate surroundings, and after use of gloves. The choice between hand disinfection and hand washing depends on how dirty or wet the hands are: hand disinfection is used on visibly clean and dry hands, while hand washing is used on wet or visibly soiled hands — and always when in contact with infectious diarrhoea, where hand washing is followed by hand disinfection.

• 01Before clean tasks and before handling food.
• 02Before and after contact with the citizen or their close contacts.
• 03After dirty tasks and after use of gloves.
• 04Handwashing not just disinfection with contagious diarrhoea.

Gloves, plastic apron or gown and possibly mask and eye protection are used when there is risk of contact with blood, secretions or other body fluids, or in case of known or suspected infection. Protective equipment must be removed in the correct order and disposed of properly so you do not become a source of infection to the next citizen.

For certain infectious diseases which must be prevented from spreading to other residents isolation can be decided — e.g. for suspected or confirmed resistant bacteria such as MRSA or for infectious gastroenteritis. The practice for isolation — what protective equipment how visits are handled and how equipment is cleaned — is determined in the local hygiene instruction based on NIR and you must always follow the specific instruction rather than improvise.

• 01You are often the one closest to the citizen most times of the day — your hygiene matters greatly.
• 02If you are in doubt about whether something is clean, treat it as unclean.
• 03Speak up if you lack personal protective equipment or are unsure of the procedure.
• 04Report to your manager if you yourself become ill with something that can spread to vulnerable users.

“Hand hygiene is the best documented way to break a transmission route – and it costs nothing.”