MRTs must be aware of and follow infection control procedures at their facility, and use routine practices* to minimize the risk of infection to patients
- 30 -50% of infections resulting from exposure in healthcare facilities are preventable, and are primarily caused by problematic patient care practices, such as poor hand washing1.
- Recent data show that in Canada, one in every nine hospital in-patients acquires a nosocomial infection2,3
- The Public Health Agency of Canada and the World Health Organization (WHO) recommend that all healthcare facilities put an efficient infection control program into place to prevent the spread of disease4,5.
- Full participation in infection control is the responsibility of every health care worker
- Good infection control practices instil confidence in patients6
- Education (for healthcare professionals, patients and hospital visitors) is an important component of infection control
- Routine practices should be the minimum level of precautions used when providing care for all patients7.
- Routine practices are an element of best practice followed by all MRTs, including proper hand hygiene according to the guidelines set out by their facility8.
- MRTs’ duty to their patients include familiarity with institutional procedures and policies regarding standard and special precautions (contact, droplet or airborne), including the proper use of personal protective equipment9.
- Hand hygiene is a major component of routine practices and one of the most effective methods to prevent transmission of pathogens associated with healthcare7.
- Like all healthcare professionals, MRTs are expected to learn and adhere to hand hygiene techniques7.
- Five moments for hand hygiene include10:
- Before touching a patient
- Before clean aseptic procedure
- After body fluid exposure risk
- After touching a patient
- After touching patient surroundings
- Gloves are also worn during certain procedures, particularly those where contact with a patient’s bodily fluids is likely7.
- Gloves are not a replacement for hand washing — hands should be washed prior to putting on, and after removing gloves
- Depending on the route of transmission (airborne, contact or droplet) a different set of additional precautions is employed for people with documented or suspected infection11.
Additional airborne precautions
- Examples of diseases which are transmitted via the airborne route include11:
- Measles (rubeola)
- Varicella (including disseminated herpes zoster)
- Additional airborne precautions include4,11,12:
- Using N95 masks for MRTs, where fit-testing has been completed
- Using surgical masks for patients, MRTs without N95 fit-testing, and others coming into contact with the infectious agent
- Instructing patients to observe respiratory hygiene/cough etiquette
- Limiting on the movement and transport of patients
- Keeping doors to rooms closed
- Airborne pathogens stay suspended in the air for long periods of time – ventilation of the environment may be required12.
Additional contact precautions
- Examples of diseases which are transmitted via contact include:
- Methycillin-resistant staphylococcus aureus (MRSA)
- Vancomycin-resistant enterococcus (VRE)
- Clostridium difficile (C. difficile)
- Contact transmission may occur directly (infected person to person) or indirectly (contaminated equipment, etc.)11.
- Additional contact precautions include4,11,12:
- Strict hand hygiene for all those who come into contact with the patient
- Using personal protective equipment such as gloves and gowns
- Carefully disposing of gloves and other items that come into contact with the patient
- Proper cleaning of equipment, according to facility policy
Additional droplet precautions
- Examples of diseases which are transmitted via the droplet route include11:
- Influenza virus
- Neisseria meningitidis
- Bordetella pertussis (whooping cough)
- Additional droplet precautions include4,11,12:
- Using a surgical mask (patient, MRT and others coming into contact with the patient)
- Using gloves and gowns
- Instructing patients to observe respiratory hygiene/cough etiquette
- Using eye protection when within 1-2 meters of patient
- Limiting the movement and transport of patients
- Good housekeeping in the workplace helps to reduce the prevalence of pathogens and discourage the growth of microorganisms13.
- Equipment is wiped with disinfectant between patients7.
- Fresh linens are used for each new patient and used linens are handled and transported in a way that avoids exposure to other patients or staff7.
- Safe waste management techniques are employed7.
- Some waste may be disposed of in the regular garbage
- Biomedical waste is disposed of according to established guidelines and standards
- Infectious patients are scheduled for the end of the day where possible.
- This allows a thorough cleaning of the room (while it remains unoccupied over a prolonged period of time), allowing the air filtration system to remove any airborne contaminants
- Airborne precautions often include a period of time where a room is left empty after an infectious patient followed by thorough cleaning
- An effective infection control program requires good communication with patients and education regarding the importance of institutional practices14,15.
- MRTs explain the importance of hand washing when entering and leaving the facility and hand hygiene awareness information is available to patients
- Family and visitors are also given instructions regarding hand hygiene and the appropriate use of Personal Protective Equipment as appropriate11
- Patients who require additional precautions should have the importance of these measures explained to them16.
- Effective communication between staff is also essential17.
- Precaution patients are clearly identified and recorded
- Additional precautions are communicated at every patient handover
Bennett JV, Brachman PS, eds: Hospital Infections. 3rd ed. Boston. Little, Brown and co., 1992.
Zoutman DE, Ford BD, Bryce E, et al. The state of infection surveillance and control at Canadian acute care hospitals. Am J Infect Control. 2003;31:266-275.
Canadian Union of Public Employees. Health care associated infections: a backgrounder. Available from: https://cupe.ca/health-care-associated-infections-backgrounder-and-fact-sheet#ftn5. [Accessed 29 Nov 2018]
World Health Organization. Practical Guidelines for Infection Control in Health Care Facilities. 2004. Available from: http://www.searo.who.int/LinkFiles/Publications_PracticalguidelinSEAROpub-41.pdf. [Accessed 2 May 2018]
Health Canada. Infection control guidelines: Hand washing, cleaning, disinfection and sterilization in health care.
Publication.gc.ca. Dec 1998. Available from: http://publications.gc.ca/collections/collection_2016/aspc-phac/HP3-1-24-S8-eng.pdf. [Accessed 28 May 2018]
O’Boyle CA, Henly SJ, Duckett LJ. Nurses’ motivation to wash their hands: a standardized measurement approach. Appl Nurs Res 2001;14:136-145.
World Health Organization. Infection control standard precautions in health care: Aide-Memoire. Available from: http://www.who.int/csr/resources/publications/4EPR_AM2.pdf. [Accessed 3 Apr 2012]
World Health Organization. WHO guidelines on hand hygiene in health care. 2009. Available from: http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf. [Accessed 2 May 2018]
Canadian Association of medical radiation technologists. Code of Ethics. CAMRT. June 2008. Available from: http://www.camrt.ca/mrt-profession/professional-resources/code-of-ethics/. [Accessed 3 Nov 2014]
World Health Organization. Your 5 Moments for Hand Hygiene. Available from: http://www.who.int/gpsc/5may/Your_5_Moments_For_Hand_Hygiene_Poster.pdf. [Accessed 25 May 2012]
Newfoundland and Labrador, Department of Health & Community Services Disease Control Division. Guideline for Routine Practices and Additional Precautions. Available from: http://westernhealth.nl.ca/uploads/PDFs/Routine_Practices_and_Additional_Precautions.pdf. [Accessed 29 May 2018]
Ontario Infection Control Committee. Infection control for regulated professionals. Available from: http://www.cmto.com/pdfs/Infection_Control_Guidelines.pdf. [Accessed 4 Apr 2012]
Ehrlich RA, Coakes DM. Patient Care in Radiography with an Introduction to Medical Imaging. 9th ed. Elsevier; 2017.
Coulter A, Ellins J. Effectiveness of strategies for informing, educating and involving patients. BMJ 2007;335(7609):24-27.
Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings. Infect Control Hosp Epidemiol 2002;23(12):S3-S40.
Siegel J, et al. Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006. Center for Disease Control. 2006. Available from: https://www.cdc.gov/infectioncontrol/pdf/guidelines/mdro-guidelines.pdf. [Accessed 24 May 2018]