Infection Control in the Physician's Office
Downloadable link to Infection Control in the Physician’s Office
(To receive a printed copy please contact the College and include your name and mailing address.)
Executive Summary
The College of Physicians and Surgeons of Ontario (the “College”) is pleased to publish the third edition of Infection Control in the Physician’s Office. These guidelines have continued to evolve from 1995 through direct experience and our changing world, as the prevention and control of the spread of infection has become a global challenge.
For the most part, these are educational guidelines for doctors. Some components have been derived from legislation and regulations, and will state in explicit terms what physicians should or should not do. However, many parts of the guidelines are best practices, designed to raise awareness about day-to-day risks of transmission in a doctor’s office, and to equip doctors with suggestions and tools to minimize such risks. Professional judgement and the realities of medical practices in Ontario will always inform how each bestpractice recommendation is used by individual doctors. In the event that Ontario experiences a serious infectious disease outbreak, these best practices may be superceded by directives from the Ministry of Health and Long-Term Care, Public Health, the College, or another designated national or provincial organization. The risks of such a situation will hopefully be mitigated by careful consideration of these guidelines by all physicians and their teams in community health practices.
The guidelines consist of three sections:
- Patient Care – how is infection transmitted, what are “routine practices” and what are some of the precautions that can be taken?
- Health Care Workers – what are the recommended immunization practices for health care workers and how can personnel health impact on potential transmission?
- The Environment – what are appropriate waste disposal, sterilization and disinfection, general housekeeping, and office design considerations?
Assisted by diagrams and flowcharts, the College hopes that this edition of the guidelines will be the most helpful one for doctors to date.
As you read the guidelines, think about your practice and where changes might be warranted to address some of the typical areas of risk.
In your practice, do you:
- Practice hand hygiene for staff and patients?
- Handle sharps properly?
- Have adequate personal protective equipment?
- Have N95 or equivalent respirators for airborne precautions?
- Complete adequate sterilization and disinfection?
- Separate and properly dispose of biomedical waste?
- Follow protocols for exposure to blood or body fluids? Vaccine storage and handling? WHMIS? Reportable communicable diseases?
- Use single-use devices only once?
All of the above are derived from legislation, regulations or accepted standards of practice based on research, evidence and experience – there is little room for variability, with the exception of the use of protective equipment.
Consider the following for your practice:
- Droplet, contact and airborne precautions;
- Signage to help your patients do the right thing, such as respiratory etiquette practices;
- The possible need to isolate a patient;
- Booking and triaging patients who are at higher risk for seriously transmissible infections;
- General housekeeping tips;
- Use of multi-dose vials;
- The benefits of a policy and procedure manual on infection control in your office;
- The role of your staff in helping to reduce the risk.
All of the above are practices worthy of review and consideration. You may not be able or need to implement all practices, but this information will help you use your professional judgement as necessary.
Note: Changes were made on page 38 under "Suggested Procedures" and to Table 3 on page 43 after this Guide was printed. If you have a printed version, please update by adding printouts of these two pages from the attached PDF version. [See link at top of this page.]