VETERINARY SUPPORT ASSISTANT

DIPLOMA COURSE

ASSIGNMENT ELEVEN

INFECTION CONTROL

Overview and learning outcomes

Overview

• Importance of infection control

• Personal protective equipment
• Cleaning and disinfection
• Sterilisation
• Hand hygiene
• Isolation of an infectious animal
• Waste

Outcomes

• Understand why it is important to have infection control protocols

• Understand the basics of cleaning and disinfection

• Learn about the different types of sterilisation and how they are used

• Know the importance of using personal protective equipment and when to use it

• Understand the importance of hand hygiene, when to wash your hands and how to do it
correctly

• Learn when and how to isolate an infectious animal

• Identify the different ways of disposing of veterinary waste

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 THE IMPORTANCE OF INFECTION CONTROL

In day-to-day lives, we are always surrounded by different types of bacteria, viruses and germs, and
these are what allow the spread of infections to occur. Infections are potentially harmful to us and
our animal patients, so it is important to try to control and prevent the spread of infection. In a
veterinary practice, not only is there a higher risk of coming into contact with infection, there is also
a large number of already ill and immune-suppressed animals, so they are more prone to illness.

The risk of this infection transmission needs to be recognised and managed, as it is crucial to
maintain the health of the patients and of the people who look after them.

Personal Protective Equipment

Personal Protective Equipment, sometimes referred to as PPE, is specialised clothing etc. that can be
worn to protect against exposure to an infectious material. It can include gloves, gowns, aprons, hats,
shoe covers, face shields, masks and goggles. Let’s take a look at these in more detail.

Gloves

They should not be necessary when examining or handling normal, healthy animals, but they should
be worn when touching any faeces, blood and body fluids etc. They should be worn for dentistry,
cleaning, when handling dirty laundry or lab samples. Gloves should be changed between animals
and jobs, disposed of quickly, and you should wash your hands after wearing them.

Facial protection

You should wear facial protection whenever you are likely to be exposed to stresses or sprays, and
this includes a mask worn with goggles or a face shield. For example, it should be used when
flushing wounds, doing dentistry and lancing abscesses etc.

Outerwear

You should wear protective outerwear like a gown or apron when cleaning or handling animals with
a suspected infectious disease. It should be changed whenever soiled.

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Shoes

Sensible shoes, with closed toes and thick soles, should be worn. The shoes must be easily cleaned
and waterproof. Disposable shoe covers can be worn if necessary, for example, if a large spill is
encountered or if you are working in the isolation unit.

CLEANING AND DISINFECTION

Let’s look at physical cleaning first, as this is the most important for you to understand. Cleaning is
the process of physically removing all signs of dirt. This is the most common method of infection
control at the vets and involves using chemicals with cleaning tools, such as a mop or sponge. It may
include dusting, mopping, and cleaning up urine and faeces within an animal’s cage. All these things
include the use of your hands to remove the dirt and microorganisms from surfaces. By doing this
using a chemical, you are usually disinfecting areas to prevent the spread of disease at the same time.
Disinfecting is the process of destroying most of the microorganisms on inanimate things by physical
or chemical means.

It is incredibly important that the general cleaning veterinary practice is of a high standard.
Cleanliness must be a priority to everybody. Most areas in a veterinary practice need cleaning and
disinfecting daily. Some areas will need a much more intensive cleaning protocol than others. For
example, the theatre needs to be kept spotless all times, whereas a general corridor may only need
mopping twice a day. All practices have their own cleaning protocols and regimes. Depending on the
type of disinfectants used and the type of work that they do, the protocols can vary widely. I can only
generalise in this lesson.

Most practices have a daily cleaning routine, and it is everybody’s responsibility to help keep the
practice clean and tidy. As a veterinary nurse or assistant you are generally required to do the
majority of the cleaning, and it is normally a veterinary nurse’s responsibility to keep the practice,
animals, equipment and themselves clean.

General rules for cleaning

• Use safety signs to inform people of wet floors

• Work from the back of the room towards the door
• Work from the top to the bottom

It is good to have a ‘clean up as you go’ attitude, as not only will this make the place cleaner, it all
will also make it safer. This could mean putting items back once they’ve been used, tidying up an
area after a vet has performed the procedure, or cleaning up after a dog as soon as it has made a
mess.

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Top cleaning tips

• As already mentioned, clean up as you go along

• Keep a second set of clothes and scrubs, in case your first set becomes contaminated

• Routinely clean and change the bedding in animals’ cages

• Remove uneaten food

• Limit the area where the animals are allowed to urinate and defecate

• Treat the animals in isolation last

• Wear the appropriate protective clothing when using cleaning chemicals

• Regularly clean walls and doors

• Cleaning must be done to a good standard to allow proper disinfection. All hair and dirt must
be removed from surfaces to allow for proper disinfecting to take place

• An example of daily infection control tasks for an impatient nurse:

o Clean and disinfect all cages and kennels

o Wash, dry and fold bedding and laundry
o Hoover, mop and disinfect the kennel areas
o Empty all the rubbish bins
o Hoover, mop and disinfect the waiting area, once consulting has finished
o Frequently check the inpatients, to see if they need cleaning out
o Frequently take the dogs out to do their business
o Wash up the food and water bowls from the inpatients
o Clean the cages and kennels out once the patient has gone home.

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General cage cleaning protocol:

• Once the animal has vacated the cage, it will need to be disinfected and cleaned properly
• First remove all newspaper, blankets and organic debris
• Spray all the surfaces with a disinfectant
• Allow time for the disinfectant to work
• Scrub the door and wipe out all the cage walls, ceiling and floor
• Allow to air-dry
• Put clean newspaper and bedding into the cage

Equipment and surfaces

It is important to remove any organic matter before using disinfectants. Make sure you use them
according to the manufacturer’s instructions. Try to minimise the dust when cleaning by first misting
the surface with a disinfectant.

Laundry

For items that are placed in the washing machine, they should be shaken out and cleared of all
organic debris first. A standard washing detergent is usually used, and sometimes a disinfectant can
be added. The highest-temperature setting on the washing machine should also be used. Heavily
soiled items or those that have been contaminated with a highly infectious disease should be
discarded.

Theatre

The theatre should contain minimal furniture. The furniture it does have should be easily movable;
this will make regular, thorough cleaning more efficient. Hats, masks and scrubs should be worn by
everyone entering the theatre, and the number of people in theatre should be the bare minimum. This
will help reduce the risk of infection. Theatre should always be left clean and tidy and ready for use.
The operating tasks for the day should be prioritised so that the cleanest sterile surgery goes first and
then the less clean operations go afterwards. For example:

• First: bone surgery

• Second: neutering
• Third: removal of a foreign body from a stomach
• Fourth: ear surgery
• Fifth: mouth surgery

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Theatre cleaning protocol:

Daily

Damp-dust all surfaces using a cloth and antiseptic solution at the beginning and end of each day.

Thoroughly clean the operating table and other surfaces between operations.

Thoroughly hoover and mop the floors at the end of the day.

Weekly

Thoroughly clean walls, floors and equipment, and all rooms connected to the theatre should have a
thorough weekly clean as well.

Spillages

For spillages of possibly infectious materials you will need to first spray the spillage with a
disinfectant, then you want to contain the spillage with an absorbent material, like a paper towel, or
cat litter. Then put on the correct protective clothing, for example, gloves, masks and possibly shoe
covers if you’ve got to step in it to clean it up. Then, pick up the material and clean and disinfect the
area. It is important to keep people and animals away from the spill area until you have finished.

Sterilisation

Sterilising is the process of destroying all microorganisms and viruses on an object. This can be
using chemicals or extreme heat. It is usually used to eradicate microorganisms and viruses from
things like surgical instruments and consulting room instruments.

TYPES OF STERILISATION

Autoclave

This is the most common type of sterilisation in the veterinary practice. It is used to sterilise all the
surgical equipment. Basically it is a piece of equipment that is a sealed tank. Objects placed in it are
exposed to heat and steam under pressure, at an extremely hot temperature, to kill all the living
organisms. Care needs to be taken about what items you put in the autoclave, because they must be
able to withstand high temperatures.

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Cold sterilisation

This is the process of soaking items in a strong disinfectant chemical. This technique is generally
used on items that can’t withstand the heat of an autoclave. As the chemicals used are quite potent it
is also a quicker method than autoclaving equipment.

Gas

It is possible to sterilise items using chemical gases, but this is usually not done in practice. The
equipment is brought in already sterilised by this method and it is usually one use only.

Ultrasound cleaners

These are very useful for cleaning surgical instruments prior to putting them in the autoclave.
Ultrasonic waves pass through a solution, which creates a vibration that scrubs the instruments clean.
This is not a good method of sterilisation, but it is a good method to use for pre-sterilisation.

HAND HYGIENE

Having a good standard of hand hygiene is important, as it reduces the bacteria on your hands as well
as the objects that you come in contact with. The use of gloves is also a good idea, but it does not
provide complete protection against contamination; the hand washing will still need to be done.
Failure to keeping up good hand hygiene will increase the risk of transmission of disease.

When to wash your hands:

• Before and after each animal you come in contact with

• After coming in contact with urine, faeces, blood or other body fluids
• Before eating or drinking
• After using the toilet
• After cleaning
• After wearing gloves
• After handling money
• After coughing or sneezing

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Hand washing can be grouped into three different methods. Each method achieves a different level of
bacteria eradication. Let’s look at these more closely:

Routine hand washing

This process uses water and soap to remove dirt and debris from the surface of the skin, along with
some of your natural oil that keeps the skin soft, but this oil also traps microorganisms. The soap by
itself breaks up this layer of oil which when you wash it off, which removes the bacteria and dirt, but
the soap does not kill bacteria.

Antiseptic hand washing

This is the same as routine hand washing, but includes using an antiseptic solution that is either
included in the soap or is added as extra. This is a more efficient way as it actively kills bacteria and
removes it from your hands.

Surgical scrub

This procedure results in a very high level of bacteria eradication. It is commonly used by a
veterinary surgeon prior to them performing surgery.

How to effectively wash your hands:

• Use water to wet hands

• Place antiseptic soap product in your palms

• Rub hands together to make the soap lather

• Wash hands thoroughly for twenty seconds, not forgetting the inside and the backs of your
fingers, the back of your hands and your thumbs

• Rinse off all the soap

• Dry your hands using a disposable paper towel

• Turn off the tap with your arms if possible, or use a disposable towel as a barrier

• Keep your fingernails very short, and do not wear artificial nails or hand jewellery.

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 ISOLATION OF INFECTIOUS ANIMALS

Animals with any contagious or zoonotic (capable of being transmitted to humans) disease should be
housed in isolation as soon as possible. The isolation area is generally a clearly marked room or
cage, away from any other animal.

Common infectious diseases that require isolation:

• Ringworm
• Canine infectious hepatitis, parvovirus, distemper
• FIP, FELV and FIV (Feline)
• Cat flu
• Leptospirosis
• Salmonellois
• Sarcoptic mange
• Toxoplasmosis

Some veterinary practices have purpose-built isolation units, others have a home-made isolation area.

A purpose-built isolation unit is a room specially built, with cages, sink, treatment table, has medical
supplies and has changing facilities for the staff. Entry to the unit will be via the changing area with
foot baths. Clean protective clothing should be worn at all times in the unit and discarded prior to
leaving.

Home-made isolation units consist of a kennel or cage that is as far away from other inpatients as
possible, and protective clothing is worn if the animal is handled. Foot baths are available on the
approach to the kennel. Any area that has contact with the animal will be thoroughly disinfected
before they are reused. The animal has separate food and water bowls, lead, blanket, etc. The area
should be clearly labelled and all staff informed. All equipment that you may need should be
gathered together for handling the animal and kept within the isolation area. The waste must be
bagged separately in the isolation area before being disposed of.

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 WASTE

The waste from a veterinary practice is strictly controlled by waste regulations of England and
Wales, by the Environment Agency. Usually the practice will employ a waste disposal service that
will provide the correct containers to dispose of the waste in, and then will collect the full containers,
normally on a weekly basis. It is the responsibility of the waste producer to ensure that the waste is
stored and disposed of responsibly, and that it is handled or dealt with by those authorised to do so.
Appropriate records should be kept of all waste that is transferred or received.

• Non-hazardous waste
o Domestic waste
This contains only domestic rubbish, which might include un-soiled
newspapers and magazines, sandwich wrappers or packets.
• Disposal in black bags.

o Pharmaceuticals
These are pharmaceuticals, not including chemotherapy drugs. This includes
out-of-date drugs, contaminated bottles and syringes etc.
• Disposal in blue container.

o Offensive waste
This is waste that is not hazardous, but is unpleasant. This would include
animal bedding and faeces.
• Disposal in yellow bags with a black stripe.

o Cadavers
These are animal bodies that are not suspected of harbouring a notifiable
disease. These are usually kept in a chest freezer until collected.
• What they are disposed in depends on whether they’re going to the pet
crematorium or being buried at home.

• Hazardous waste
o Cytotoxic and cytostatic pharmaceuticals
These are generally chemotherapy drugs. Extreme care should be taken when
handling and disposing of these items. They may include bottles and vials,
syringes, needles and animal bedding.
• Disposed of in purple and yellow containers.

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 o Contaminated sharps
These are needles and scalpels that have a risk of infection to any animal or
person who may come contact with them.
• Disposed in yellow sharps container.

o Infectious clinical waste

This is any waste that contains microorganisms that are known to cause
disease in humans or animals. This includes anything that presents a risk of
infection, for example swabs, gloves, blood and body parts, and infectious
animal bedding. Infectious cadavers are also put in this category.
• Disposed in yellow containers.

o Photographic chemicals
This includes the x-ray chemical solutions.
• Disposed of in leak-proof drums.

TUTOR TALK: You have now come to the end of this assignment. Answer the questions
relating to the work that you have just covered and return them to the College for marking.

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“Empty pockets never held anyone back. Only empty heads and empty hearts can do that.”

Norman Vincent Peale

Veterinary Support Assistant Diploma Course – Assignment Eleven – Page 11

STUDENT NOTES: Please use the space below for recording what you consider to be
any pertinent information or notes. You may find it helpful to refer back to it later on!

Veterinary Support Assistant Diploma Course – Assignment Eleven – Page 12