Glossary

This section outlines the way in which certain terms are used in these guidelines.

Acinetobacter

An aerobic Gram-negative bacillus commonly isolated from the hospital environment (especially intensive care units) and hospitalised patients; can cause healthcare-associated infections, especially wound infections and pneumonia.

Aerosols

Microscopic particles < 5 µm in size that are the residue of evaporated droplets and are produced when a person coughs, sneezes, shouts, or sings. These particles can remain suspended in the air for prolonged periods of time and can be carried on normal air currents in a room or beyond, to adjacent spaces or areas receiving exhaust air.

Airborne precautions

A set of practices used for patients known or suspected to be infected with agents transmitted person-to-person by the airborne route.

Alcohol-based hand rub

A TGA-registered alcohol-containing preparation designed for reducing the number of viable microorganisms on the hands without the use or aid of running water and which is included on the ARTG as a medicinal product.

Anteroom

A small room leading from a corridor into a room.

Antibiogram

The result of a laboratory testing for the sensitivity of an isolated bacterial strain to different antibiotics.

Antibiotic

A substance that kills or inhibits the growth of bacteria, fungi or parasites.

Antisepsis

The use of chemical or physical methods to prevent infection by destroying or inhibiting the growth of harmful microorganisms.

Asepsis

‘Freedom from infection or infectious (pathogenic) material'.

Aseptic Non Touch Technique (ANTT)

A practice framework for aseptic technique.

Aseptic technique

An aseptic technique aims to prevent microorganisms on hands, surfaces and equipment from being introduced to susceptible sites. Therefore, unlike sterile techniques, aseptic techniques can be achieved in typical ward and home settings.

Bloodstream infection

The presence of live pathogens in the blood, causing an infection.

Bundle

A set of evidence-based practices that have been shown to improve outcomes when performed collectively and consistently. The concept was developed by the Institute for Healthcare Improvement in the United States to improve the care process and patient outcomes.

Catheter

A thin, flexible, hollow tube used to add or remove fluids from the body.

Clean technique

Clean technique refers to practices that reduce the number of infectious agents, and should be considered the minimum level of infection control for non-invasive patient-care activities. Practices include: personal hygiene, particularly hand hygiene, to reduce the number of infectious agents on the skin; use of barriers to reduce transmission of infectious agents (including proper handling and disposal of sharps); environmental cleaning; and reprocessing of equipment between patient uses.

Clinical waste

Waste material that consists wholly or partly of human or animal tissue, blood or body substances, excretions, drugs or other pharmaceutical products, swabs/ dressings, syringes, needles or other sharp instruments.

Cohorting

Placing together in the same room patients who are infected with the same pathogen and are suitable roommates.

Colonisation

The sustained presence of replicating infectious agents on or in the body without the production of an immune response or disease.

Contact

The touching of any patient or their immediate surroundings or performing any procedure.

Contact point

The area of direct contact of skin to equipment.

Contact precautions

A set of practices used to prevent transmission of infectious agents that are spread by direct or indirect contact with the patient or the patient’s environment.

Decontamination

Use of physical or chemical means to remove, inactivate, or destroy pathogens on a surface or item so that they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal.

Detergent solution

A medical-grade detergent product (that is registered as a Class I Medical Device with the TGA and which is intended to be used in the cleaning of surfaces or other medical devices) diluted with water as per manufacturer’s instructions.

Disinfectant

A TGA-registered disinfectant chemical product that is intended for use in disinfection of surfaces or medical devices.

Disinfection

Destruction of pathogenic and other kinds of microorganisms by physical or chemical means.

Droplet precautions

A set of practices used for patients known or suspected to be infected with agents transmitted by respiratory droplets.

Droplets

Small particles of moisture generated when a person coughs or sneezes, or when water is converted to a fine mist by an aerator or shower head. These particles, intermediate in size between drops and droplet nuclei, can contain infectious microorganisms and tend to quickly settle from the air such that risk of disease transmission is usually limited to persons in close proximity (e.g. at least 1 metre) to the droplet source.

Engineering controls

Removal or isolation of a workplace hazard through technology.

Epidemic

A widespread outbreak of an infectious disease. Many people are infected at the same time.

Fit check

A quick check to ensure that the respirator is fitting each time it is put on.

Fit test

A method of ensuring that a respirator is fitted correctly and suitable for use by a specific individual.

Hand hygiene

A general term applying to processes aiming to reduce the number of microorganisms on hands. This includes:

application of a waterless antimicrobial agent (e.g. alcohol-based hand rub) to the surface of the hands; and

use of soap/solution (plain or antimicrobial) and water (if hands are visibly soiled), followed by patting dry with single-use towels.

Healthcare facility

Any facility that delivers healthcare services. Healthcare facilities could be hospitals, general practice clinics, dentistry practices, other community-based office practices, day surgery centres, emergency services, domiciliary nursing services, long-term care facilities, Indigenous medical services, alternative health provider facilities and other community service facilities, such as needle exchanges.

Healthcare worker

s

All people delivering healthcare services, including students and trainees, who have contact with patients or with blood or body substances.

Healthcare-associated infections

Infections acquired in healthcare facilities (‘nosocomial’ infections) and infections that occur as a result of healthcare interventions (‘iatrogenic’ infections), and which may manifest after people leave the healthcare facility.

High level disinfection

Minimum treatment recommended for reprocessing instruments and devices that cannot be sterilised for use in semi-critical sites

High-efficiency particulate air (HEPA) filter

An air filter that removes >99.97% of particles > 0.3 microns (the most penetrating particle size) at a specified flow rate of air.

High-risk patients

Patients with an increased probability of infection due to their underlying medical condition. Often refers to patients in intensive care units, those receiving total parenteral nutrition, and immunocompromised patients.

Hospital-grade disinfectant

A TGA-registered disinfectant for surfaces for use in healthcare or healthcare-related applications.

Hypochlorite

A chlorine-based disinfectant.

Immunocompromised

Having an immune system that has been impaired by disease or treatment.

Incidence

The number of new events (e.g. cases of disease) occurring in a population over defined period of time.

Infectious agent

An infectious agent (also called a pathogen or germ) is a biological agent that causes disease or illness to its host. Most infectious agents are microorganisms, such as bacteria, viruses, fungi, parasites and prions.

Instrument disinfectant

A TGA-registered disinfectant for medical devices.

Intermediate level disinfection

Minimum treatment recommended for reprocessing instruments and devices for use in non-critical sites, or where there are specific concerns regarding contamination of surfaces with species of myobacteria (e.g. Mycobacterium tuberculosis)

Invasive procedure

Entry into tissues, cavities or organs or repair of traumatic injuries.

Key parts

Parts of the procedure equipment or solutions that must remain aseptic throughout clinical procedures, in order to protect the patient from contamination or infection. For example a wound dressing, catheter lubrication, syringe tip, needle etc. In IV therapy, key parts are usually those that come into direct contact with the liquid infusion e.g. needles, syringe tips, exposed central line lumens.

Key sites

Susceptible open or broken wounds, surgical or intravenous access sites.

Klebsiella pneumoniae

Gram-negative bacteria frequently responsible for healthcare associated infections of wounds and urinary tract, particularly in immunocompromised patients; may also cause pneumonia.

Long-term care facilities

A range of residential and outpatient facilities designed to meet the bio-psychosocial needs of persons with sustained self-care deficits.

Low-level disinfection

An alternative treatment to cleaning alone when devices for use in non-critical sites are reprocessed and when only vegetative bactericidal activity is needed.

Medical device

A device that is intended for use with humans and used in therapeutic processes, being entered onto the ARTG.

Methicillin-resistant Staphylococcus aureus (MRSA)

Strains of Staphylococcus aureus that are resistant to many of the antibiotics commonly used to treat infections. Epidemic strains also have a capacity to spread easily from person-to-person.

Multi-drug resistant organisms (MROs)

In general, bacteria that are resistant to one or more classes of antimicrobial agents and usually are resistant to all but one or two commercially available antimicrobial agents.

Needle-free devices (also needleless intravascular catheter connectors)

Intravascular connector systems developed to help reduce the incidence of needlestick injury while facilitating medication delivery through intravascular catheters. There are three types of needle-free connectors: blunt cannula (two-piece) systems, one-piece needle-free systems, and one-piece needle-free systems with positive pressure.

Negative pressure room

A single-occupancy patient-care room used to isolate persons with a suspected or confirmed airborne infectious disease. Environmental factors are controlled in negative pressure rooms to minimise the transmission of infectious agents that are usually transmitted from person to person by droplet nuclei associated with coughing or aerosolisation of contaminated fluids.

P2 respirator

A particulate filter personal respiratory protection device or P2 respirator is a close fitting mask worn for airborne precautions, which is capable of filtering 0.3μm particles. A P2 respirator must comply with AS/NZS 1716:2009.

Pandemic

An epidemic that is geographically widespread, occurring throughout a region or even throughout the world.

Patient contact

Involves touching the patient and their immediate surroundings, or performing any procedure on the patient.

Patient surroundings

All inanimate surfaces that are touched by or in physical contact with the patient (such as bed rails, bedside table, bed linen, invasive devices, dressings, personal belongings and food) and surfaces frequently touched by healthcare workers while caring for the patient (such as monitors, knobs and buttons).

Patient-care area

The room or area in which patient care takes place.

Percutaneous injury

An injury that results in a sharp instrument/object, e.g. needle, scalpel, cutting or puncturing the skin.

Personal protective equipment (PPE)

A variety of barriers used alone or in combination to protect mucous membranes, skin, and clothing from contact with infectious agents. PPE includes gloves, masks, respirators, protective eyewear, face shields, and gowns.

Phlebitis

Inflammation of the wall of a vein.

Powered air-purifying respirator (PAPR)

Powered air-purifying respirator (PAPR) devices should conform to AS/NZS 1715 and AS/ANZS 1716, and must only be used by healthcare workers who are trained in their use. The manufacturer’s instructions for cleaning, decontaminating and maintenance must be followed. PAPR may be suitable for healthcare workers with facial hair and those who fail fit testing for P2 respirators.

Prevalence

The number of events (e.g. cases of disease) present in a defined population at one point in time.

Procedure

An act of care for a patient where there is a risk of direct introduction of a pathogen to the patient.

Randomised controlled trial (RCT)

A clinical trial where at least two treatment groups are compared, and non-randomised control trial (NRCT) one of them serving as the control group, and treatment allocation is carried out using a random, unbiased method. A non-randomised controlled trial compares a control and treatment group but allocation to each group is not random. Bias is more likely to occur in NRCT.

Respiratory hygiene and cough etiquette

A combination of measures designed to minimize the transmission of respiratory pathogens via droplet or airborne routes in healthcare settings.

Routine

Performed as part of usual practice (as opposed to the use of additional measures in specific circumstances e.g. where invasive procedures are conducted or in the event of an outbreak).

Sharps

Instruments used in delivering healthcare that can inflict a penetrating injury, e.g. needles, lancets and scalpels.

Single-use

Single-use means the medical device is intended to be used on an individual patient during a single procedure and then discarded. It is not intended to be reprocessed and used on another patient. Some single-use devices are marketed as non-sterile which require processing to make them sterile and ready for use. The manufacturer of the device will include appropriate processing instructions to make it ready for use.

Single-use devices

Single-use devices are medical devices that are labelled by the original manufacturer as ‘single use’ and are only intended to be used once. http://www.tga.gov.au/devices/fs-sudman.htm

Standard precautions

Work practices that constitute the first-line approach to infection prevention and control in the healthcare environment. These are recommended for the treatment and care of all patients.

Standard-ANTT

An approach to ANTT used for technically simple aseptic procedures.

Sterile

Free from all living microorganisms; usually described as a probability (e.g. the probability of a surviving microorganism being 1 in 1 million).

Sterile technique

Sterile technique aims to eliminate microorganisms from areas and objects, and should be undertaken by all healthcare workers undertaking invasive medical procedures. This includes: ensuring that everything within a defined radius is clean and sterile, or as a minimum subject to high level chemical or thermal disinfection; use of skin antisepsis and sterile personal protective equipment; and reprocessing of instruments between patient uses. Due to the natural multitude of organisms in the atmosphere it is not possible to achieve a true sterile technique for most invasive procedures in a typical hospital environment (even when wearing sterile gloves). Sterile techniques can only be achieved in controlled environments such as a laminar air flow cabinet or a specially equipped theatre. The commonly used term, ‘sterile technique’ is therefore inaccurate, as practitioners are not actually achieving their stated objective.

Sterilisation

Use of a physical or chemical procedure to destroy all microorganisms including substantial numbers of resistant bacterial spores.

Strain

A strain is a genetic variant or subtype of a microorganism (e.g. a virus, bacterium or fungus). Some strains may be more dangerous or difficult to treat than others.

Surface barrier

Barriers (e.g. clear plastic wrap, bags, sheets, tubing or other materials impervious to moisture) designed to help prevent contamination of surfaces and equipment.

Surgical hand preparation

The process of eliminating transient and reducing resident flora prior to surgery. This comprises removal of hand jewellery, performing hand hygiene with liquid soap if hands are visibly soiled, removing debris from underneath fingernails and scrubbing hands and forearms using a suitable antimicrobial formulation.

Surgical masks

Loose-fitting, single-use items that cover the nose and mouth. These include products labelled as dental, medical procedure, isolation and laser masks.

Surgical-ANTT

An approach to ANTT used for technically complex aseptic procedures.

Surgical-site infection

An infection at the site of a surgical operation that is caused by the operation.

Surveillance

Disease surveillance is an epidemiological practice by which the spread of disease is monitored in order to establish patterns of progression. The main role of disease surveillance is to predict, observe and minimise the harm caused by outbreak, epidemic and pandemic situations, as well as increase knowledge as to what factors might contribute to such circumstances.

Targeted surveillance

A process in which data are collated on the susceptibilities and resistances of disease-causing microbes to various antimicrobial treatments. Targeted surveillance gathers data that is not generated by routine testing: specific species or groups of species are examined in detail to answer important questions that cannot be addressed by passive surveillance.

Transmission-based precautions (formerly additional precautions)

Extra work practices in situations where standard precautions alone may be insufficient to prevent infection (e.g. for patients known or suspected to be infected or colonised with infectious agents that may not be contained with standard precautions alone).

Vancomycin resistant enterococci (VRE)

Enterococci are Gram-positive bacteria that are naturally present in the intestinal tract of all people. Vancomycin is an antibiotic to which some strains of enterococci have become resistant. These resistant strains are referred to as VRE and are frequently resistant to other antibiotics generally used to treat enterococcal infections.