Infection Control

Establish a written IPC policy endorsed by the practice principal; review annually or after a significant incident.
Nominate an IPC lead (usually the nurse manager) with clear authority to act on breaches.
Complete an annual risk assessment covering patient profile (immunocompromised, invasive procedures), building layout, ventilation and equipment.

Hand hygiene – alcohol‑based rub at point of care; audit at least twice yearly using the 5 Moments tool. RACGP
PPE – gloves, surgical mask, eye protection or gown according to the task and exposure risk; supply sizes that suit all staff.
Respiratory hygiene / cough etiquette – masks and tissues at reception, signage, isolation of symptomatic patients.
Safe injection practices – single‑use needles/syringes, rubber‑stopper disinfection, dedicated vaccine fridge (cold‑chain log).
Sharps safety – sharps containers at eye level and within arm’s reach of procedure couch; close and replace at ¾ full.

Contact – gloves and gown; dedicated equipment, terminal clean of room.
Droplet – surgical mask within 1 m; patient mask for transfers.
Airborne – fit‑tested P2/N95, keep door closed, defer non‑urgent aerosol‑generating procedures unless in negative‑pressure or adequately ventilated room. ACSQHC

Zoning – identify “clean”, “contaminated”, and “equipment reprocessing” areas.
Routine cleaning schedule – detergent wipe daily; disinfect high‑touch surfaces (door handles, armrests) between sessions.
Spill management kit – sodium hypochlorite ≈ 1000 ppm for blood/body‑fluid spills; staff trained in use.
TGA‑listed disinfectants – adhere to manufacturer contact times; keep Safety Data Sheets accessible.

Follow AS/NZS 4815 (office‑based practice) or AS/NZS 4187 (if table‑top steriliser used for critical instruments).
Use a tracked three‑sink or automated washer‑disinfector flow: cleaning → thermal disinfection → drying → inspection → packaging → sterilisation → storage.
Maintain batch records (chemical & biological indicators, cycle print‑outs) for 7 yrs. RACGP

Segregate into clinical (yellow), cytotoxic (purple), pharmaceutical (red), general (black/opaque), and recyclable streams as per state EPA.
Sharps containers certified to AS 4031; close, label and contract licensed waste collector when full.

Pre‑employment evidence or serology for Hep B, MMR, varicella, pertussis, influenza ± COVID‑19‑boosters.
Maintain an immunisation register; declination forms where vaccine refused.
Policy for work exclusion of staff with conjunctivitis, gastroenteritis, varicella, influenza‑like illness until non‑infectious.

Needle‑stick protocol: immediate wash, bleed, report; baseline serology (HBsAg, anti‑HBs, anti‑HCV, HIV Ag/Ab); offer PEP as per national guideline; document in incident register.
Apply open disclosure principles and lodge claim with insurer if patient affected.

Aim for ≥ 6 air changes/hour in treatment and procedure rooms; use HEPA purifiers if mechanical ventilation limited.
Ensure potable water quality; flush unused outlets weekly to prevent Legionella.

Quarterly audits: hand‑hygiene compliance, environmental cleaning checklists, vaccine fridge logs, steriliser cycles.
Annual outbreak drill (e.g. measles, influenza, gastroenteritis).
New staff induction plus 12‑monthly refresher on IPC policy, PPE donning/doffing, and reprocessing steps.

</details>

Common medico‑legal pitfalls (and how to avoid them)

Pitfall	Risk	Mitigation
No written IPC policy	Breach of RACGP & NSQHS → accreditation failure; difficult defence if infection occurs.	Adopt RACGP template, review annually, record staff sign‑off.
Inadequate instrument tracking	Inability to trace patient cohort after steriliser breach → public‑health alert, legal liability.	Batch‑number every pouch; log patient & item in EMR.
Poor documentation of vaccination cold chain	Invalid vaccine potency → revaccination costs, patient harm.	Daily min/max logs, data‑logger downloads, backup power plan.
Reusable “single‑use” items (e.g. disposable specula)	Cross‑infection, TGA violation.	Stock adequate disposables, audit bins for re‑use breaches.
Staff attend work symptomatic	Outbreak among vulnerable patients → negligence claim.	Clear fitness‑for‑work policy, access to paid pandemic leave.

Start with hand hygiene – easiest audit with big impact.
Standardise kits – labelled procedure trays (suture, IUD, iron infusion) with only necessary items; reduces contamination and waste.
Use cloud‑based logs – automate fridge temps and steriliser cycle uploads to cut paperwork.
Leverage PHN resources – many Primary Health Networks offer free IPC training and policy templates tailored to RACGP accreditation.