Dec. 23.]
THE NEW ZEALAND GAZETTE.
3447

(3.) A maternity nurse or a midwife who is attending a case in
which there are foul-smelling discharges shall not go to another case
without first changing her dress, and thoroughly cleansing and
disinfecting in an approved manner her hands and forearms, and
sterilizing in an approved manner such appliances as she may have
had occasion to use and is obliged to take with her.

(4.) After any confinement every maternity nurse or midwife
shall carefully cleanse her hands, arms, and finger-nails from all remains
of blood, lochia, or liquor amnii. She shall keep her nails cut short,
and preserve the skin of her hands, as far as possible, from chaps and
other injuries.

(5.) Every maternity nurse and every midwife shall carry with her
a midwifery bag or case made of canvas or leather, with a detachable
lining which can be boiled. The bag shall contain—

(a.) Clinical thermometer :
(b.) Metal catheter :
(c.) A douche-can or siphon douche with glass vaginal nozzle
carried separately :
(d.) A rectal nozzle for enemata (or an enema syringe):
(e.) A pair of scissors :
(f.) A clean nail-brush, antiseptic soap, and clean towel :
(g.) A pair of rubber gloves and two guarded finger-stalls :
(h.) An efficient antiseptic for disinfecting the hands, &c. :
(i.) An antiseptic for douching in special cases :
(j.) Soft cotton thread (boiled) for tying cord :
(k.) A small supply of sterilized cotton-wool, tow, and clean boiled
linen :*
(l.) A small bottle of ergot (only to be used after third stage of
labour) and of tincture of iodine :
(m.) A gum-elastic or rubber catheter.

(6.) On each occasion on which the genital organs or their neighbourhood
have to be touched, every maternity nurse or midwife shall
previously cleanse and disinfect such parts in an approved manner,
and shall disinfect her hands and forearms by scrubbing vigorously
with hot water and antiseptic soap for five minutes at least, rinsing
with fresh water and soaking in an approved antiseptic solution for
five minutes.

(7.) All instruments and other appliances brought into contact
with the patient's generative organs shall be sterilized by boiling in
water for at least ten minutes.

(8.) (a.) Vaginal examinations shall not be made by maternity
nurses, and shall be made by midwives only when necessary. Before
making any such examination, or before passing a catheter, the
patient's external parts shall be washed with soap and water, and
shall then be swabbed with an antiseptic solution. The nurse or
midwife shall then disinfect her hands in the manner hereinbefore
prescribed, and put on the hand a sterilized glove or guarded finger-
stall. The perineum and vulva and such parts of the patient as may
come into contact with the gloved hand in making a vaginal examination
shall be protected by covering them with guards or with towels
properly sterilized by boiling, or by other adequate means.

(b.) For all washing of the external parts during labour or the
lying-in period sponges or flannels shall not be used, but materials
which can be boiled before use and burned afterwards, such as linen,
cotton-wool, cotton-waste, or tow. When possible such materials
shall be sterilized by steam or by boiling, and if this is impossible
they shall be placed to soak in a basin of antiseptic lotion in which
they shall remain for at least one hour before use.

(c.) A midwife shall not make a vaginal examination during the
third stage of labour unless some serious complication has occurred.

(9.) Whenever any maternity nurse or midwife has been in
attendance upon a patient suffering from puerperal infections, scarlet
fever, erysipelas, or from any illness of a suppurative character, she
shall disinfect herself and her clothing, and shall sterilize all her
instruments and other appliances in accordance with the directions
of the Medical Officer of Health, or, in the absence of any specific
direction, in accordance with the provisions of the Fifth Schedule
hereto. She shall not attend any other patients until the Medical
Officer of Health has certified that she may do so.

(10.) Whenever any maternity nurse or midwife has attended a
case of puerperal fever or other infectious disease she shall immediately
report the fact to the Medical Officer of Health.

• These articles must be contained in separate sterilizable containers.