Its Everyones Responsibility ANNUAL INSERVICE and New Employee Orientation INFECTION PREVENTION What is the most important thing all staff can do to help prevent the spread of infection ID: 742405
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“Infection Prevention”It’s Everyone’s Responsibility!
ANNUAL INSERVICEandNew Employee Orientation Slide2
INFECTION PREVENTIONWhat is the most important thing all staff can do to help prevent the spread of infection?Hand hygiene!Slide3
HAND HYGIENEMost important defense against spreading infectionWash hands a minimum of 15-20 sec with soap & warm water, using friction, getting in-between fingers and under nails.
You can use alcohol gels/foams if hands are not visibly soiled; apply before entering a patient’s room or care areaPerform hand hygiene before and after patient care, andBetween procedures even when on the same patient, andPerform hand hygiene when changing bandage dressings on a patient. Remove soiled bandages, then perform hand hygiene, and apply clean gloves before applying fresh bandagesRemove gloves when task is completed, and perform hand hygiene upon exiting the roomSlide4
MICROORGANISMSA microorganism is needed in order for an infection to occur. All of the following organisms have the potential of causing an infection:Slide5
BacteriaVirusesFungiParasitesAll can cause infectionSlide6
Who can get infections?Anyone! Most at risk:Infants, and the very youngElderlySeriously Ill
Long-term care residentsThose who are in poor physical/nutritional healthSlide7
How are infections spread?Organism needed Carrier, i.e. can be a healthcare worker, patient, visitor, etc.
Organism needs a way out, i.e. sneezing, coughing, talking, touching via contaminated handsOrganism travels through respiratory droplets via air currents, via contaminated hands or contaminated environmental surfacesOrganism needs a way in to the body, i.e. breathing, swallowing, break in the skin; mucosal membranes, i.e. eyes, nose, mouth
The above chain of events all need to be present in order for an infection to take place.If this chain is broken and even one event doesn’t occur, an infection cannot take place.Standard Precautions are used to break that chain of infection!Whether an Infection occurs depends partially on the immune systemSlide8
What precautions are used for everyone?Slide9
Standard Precautions You don’t necessarily know who is infectious and who isn’t!Standard Precautions are used for everyone!Assess the situation you are in to determine use of PPE
(personal protective equipment) as listed below:Hand hygieneGlovesMasksGogglesGownsSlide10
Respiratory hygiene/Cough etiquetteAnother component of Standard PrecautionsCough or sneeze into tissue; dispose of in waste basketCough or sneeze into elbow, not hands!
Wear mask or use a tissue to cover your cough or sneezeWash hands or use alcohol gelRespiratory hygiene/cough etiquette is really stressed during influenza season Slide11
Safe Injection PracticesAnother component of Standard PrecautionsUse 1 needle, 1 patient, each and every timeUse single-dose vials whenever possibleDo NOT re-cap needles!If using multi-dose vials, use a clean syringe, cannula, and needle every time!Slide12
Transmission-based precautionsContactDropletAirborneSlide13
DROPLET PRECAUTIONSUse in addition to Standard Precautions
Organisms are spread through large respiratory dropletsThe organisms travel approx. 3-6 ft. via air currentsAlways wear a mask!Isolate the patient. Place patient in a room by themselves or place patient with another patient who has the same type of infection. This is called “cohorting.”Place Droplet isolation sign on wall outside the patient’s roomIf patients have RSV, influenza, as two examples, place in Droplet isolation.Slide14
CONTACT PRECAUTIONSUse in addition to Standard PrecautionsIsolate the patient in a single room or cohort with another patient who has the same type of infection
Place Contact isolation sign on wall outside the patient’s roomUse PPE (personal protective equipment) as situation dictatesPlace patient in Contact isolation if they have infections such as MRSA, VRE, C. DIFF, Rotavirus, RSV; Norovirus, draining wounds, cellulitis, uncontrolled diarrhea, as examples.Slide15
AIRBORNE PRECAUTIONSUse in addition to Standard PrecautionsSet up a negative pressure room; use a HEPA UNIT, and roll into designated patient room
ER is set up for negative pressure Employees need to wear N95 masks; employees need to pass annual fit-testingEmployees who have not been fit-tested or cannot pass the fit test, should not enter the patient care areaIf patient is transported out of the room, have the patient put on a regular mask or cover the mouth with a tissuePatient is placed in a Single roomDoor is to remain closed at all timesAIRBORNE Isolation Sign is placed on wall outside the patient’s roomOrganisms are spread by small resp. droplets
that remain suspended in the air and can travel for a long distance. Tuberculosis, chickenpox, measles are examples of infections where patients need to be placed in Airborne IsolationSlide16
Personal Protective Equipment (PPE)DONGown (fasten at neck and waist)Mask (secure ties; fit wire piece to nose)
Goggles (adjust to fit)Gloves (cover wrist of gown) REMOVEGlovesGogglesGownMask (grasp ties, not mask)Perform hand hygieneSlide17
BLOODBORNE PATHOGENSHow do we protect ourselves from bloodborne pathogens?Get hepatitis B vaccine. The hepatitis B vaccine is the
BEST way to protect yourself. In addition, use Standard Precautions!This is available to ALL employees free of charge. Healthcare workers should all get the hepatitis B vaccine, especially those who work in direct patient care.Slide18
BLOODBORNE PATHOGENSBloodborne pathogens are spread through blood, body secretions, body fluids (bacteria, fungus, virus, parasites)Organisms enter the body through cuts, abrasions, mucous membranes such as the eyes, ears and nose.
Use sharps containers for all sharps such as needles, broken glass, scalpels, lancets. Discard the sharps container when it is ¾ full. Do not overfill! Close the cover and lock it! Dispose of appropriately. This is biohazard waste and will be incinerated.Pick up broken glass by mechanical means such as a broom and dust panBloodborne Pathogen Policy must be made available w/in 15 days of the employees’ requestNew device evaluations must be performed by any staff who will use the device, not just the supervisors of that department.Slide19
Exposure incident..who do you contact?Slide20
EXPOSURE INCIDENTSIf you have a needle stick, blood or body fluid exposure, perform first aid immediately by washing with soap and water, then flushing with copious amounts of water, then:Contact risk manager, Paula Brown or Mel Johnson, or your immediate
supervisorComplete an incident report on the Healthcare Safety Portal Zone systemGet a medical exam by the Physician you selectedDetermine if there is documented evidence that you responded to the hepatitis B vaccine; test source and employee for HIV, Hepatitis B, and hepatitis C per recommended guidelines.Slide21
Where are blood spill kits located?Slide22
BLOOD SPILL KITSClinic-back roomGSH
-utility room across from nurses’ stationHospital-Lab & Housekeeping depts.Wellness CenterContents:Instructions for useAbsorbent materialGlovesGoggles, mask
Biohazard bagsDisinfectant Hand gelCheck expiration dates on contents! Replace the expired supply!Slide23
ENVIRONMENTAL CLEANINGDaily disinfect frequently touched areas. These are called “high touch” items:Light switchesCall lights
Bedside railsHallway railsPhonesToilet areasBedside tablesIV polesDivider curtains-replace upon patient discharge or when isolation has been discontinuedSlide24
Where do you find instructions for kill time, how to use, etc for disinfectant products?
The Manufacturer’s Label!Kill time: This is the time that it takes to kill the organisms that the manufacturer claims it will kill. The surface must remain wet for that amount of time, or the surface must be re-wet.Read the manufacturer’s label to determine if the product can be used as a concentrate, or if it needs to be diluted. Follow the instructions exactly!More is not better!! To effectively kill the organism, follow the instructions for each product. They are not all the same!Slide25
DISINFECTANTSDisinfectant must be EPA-registeredThe disinfectant must be in a bottle that is labeled with the manufacturer’s label that is specific for that product.
Bleach is the disinfectant that should be used for organisms such as the following as they may contain spores, and the EPA-registered disinfectants that are used throughout the facility are not effective against the spores:C. difficile; Norovirus; Rotavirus A 1:10 dilution must be made fresh daily or you can use wipes that have been pre-moistened with a 1:10 bleach solution that are very effective and convenient to useC. diff, Norovirus, Rotavirus: Wash hands with soap & water! Alcohol gels or foams are not effective against the spores which these organisms can potentially have.Slide26
GLUCOMETER DISINFECTIONGlucometers must be cleaned after every use!Follow the manufacturer’s instructions on EACH glucometer. If there are no cleaning instructions for that glucometer, it must be used for one patient only…not used on multiple patients!
Alcohol is NOT acceptable for disinfecting glucometers! It does not provide sustained antimicrobial activity.Use an EPA-registered disinfectant. The PDI Super Sani-Cloth wipes are an approved EPA-registered disinfectant, and can be used to clean and disinfect the glucometers.Slide27
KEYBOARD DISINFECTIONKeyboards-daily disinfection is recommended, and when visibly soiledDisinfectant
-alcohol removes bacteria but doesn’t provide sustained activity against organismsQuaternary ammoniums-EPA-registered, PDI Sani-Cloth Wipes: provides sustained activity against even VRE, Pseudomonas up to 48 hours and is a good way to disinfect the keyboards.Keyboard covers-disinfect same way with a disinfectant that is registered with the EPA.Damage-Disinfectants do not damage keyboardsSlide28
IMMUNIZATIONSThese are the following immunizations that are recommended for healthcare workers:
Hepatitis B vaccineInfluenza vaccine Varicella vaccineMMRTdapChildhood vaccine recordsTurn your vaccination records into HRSlide29
TUBERCULIN SKIN TEST (TST)A 2-step TST is done at hire if there is no documented evidence of one being done w/in the last 12 months prior to hire.If you have a Positive TST, do the following:See a ProviderGet a baseline chest x-ray
If it is determined that you have “Latent “ TB; you are NOT infectious, you are NOT ill or symptomatic, and you can still work, but treatment IS recommended as 1:5 will develop TB in the future. This is to protect you!If it is determined that you have
“Active” TB, you ARE infectious, you ARE symptomatic, and you will need to be treated. You also will not be able to work until it has been determined by your Provider and through laboratory testing that you are no longer infectious.
Once you have a positive TST, you do not get tested again nor do you get repeat chest x-rays. Instead, complete a TB questionnaire annually which will help determine if you have become symptomatic or not.Slide30
TUBERCULOSISContagious disease-bacteria is spread from person to person and travels on air currents via small respiratory droplets Remains suspended for long timeUsually affects lungsCan also affect,
BrainKidneysSpineWoundsSlide31
LATENT TB VS ACTIVE TBLatentAsymptomaticNot contagiousCan workNeed 9 months INH preventative treatment
ActiveSymptomaticContagiousCannot work until you are determined to be non-infectious.Need treatmentSlide32
SUSCEPTIBILITYThe following have a higher incidence of contracting TB,Medically underserved populationsForeign-born>/= 65
Current or past prisonersHomelessAlcoholicsIV drug users, substance abusersSlide33
SIGNS & SYMPTOMS of TBBad cough > 3 weeksCoughing up blood, bloody sputumPain in chestFatigueUnexplained weight loss
Loss of appetiteChillsFeverNight sweatsSlide34
What is your BEST line of defense against influenza?Influenza vaccine!!!EVERYONE, regardless of your department, should be vaccinated against influenza on an ANNUAL
basis.Virus strains change from year to year.It is facility policy that you sign a declination form if you refuse the vaccine.Slide35
INFLUENZAInfluenza is a viral respiratory illnessIt is a reportable condition to the State Health DepartmentIf you have not been vaccinated, you must wear a mask during your entire shift throughout the entire influenza season.
You are not allowed to work if you have influenzaInfluenza is very contagiousSymptomsGenerally comes on quicklyCoughSore throatRunny noseBody achesFever (generally > 100.4 degrees F)Slide36
PERSONNELEmployees are not allowed to work if,Fever > 100.4 degrees F (you must be 24 hrs without a fever AND without the use of fever-reducing meds)
Vomiting, diarrhea (stay home until you are asymptomatic)Notify immediate Supervisor if you are illManagers-complete Infection Prevention form on Healthcare Safety Portal Zone SystemSlide37
NOROVIRUSContact Precautions-continue for a minimum of 48 hours after resolution of symptoms (employees need to stay home)Suspend group activities, eating in dining room, etc.
Wash hands with soap & water. Alcohol gels and foams are not effective!Put on gloves & gown prior to room entryCleaning and disinfecting: Use a 1:10 BLEACH solutionPre-diluted 1:10 bleach wipes are effective and convenient!Slide38
What is a healthcare-associated infection (HAI)?It is an infection that a patient/resident has acquired 48-72 hours AFTER admission to a healthcare facility. They did not come into the facility with that infection and,
They are preventable!Use Standard Precautions and be compliant with hand hygiene to help prevent transmission of infections.Slide39
REMEMBER!!!Comply with hand hygiene BEFORE and AFTER ENTERING/LEAVING PATIENT CARE AREA!Infection Prevention is EVERYONES’ Business!