INFECTION PREVENTION In The - PowerPoint Presentation

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INFECTION

PREVENTION

In The

Healthcare

Setting

Part 3

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2

Transmission Based

Precautions

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Direct or indirect contact with skin or mucous membranes

Contact Precautions

CONTACT

ISOLATION ( In addition to STANDARD PRECAUTIONS )GLOVES: REQUIRED.Remove gloves before leaving the roomHANDS: Use antimicrobial soap and water or alcohol gel if hands are not visibly soiled.GOWNS: REQUIRED when there is a possibility of contact with patients, surfaces, or patient care items.

ATTIRE WORN

Indicated for:

Multi-drug

Resistant Organisms

Clostridium

difficile (C.dif.)

RSV

(Respiratory Syncytial Virus)

Scabies

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DROPLET ISOLATION( In addition to STANDARD PRECAUTIONS )MASK: Mask covering eyes, nose AND mouthREQUIRED when you are within 3 feet of the patient.GLOVES: REQUIRED if you will touch anything contaminated with respiratory secretions.GOWN: REQUIRED if clothing will contact contaminated surfaces or respiratory secretionsHANDS: USE ANTIMICROBIAL SOAP & WATER OR ALCOHOL GEL IF HANDS ARE NOT VISIBLY CONTAMINATED.

Droplet Precautions

Mucous membrane to mucous membrane contact with an infectious agent

ATTIRE WORN

Indicated for:

MDRO in Sputum

Meningitis

Pertussis

Influenza

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AIRBORNE ISOLATION( In addition to STANDARD PRECAUTIONS )Keep room door(s) closed at all times. Dedicated room and HEPA Filter Unit REQUIRED MASK: N95 mask REQUIRED BY ALL EMPLOYEES at all times while in room.Patient must remain in the room unless absolutely necessary. During transport, place a surgical mask on the patient.HANDS: USE ANTIMICROBIAL SOAP & WATER OR ALCOHOL GEL IF HANDS NOT VISIBLY CONTAMINATED.

Infectious Airborne droplets or aerosols into lungs

Airborne Precautions

ATTIRE WORN

Indicated for:

Tuberculosis

Varicella Zoster (Chicken Pox)

Measles (Rubeola)

SARS (and Contact Precautions

Avian Flu (and Contact Precautions)

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Isolation Rooms: Reservoirs for Bacteria

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Wear appropriate PPE when entering an isolation room will minimize risk of

exposure to an infectious pathogen.

Removal of PPE upon exiting an isolation room prevents transmission to

others or inanimate objects (door knobs etc.)

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ABCs of Transporting Patients

PRIOR to transporting a patient, all infectious material must be contained.This is accomplished by: Keeping wounds covered Putting patient in a clean gown Covering the patient with clean linen Masking any coughing patients Practicing proper hand hygiene while out of room Appropriate disinfection of equipment during transportation

PPE

during transport should be used ONLY

in the event that the above steps are followed and remain ineffective, presenting a risk of exposure.

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How to get from point A to point B

Contain infectious material (i.e., cover wounds, clean gown to patient, clean bed covers, diaper if having diarrhea).

Discard

contaminated

protective equipment prior to exiting room.

Perform hand hygiene

Transport to destination

Use hand hygiene

Don necessary protective equipment at destination

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Before Transporting a Patient, Ask Yourself…

Is all infectious material contained?Does the patient have a clean gown and linen?If not, has the patient been appropriately prepared for transport

ALWAYS PRACTICE A TEAM APPROACH WHEN PREPARING A PATIENT FOR TRANSPORT

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ENVIRONMENT OF CARE

ENVIRONMENT OF CARE

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Patient Care Equipment

Disposable: use once and discardSingle Patient: use item for the entire hospital stay, discard when visibly soiled Reusable: items are cleaned and disinfected between each patient or returned to Central Supply for reprocessing (depending on item)

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Cleaning and Disinfection

Cleaning: Removal of all visible soil, blood, body fluid from inanimate objects.Disinfection: Elimination of many or all pathogenic microorganisms, on inanimate objects (except spores).

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ITEMS WITH

NO VISIBLE BLOOD OR SOILDisinfect with manufacturer recommended disinfectant (1 Step)

ITEMS WITH VISIBLE BLOOD OR SOIL 1. Clean by removing visible soil or blood 2. Disinfect after removing visible soil (2 steps)

Cleaning Reusable Patient Equipment

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Disinfectant Use

The length of time a disinfectant must remain on a surface to effectively eliminate pathogens.Rewet surfaces that dry before the contact time has passed.

5 minutes

“Contact Time” or “Wet Time”

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Proper Segregation of Medical Waste

“A Safety Must”

Why should

d I care?It minimizes the potential for the spread of disease from a medical setting to the general public; andIt reduces the overall amount of infectious medical waste producedhelps to protect the environment, and reduces medical facilities’ treatment expenditures

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Improper Waste Segregation

Blood (Biohazard Waste)

mixed with regular trash

Sharps waste mixed with

Blood / Body Fluids (Biohazard Waste),

container not lined and missing lid

Regular trash and Pharmaceutical

Waste in biohazard waste, bag is torn

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Proper Waste Segregation

WHY?

No medication left in the IV bagNo sharps are attachedNo visible Patient Health Information (PHI) Staff has covered all PHI with an “Identi-hide” label.

WHY?

Bag is properly tied and not overfilled.

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Visitors

An Important Part of Our Safety Team

Hand

Hygiene Cough Etiquette Isolation precautions Appropriate use of PPE Delay of visits when sick

Share infection prevention strategies including:

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Take a Proactive Approach to Respiratory Etiquette

Cough in your sleeve.Offer a coughing patients / visitors a mask.Offer patients / visitors tissue.Offer a patient / visitor hand gel upon arrival on your unitEncourage hygiene practice in your unit

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Stay Home When You Are Sick

Patients-are at risk of acquisition of a healthcare associated infectionStaff-are at risk of an unnecessary exposure The sick employee– delays his/her own recovery

Working while sick affects everyone

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Seasonal flu accounts for approximately 225,000 hospitalizations and up to 50,000 deaths in the United States each year.Impossible to predict when next influenza pandemic may arise or the severity.

The CDC recommends that

ALL

healthcare workers receive the flu vaccine.

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HCW Vaccination and Patient Safety

Up to 45% of unvaccinated healthcare workers may acquire influenza infection. HCW may have flu virus in their bodies and never develop flu symptoms, but can infect others.Flu vaccination will protects patient, co-workers, family, and friends against the flu infection or other complications. Improves patient outcomesDecreased absenteeism and cases of flu among staff.Takes only minutes – saves lives

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References

Guideline

for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare

Settings, 2007. Jane

D. Siegel, MD; Emily Rhinehart, RN MPH CIC; Marguerite Jackson, PhD; Linda Chiarello, RN MS; the

Healthcare

Infection Control Practices Advisory

Committee.

http

://

www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf

William A. Rutala, Ph.D., M.P.H., David J. Weber, M.D., M.P.H., and the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2008)

Guideline for Disinfection and Sterilization in Healthcare Facilities,

Centers for Disease Control and

Prevention.

http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf

Lynne Sehulster, Ph.D., Raymond Y.W. Chinn, M.D., Center for Disease Control and

Prevention / Healthcare Infection Control Practices Advisory Committee (HICPAC)

(2003),

Guidelines for Environmental Infection Control in Health-Care Facilities

http

://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm

Centers for Disease Control and Prevention Influenza website

http://www.cdc.gov/flu/about/disease/index.htm

CDC Advisory Committee on Immunization Practices (ACIP) 2013-2014

http://www.cdc.gov/flu/professionals/acip/index.htm