INFECTION CONTROL ORIENTATION TRAINING 2006

Transcription

1 INFECTION CONTROL ORIENTATION TRAINING 2006

2 INFECTION CONTROL OSHA BLOODBORNE PATHOGEN STANDARD STANDARD PRECAUTIONS RISK OF EXPOSURE TO CONTAMINATED MATERIALS USE OF PROTECTIVE EQUIPMENT FOLLOW-UP OF CONTAMINATED EXPOSURES HEPATITIS VACCINE

3 INFECTION CONTROL SPECIFIC ISSUES GLOVES: LATEX ALLERGIES AVAILABILITY/USE OF PROTECTIVE EQUIPMENT USE OF SAFETY DEVICES SYRINGES NEEDLELESS IV TUBING SAFETY PERIPHERAL IV CATHETERS

4 INFECTION CONTROL TUBERCULOSIS CURRENT INFECTION CONTROL GUIDELINES FROM CDC OSHA STANDARD WITHDRAWN (5/2003) USE OF SPECIAL AIRFLOW ISOLATION ROOMS(7S, 7E, MICU,PICU,ED,4W) HEALTHCARE WORKERS MUST USE N95 RESPIRATORS (annual fit test required) PATIENT WEARS SURGICAL MASK WHEN OUT OF ROOM

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6 INFECTION CONTROL: COST $4.5 BILLION PER YEAR (1996) 88,000 DEATHS PER YEAR

7 What are the 10 most common causes of infection?

8 What are the 10 most common causes of infection?

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10 STUDY DESIGN OBSERVATIONAL EVALUATE OPPORTUNITIES FOR HAND HYGIENE BEFORE/DURING/AFTER PATIENT CARE EVALUATE ADEQUACY OF HAND HYGIENE ADEQUATE: >15 SECOND WASH OR USE OF ALCOHOL HANDRINSE NON-COMPLIANT: NO HAND HYGIENE OBSERVED

11 STUDY FRAMEWORK CENTERS FOR DISEASE CONTROL GUIDELINE FOR HAND HYGIENE IN HEALTHCARE SETTINGS (OCTOBER 2002) HANDWASHING WHEN HANDS VISIBLY SOILED ALCOHOL HANDRINSE IF NOT VISIBLY SOILED DECONTAMINATE HANDS BEFORE PATIENT CONTACT DECONTAMINATE HANDS BEFORE DONNING STERILE GLOVES DECONTAMINATE HANDS BEFORE PATIENT CARE PROCEDURES DECONTAMINATE HANDS AFTER PATIENT CONTACT DECONTAMINATE HANDS IF MOVING FROM CONTAMINATED SITE TO CLEAN SITE DURING PATIENT CARE DECONTAMINATE HANDS AFTER CONTACT WITH EQUIPMENT DECONTAMINATE HANDS AFTER REMOVING GLOVES DECONTAMINATE HANDS BEFORE EATING AND AFTER USING RESTROOM

12 LITERATURE REVIEW OBSERVATIONAL STUDIES ( ) OVERALL POOR COMPLIANCE BY HEALTHCARE WORKERS MEAN BASELINE RATES 5%-81% OVERALL AVERAGE: 40% INTERVENTIONAL ACTIONS INSERVICE FEEDBACK DISTRIBUTION OF INFORMATION IMPLEMENTATION OF ALCOHOL HANDRINSES COMPLIANCE AFTER INTERVENTIONS INCREASED BY 15-20%

13 ONGOING OBSERVATIONAL EVALUATION FOR STAFF COMPLIANCE WITH HAND HYGIENE 100% 2006 (YTD) Handwashing Compliance by Group 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% RN LVN Aide student MD Other compliance rate Overall Rate

14 RESULTS FROM CURRENT EVALUATION 100% Hand Hygiene Compliance Rates by Hospital Unit 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 7 SOUTH 7EAST 7WEST 6SOUTH 6EAST 6WEST 5SOUTH 5WEST 4SOUTH 4WEST 3SOUTH NURSERY L&D STC2 STC3 STC4 STC5 CICU SICU PICU MICU ED STC1 SF2N SF3N SF3S 2006 OVERALL UNIT RATE S&W 2004 OVERALL HOSPITAL RESULTS S&W 2006 OVERALL HOSPITAL RESULTS S&W 2005 OVERALL HOSPITAL RESULTS

15 HAND HYGIENE RECOMMENDATIONS

16 HAND HYGIENE RECOMMENDATIONS It is now expected that all health care providers will perform hand hygiene before and after all patient encounters. Use of the alcohol hand rinse is an acceptable alternative to soap and water when hands are not visibly soiled. Soap and water must be used after potential exposure to Clostridium difficile. S&W Quality Council 2006

17 IT S ALL IN YOUR HANDS WASH THEM USE ALCOHOL HANDRINSE

18 And do not wear artificial nails "No artificial nails or nail polish for direct patient care providers which includes the residents and medical students.

19 INFECTION CONTROL EQUIPMENT AS A SOURCE OF NOSOCOMIAL INFECTION THE STETHOSCOPE??? 11 GENERA & SPECIES OF BACTERIA WERE ISOLATED STAPH EPI- 100% STAPH AUREUS- 38% ISOPROPYL ALCOHOL IS AN EFFECTIVE CLEANING AGENT WHEN APPLIED TO THE STETHOSCOPE DIAPHRAGM ARCH. INTERN MED. 1997;157:

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23 INFECTION CONTROL ISOLATION CATEGORIES CONTACT ISOLATION DIRECT CONTACT TRANSMISSION ISSUES WOUND/DRESSING ISOLATION ENTERIC PATHOGENS RESISTANT ORGANISM ISOLATION VRE ISOLATION PROTOCOLS: PATIENT MUST REMAIN ON ISOLATION FOR ALL ADMISSIONS CHICKENPOX (ALONG WITH AIRBORNE )

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25 INFECTION CONTROL ISOLATION CATEGORIES CONTACT ISOLATION GLOVES FOR CONTAMINATED CONTACT GOWN IF RISK OF CLOTHING CONTAMINATION MASK/EYEWEAR IF RISK OF FACIAL CONTAMINATION GOOD HANDWASHING!!!

26 INFECTION CONTROL REMOVING PATIENTS FROM RESISTANT ORGANISM ISOLATION (MAINTAIN STANDARD PRECAUTIONS) MRSA NEGATIVE CULTURE FROM ORIGINAL SITE NO CURRENT INFECTION OR TREATMENT VRE THREE NEGATIVE RECTAL SWAB CULTURES OVER THREE WEEKS NEGATIVE ORIGINAL SOURCE NO CURRENT INFECTION OR TREATMENT

27 INFECTION CONTROL ISOLATION CATEGORIES DROPLET ISOLATION MENINGITIS MENINGOCOCCAL H. FLU INFLUENZA PERTUSSIS RUBELLA

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29 INFECTION CONTROL ISOLATION CATEGORIES DROPLET ISOLATION PRIVATE ROOM REGULAR AIRFLOW WEAR REGULAR MASK FOR PATIENT CARE USUALLY 24 HOUR DURATION

30 INFECTION CONTROL ISOLATION CATEGORIES AIRBORNE ISOLATION TUBERCULOSIS CHICKENPOX (WITH CONTACT ISOLATION)

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32 INFECTION CONTROL ISOLATION CATEGORIES AIRBORNE ISOLATION PRIVATE ROOM WITH NEGATIVE AIRFLOW OR HEPA FILTERED AIR FOR TUBERCULOSIS: MUST WEAR SPECIAL N-95 RESPIRATOR FOR CHICKENPOX MASK IF NON-IMMUNE... CDC RECOMMENDS THAT ONLY IMMUNE PERSONNEL CARE FOR PATIENTS WITH VARICELLA INFECTION...

33 INFECTION CONTROL INFECTION CONTROL PLAN CDC ISOLATION RECOMMENDATIONS ISOLATION QUICK REFERENCE TB CONTROL PLAN OSHA EXPOSURE CONTROL PLAN CLINIC PLAN/AMBULATORY PLAN **AVAILABLE ON INTRANET

34 INFECTION CONTROL WASTE MANAGEMENT PROPER DISPOSAL OF CONTAMINATED MATERIALS ALL MEDICAL WASTE- AUTOCLAVE BAGS SHARPS WASTE- NEEDLEBOXES LINEN- ALL CONSIDERED CONTAMINATED USE BLUE PLASTIC BAGS at S&W USE pink bags with white liners at VAMC

35 INFECTION CONTROL EMPLOYEE HEALTH ISSUES TB SKIN TESTING N-95 RESPIRATOR FIT TESTING HEPATITIS B VACCINE OTHER IMMUNIZATION INFORMATION HEPATITIS A VARICELLA FOLLOW-UP CONTAMINATED EXPOSURES

36 INFECTION CONTROL INFECTION CONTROL S&W OFFICE X X44917 X43241 INFECTION CONTROL S&W PAGERS #0426 #1220 #0996 INFECTION CONTROL VAMC x or cell phone

37 Isolation Signs VAMC Acute care

38 Nutrition & Food Service Employees: May Enter STOP Wash Hands on Entering and Leaving Room Gloves To Enter the Room Visitors: Report to Nurses Station Before Entering Room Gown For Contact with Patient, Environmental Surfaces or Items in Room Visitantes: Favor de Presentarse a La Sala De Enfermeras antes de Entrar al Cuarto

39 STOP Wash Hands on Entering and Leaving Room N95 or HEPA Respirator to Enter Negative Air Pressure Keep Door Closed Visitors: Report to Nurses Station Before Entering Room Visitantes: Favor de Presentarse a La Sala De Enfermeras antes de Entrar al Cuarto

40 Nutrition & Food Service Employees: May NOT enter STOP Wash Hands on Entering and Leaving Room Mask to Enter Room Visitors: Report to Nurses Station Before Entering Room Visitantes: Favor de Presentarse a La Sala De Enfermeras antes de Entrar al Cuarto

41 Isolation Signs VAMC Long Term Care And Nursing Home Care Units

42 DROPLET ISOLATION Use in Long Term Care Nursing Home Care Units Mask is required to enter The Red Dot is to alert Nutrition and Food Service staff not to enter the patient s room. Nursing will take the food tray to the patient DROPLET ISOLATION Use in LTC/NHCUs Back of Sign with Red Dot

43 STOP Staff & Visitors Before Entering Room Visitors: Report to Nurses Station for Instructions ALTO! Antes de Entrar al Cuarto Visitantes: Favor de Presentarse a La Sala de Enfermeras Nutrition & Food Service Employees: May Not enter

44 CONTACT ISOLATION For Use in LTC/NHCUs The Green Dot is to inform Nutrition and Food Service employee it is OK to deliver the food tray to the patient s room CONTACT ISOLATION Use in LTC/NHCUs Back of sign with green dot

45 STOP Before Entering Room All Staff & Visitors: Report to Nurses Station for Instructions ALTO! Antes de Entrar al Cuarto Visitantes: Favor de Presentarse a La Sala de Enfermeras Nutrition & Food Service Employees: May Enter

46 The End Proceed to the Post Test Down load the Post Test Complete the Post Test Return the post test to Dr. Sandra Oliver at 407i TAMUII

47 Post test Question 1 What is the single most important thing that you can do to prevent the spread of infection?

48 Post Test Question 2 The CDC recommends that a nonimmune healthcare worker may take care of an isolated patient with Chicken Pox as long as a surgical mask is worn by the healthcare worker. True False

49 Post Test Question 3 What is a common organism that requires contact isolation A. TB B. VRE C. Bacterial Meningitis D. Measles