Infection Prevention
Infection Prevention Implementation and adherence to infection prevention practices are the keys to preventing the transmission of infectious diseases to yourself, family members, other patients, coworkers and community members in general. Preventing hospital acquired infections can save a life!!
Infection Prevention Practices Hand hygiene Standard Precautions/Transmission-Based Precautions Respiratory hygiene When followed properly, each practice decreases the risk of spreading common pathogens. However, hand hygiene is the single most effective means of preventing the spread of all infections among hospital patients and personnel.
Hand Hygiene The proper way to wash you hands using soap and water: Wet your hands Apply soap and scrub for at least 15 seconds. Washing all areas of the hand, including under the nails and between the fingers. Rinse well Dry hands with paper towel Apply lotion Use paper towel or elbow to turn off faucet Use paper towel to turn the door knob when leaving the restroom.
Hand Hygiene The proper way to wash your hands when using waterless hand cleaner: Apply 1.5 to 3 ml of an alcohol based cleaner to the palm of one hand and rub hands together Cover all surfaces of your hands and fingers Include areas around/under fingernails Continue rubbing hands together until alcohol dries IF you have applied a sufficient amount of alcohol hand rub, it should take at least 10 15 seconds of rubbing before your hands feel dry.
Did You Know? It is hospital policy that any caregiver with direct patient contact is not allowed to wear artificial nails or nail enhancements. They are an infection control issue!
Hands must be washed with soap and water when caring for a patient infected with C. diff., not waterless hand cleanser. None of the waterless hand rubs are known to be effective against C. diff. spores.
SPEAK UP If you see any staff member not wash their hands before patient care or after patient care Speak Up Remind them (in a non-threatening manner) to wash their hands. If someone reminds You to wash your hands say Thank you for reminding me! Doing so protects You, Your Coworkers and Other Patients from disease transmission
Standard Precautions Standard Precautions include: Blood and Body Fluid Precautions -designed to reduce the risk of transmission of blood-borne borne pathogens) and Body Substance Isolation (BSI) -designed to reduce the risk of transmission of pathogens from moist body substances Standard Precautions apply to 1) blood; 2) all body fluids, secretions, and excretions except sweat, regardless of whether or not they contain visible blood; 3) non-intact skin; and 4) mucous membranes. Standard Precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in hospitals.
Standard Precautions Include Hand washing Gloves Mask, eye protection, face shield Gown Patient care equipment Environmental Control Linen Occupational health and blood-borne borne pathogens Patient placement
Hand washing Wash hands after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn. Wash hands immediately after gloves are removed, between patient contacts, and when otherwise indicated to avoid transfer of microorganisms to other patients or environments. It may be necessary to wash hands between tasks and procedures on the same patient to prevent cross-contamination contamination of different body sites.
Gloves Wear gloves (clean, non-sterile gloves are adequate) when touching blood, body fluids, secretions, excretions, and contaminated items. Put on clean gloves just before touching mucous membranes and non-intact skin. Change gloves between tasks and procedures on the same patient after contact with material that may contain a high concentration of microorganisms. Remove gloves promptly after use, before touching non- contaminated items and environmental surfaces, and before going to another patient, and wash hands immediately to avoid transfer of microorganisms to other patients or environments.
Mask, Eye Protection, Face Shield Wear a mask and eye protection or a face shield to protect mucous membranes of the eyes, nose, and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions.
Gown Wear a gown (a clean, non-sterile gown is adequate) to protect skin and to prevent soiling of clothing during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. Select a gown that is appropriate for the activity and amount of fluid likely to be encountered. Remove a soiled gown as promptly as possible, and wash hands to avoid transfer of microorganisms to other patients or environments.
Patient-Care Equipment Handle used patient-care equipment soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other patients and environments. Ensure that reusable equipment is not used for the care of another patient until it has been cleaned and reprocessed appropriately. Ensure that single-use items are discarded properly.
Environmental Control Procedures for the routine care, cleaning, and disinfection of environmental surfaces, beds, bedrails, bedside equipment, and other frequently touched surfaces must be followed.
Linen Handle, transport, and process used linen soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures and contamination of clothing, and that avoids transfer of microorganisms to other patients and environments. Place used linen in appropriate receptacle. Do not place used linen on the floor.
Occupational Health and Blood-borne Pathogens Take care to prevent injuries when using needles, scalpels, and other sharp instruments or devices; when handling sharp instruments after procedures; when cleaning used instruments; and when disposing of used needles. Never recap used needles, or otherwise manipulate them using both hands, or use any other technique that involves directing the point of a needle toward any part of the body; rather, use either a one-handed "scoop" technique or a mechanical device designed for holding the needle sheath. Use all attached safety devices on needles and intravenous catheters as indicated by the manufacturer.
Place used disposable syringes and needles, scalpel blades, and other sharp items in appropriate puncture-resistant resistant containers, which are located as close as practical to the area in which the items were used, and place reusable syringes and needles in a puncture-resistant resistant container for transport to the reprocessing area. Use mouthpieces, resuscitation bags, or other ventilation devices as an alternative to mouth-to- mouth resuscitation methods in areas where the need for resuscitation is predictable.
Patient Placement Appropriate patient placement is a significant component of isolation precautions. A patient who is infectious or is suspected as having an infectious process needs to be placed in a private room. When a private room is not available, an infected patient may be placed with another appropriate room-mate mate (patient infected with the same germs). If there are any questions, please consult with the Infection Control practitioner.
Transmission-based precautions are used in combination with Standard Precautions
Transmission-based Precautions include: Droplet precautions Contact precautions Airborne Infection Isolation
Before entering any patient room- look to see if there is a precaution sign on the door. Precaution signs are color coded and give specific instructions on what precautions (personal protective equipment-ppe) is needed to enter the room.
Droplet Precautions In addition to Standard Precautions, use Droplet Precautions for patients known or suspected to be infected with microorganisms transmitted by droplets. Droplets can be generated by the patient during coughing, sneezing, talking or in the performance of procedures. Examples include patients with influenza, strep pneumonia and MRSA in sputum.
Droplet Precautions Include Patient placement - place the patient in a private room. Mask- wear a mask within 3 feet of patient. Patient transport -if transport is necessary, minimize patient dispersal of droplets by having the patient wear a mask, if possible.
Contact Precautions In addition to Standard Precautions, Contact Precautions should be used for the care of patients known or suspected to have illnesses that can be spread by direct contact with an infected person, or the surfaces in the room. Examples include patients with MRSA, scabies or draining wounds. Contact Precaution sign with a brown stripe on it indicates C-diff these patient rooms have to be cleaned with bleach and hand hygiene needs to be done with soap and water.
Contact Precautions Include: Gloves and hand hygiene - Wear gloves and wash hands often. Gown Wear a gown when in the room having direct contact with a patient. Patient transport Limit movement to essential purposes only. Patient care equipment Have dedicated equipment for just that patient. Patient placement Place patient in a private room.
Airborne Infection Isolation In addition to Standard Precautions, Airborne Infection Isolation measures are designed to reduce the risk of transmission of infectious agents that may be suspended in the air. Examples include patients with TB, SARS, Measles and weaping herpes zoster. Patients must be given a private room with special air handling and ventilation (negative pressure). Remember when entering a negative pressure room always enter through the ante room with our N95 mask already on.
About TB Tuberculosis (TB) is a contagious disease affecting the lungs. TB is transmitted by very small droplets in the air, and can spread through coughing, sneezing, or speaking. People who have close contact with those already suffering with TB and people who have a weak immune system have a greater risk for developing TB.
Signs and Symptoms of TB A person with TB may: Have a cough Experience chills Have night sweats Have a fever Have a decreased appetite and/or recent weight loss. Feel very tired
Quickly Identifying, isolating, and treating contagious patients is the best way to prevent the spread of TB. Anyone suspected of having TB should be placed in an isolation room and placed on airborne precautions. TB has become harder to treat because some forms of TB do not respond to the antibiotics. (Multi drug resistant TB)
Respirators You must be fitted with a N95 mask or other approved respirator to be properly protected from TB. (A surgical mask does not provide adequate protection). Employees with facial hair often cannot get a tight fit when wearing a mask-type respirator, therefore, they need to wear a Powered Air Purifier Respirator (PAPR). You must be cleared by a physician and fill out a health questionnaire before being fitted for a respirator. If any part of the filter on your respirator is damaged or soiled it needs to be replaced.
If you test positive on a TB skin test or show symptoms of TB, you should limit contact with other people and contact the Employee Health Nurse. You should request testing for TB if: You have had a cough for longer than two weeks, Show any symptoms of TB, Have had a recent exposure to a person testing positive for TB or Travel to high risk areas inside and outside the USA
Any possible TB exposure needs to be reported to Carol Smith, Employee Health Nurse
What To Do When You Are The One Sick Personnel who have responsibilities for patient care, who have significant patient exposure, and develop signs and symptoms of a transmissible infectious disease while at work, should report promptly to their supervisor. The employee will be referred to the Employee Health Nurse or ED (after hours) for assessment and determine if they can remain at work or should go home.