Windsor Regional Hospital believes that Infection Prevention and Control is vital to patient safety. ALL persons working in the hospital have a RESPONSIBILITY to practice good infection prevention and control. All staff, patients and visitors are asked to perform hand hygiene when entering/exiting the hospital. There are 2 methods for performing hand hygiene: Alcohol-Based Hand Rub (ABHR) PREFERRED METHOD - kills micro-organisms on your hands - more effective and more readily available then soap and water when hands are not visibly soiled. Rub 1-2 pumps (loonie sized amount) of ABHR into palms, fingers, wrists, etc. for 15 seconds (or until dry) Hand Washing (Soap and Water) Use when hands are visibly soiled. Use a dedicated hygiene sink - Do not use sinks that are intended for patient use or special procedures. Apply soap to wet hands and lather 15 seconds. Rinse thoroughly under warm running water. Dry with a paper towel and turn off tap (and open door) with a paper towel Note: If hands are visibly soiled and there is no running water, use a moist towelette to remove visible soil and then ABHR NOTE: Rings, watches, bracelets and nail adornments all decrease the effectiveness of hand hygiene and are discouraged. If watches and bracelets are worn, they must be removed or pushed high up on the arm prior to performing hand hygiene. 4 Moments of Hand Hygiene WRH follows the Ontario Ministry of Health and Long-Term Care's 4 Moments of Hand Hygiene initiative. Regular hand hygiene audits are conducted throughout the hospital to ensure that ALL healthcare providers (including physicians) are maintaining a safe environment for our patients. The hospital has adopted the 2x4 Patient Safety Campaign. This campaign embraces and promotes the use of 2 client identifiers and the 4 moments of hand hygiene. 1
When to Perform Hand Hygiene Upon entry/exit of the hospital After using the restroom; before/after eating After coughing, sneezing, blowing of nose, smoking or any other task where hands may become contaminated with secretions/excretions Before/after contact with patient/patient environment Before putting on gloves; after removal of gloves When moving from a contaminated body site to a clean body site At any other time when in doubt about the necessity for doing so Before/After contact with a patient or items in the patient environment (upon entry to and exit from the room or bed space When moving from a contaminated body site to a clean body site during health care acitvities Routine Practices ALL patients are considered potentially infectious, even when asymptomatic. As a result, routine practices are used with ALL patients during ALL care. Personal Protective Equipment (PPE) Gloves: Worn anytime hands may come into contact with mucous membranes, non-intact skin, tissue, blood, body fluids, excretions, secretions or contaminated equipment/environment Wash hands prior to putting on gloves and immediately after removal Single use Single patient Change gloves when moving from a contaminated body site to a clean site on the same patient Gowns: Worn when it is anticipated that a procedure/activity is likely to generate splashes/sprays of blood, body fluid, secretions or excretions Isolation gowns are yellow in colour Should be put on immediately prior to the task for which it was worn and tied at neck and waist Do not hang up or store for later use Should not be worn outside of the patient environment Patients are not to wear isolation gowns - a clean hospital gown meets the needs of the patient Masks: Used to protect mucous membranes of the nose and mouth against splashes/sprays of blood, body fluid, excretions or secretions or within 2 meters of a coughing patient. Ensure the mask covers your nose and mouth Do NOT touch the mask during use Correctly remove mask immediately after task completion and discard appropriately Do not re-use disposable masks; discard after use Eye Protection: Used to protect eyes from splashes/sprays of blood/body fluid/secretions/excretions (or within 2 meters of a coughing patient) When a mask is required, it is very likely you will also require eye protection Prescription eye glasses are NOT acceptable as eye protection, but may be worn under face shields or goggles Discard appropriately or disinfect (if re-usable e.g., goggles) immediately after task 2
Personal Protective Equipment The required Personal Protective Equipment (PPE) is outlined on each of the isolation signs. There is a preferred way for donning and doffing (removing) PPE: Donning PPE: 1. Perform hand hygiene 2. Put gown on 3. Put on mask 4. Put on eye protection 5. Put gloves on Doffing PPE: 1. Remove gloves 2. Remove gown 3. Perform hand hygiene 4. Remove eye protection 5. Remove mask 6. Perform hand hygiene Risk Assessment A risk assessment must be performed before each interaction with a patient or their environment. This assessment will determine whether you require PPE, including the type of PPE you should wear. hand exposure? Gloves 1. Will you be exposed, to blood, body fluids, excretions, secretions or the patient environment? face exposure? Mask / eye protection clothing or skin exposure? Gown Does patient have known infection or 2. symptoms of infection? yes Additional Precaution Signage at patient room entrance or bed space 3
Additional Practices (In addition to Routine Practices) Transmission Description Guidelines Signage Contact E.g. VRE, MRSA, Cdiff, scabies, gastro-intestinal illness Patient has known/suspected organism that can spread by hands, clothing and touching either the patient or items in the patient environment before/after - Proper patient placement - Staff wear gloves and long sleeved gown - Dedicated patient equipment (or clean between use) Droplet E.g. meningitis, pneumonia, whooping cough, mumps, rubella, respiratory tract viruses (Adenovirus, Rhinovirus) with an organism that can spread by droplets, often coughing or sneezing - Patient Placement - Staff wear mask and eye wear - Dedicated patient equipment (or clean between use) Droplet / Contact e.g. influenza, RSV, Febrile Respiratory Illness (FRI) with an organism that can be spread by droplets as well as by hands, clothing and touching either the patient or items in the patient environment - Patient placement - Wear gloves, long sleeve gown, mask and eye protection - Patient transport - Dedicated equipment (or clean between use) Airborne E.g. TB, measles, chicken pox (varicella) with an organism that can spread by very small droplets through coughing or sneezing, but stays in the air for a long time and travels for long distances on air currents - Place patient in a negative pressure room with door closed - Staff wear N95 mask - Limit patient transport (mask must be worn during transport) - Susceptible or unimmunized staff or visitors should not enter Cubicle Isolation with Contact Precautions Precautionary measure when awaiting MRSA/VRE results (to prevent transfer from patient to patient) - Cubicle space in room /curtains define space - Contact precautions when in patient space - Touch area in patient bathroom cleaned after patient use
Contacts: Hours of Operation: 0700 1500 Monday to Friday After hours Call on-call supervisor Office Locations: Met Campus: 4 West Room 4311 Ouellette Campus: 5th floor Room 530 IPAC Practitioners (Met Campus): Karen Padbury x52358 Cell: (519) 995-2637 Karen Skinner x52378 Cell: (519) 995-4717 Angela Murray-Watters x52851 Cell: (519) 995-6204 Karen Calibaba x52829 Cell: (519) 551-2431 IPAC Practitioners (Ouellette Campus): Diane Deveau x33578 Cell: (519) 995-6843 Anita Bertelle x33578 Cell: (519) 995-6248 Jennifer Barris x33578 Cell: (519) 995-8562 IPAC Manager: Erika Vitale x33835 5