Presentation on theme: "CHARISSA FAY BORJA-TABORA, MD, FPPS,FPIDSP"— Presentation transcript:
1 CHARISSA FAY BORJA-TABORA, MD, FPPS,FPIDSP CHAIR, INFECTION PREVENTION AND CONTROL COMMITTEERITM
2 ObjectiveUnderstand the importance of infection control in preventing healthcare-associated infectionKnow basic infection control practices such as standard precautions and Hand HygieneSuggested Reading:WHO Aide-Memoire: Infection PreventionWHO Aide-Memoire: Standard PrecautionsWHO Aide-Memoire: Hand HygieneHand out/materialsHow top Hand Rub posterHow to Hand Wash posterCompetency Checklist (x 1each person) (photocopy)Hand Hygiene Quiz (x 1each person) (photocopy)Water-Based PaintSterile Gloves (Exam Gloves acceptable; 1 set for each person)
3 Infection occurs when all six links in the chain are intact. Chain of InfectionCertain conditions must be met in order for a microbe or infectious disease to be spread from person to person.Infection occurs when all six links in the chain are intact.Source: OSHA
4 Ebola and the Chain of Infection in Healthcare Facilities Pathogenic Microorganism:Ebola virusReservoir:Patient infected with EbolaMeans of Escape:Blood and body fluids (blood, saliva, urine, sperm etc.)Mode of Transmission:Direct contact with blood and body fluids of infected personContact with contaminated surfaces/equipmentMeans of Entry:Non-intact skin, mucous membranes, sharps injuryHost Susceptibility:Poor nutrition, stress, exhaustion, non-intact skin
5 Infection Control What? Breaking the chain of infection Why? Prevent infections within health facilitiesHow? Consistent practice of protocols that prevent an infectious agent moving from one host to anotherWho? Protects:PatientsHCWsVisitorsOther staff
6 “If carefully implemented, Infection Prevention and Control measures will reduce or stop the spread of the [Ebola] virus and protect health-care workers (HCWs) and others.”-WHO 2014Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola
7 So how strong is infection control at your facility? Infection Control can:Stop/reduce the spread of EbolaProtect Health care workersSo how strong is infection control at your facility?
8 Core Components for Infection Prevention & Control (IPC) Programs Checklist Organization of IPC program Technical guidelines Human resources (training, staffing, occupational health) Surveillance of diseases and monitoring of practices Microbiology laboratory support Clean and safe environment Monitoring and evaluation of IPC program Links with public health and other servicesSlide adapted and used with permission from World Health Organization
9 INFECTION CONTROL PREPAREDNESS CHECKLIST Done and completedOn goingNot StartedFACILITYReview triage and placement procedure and ensure that treatment and isolation areas have been identifiedxInspect identified treatment areas to check if they meet IPC recommendations (floor plan, adequate ventilation, electricity and water, comfort room etc/)Ensure that all Airborne Infection Isolation Rooms (AIIR) are functioning correctly and are appropriately monitored for airflow and exhaust handling. (Calibration of measuring devices, check HEPA filter status)Ensure that healthcare personnel have ready access, including via telephone, to medical consultation.Post appropriate signage alerting healthcare personnel to isolation status, PPE required, proper hygiene, and handling/management of infected patients and contaminated supplies. xDevelop contingency plans for staffing, logistics, budget, procurement, security, and treatment.
10 INFECTION CONTROL PREPAREDNESS CHECKLIST ADMINISTRATIVE GUIDANCE Done and completedOn goingNot StartedADMINISTRATIVE GUIDANCEReview your hospital’s infection control procedures to ensure adequate implementation for preventing the spread of Ebola. Review consistency with DOH, WHO, CDC guidelines.xReview policies and procedures for screening, minimizing healthcare personnel exposure, isolation, medical consultation appropriate for Ebola exposure and/or illness, and monitoring and management of potentially exposed healthcare personnel xReview roles of the infection control practitioner to:Ensure appropriate infection control procedures are being followed, including for lab, food, environmental services, and other personnel, andMaintain updated case definitions, management, surveillance and reporting recommendations.
11 INFECTION CONTROL PREPAREDNESS CHECKLIST ADMINISTRATIVE GUIDANCE Done and completedOn goingNot StartedADMINISTRATIVE GUIDANCEReview and distribute the Guidelines for Environmental Infection Control in Health-Care Facilities.xReview laboratory procedures for appropriate specimen collection, transport, and testing of specimens from patients who are suspected to be infected with Ebola virus.Review policies and procedures for screening and work restrictions for exposed or ill healthcare personnel, and develop sick leave policies for healthcare personnel that are flexible and consistent with recommendations,Review protocols for sharps injuriesEnsure all HCP handling EVD patients proper medical clearance
12 INFECTION CONTROL PREPAREDNESS CHECKLIST Done and completedOn goingNot StartedTRAININGReview ICP training status of all personnel. All training requirements in PPE and infection control should be metxEducate and train HCP on the following areas:Management and exposure precautions for suspected or confirmed Ebola casesProper use of PPE (donning and doffing)Hand HygieneRespiratory fit testSick leave policiesSafe sharp practicesWaste ManagementReview environmental cleaning procedures and provide education/refresher training for cleaning staffConduct education and refresher training with healthcare personnel on Ebola for special pathogen handling in the laboratory.Review plans for special handling of linens, supplies, and equipmentProvide education/refresher training for healthcare personnel responsible for cleaning.
13 INFECTION CONTROL PREPAREDNESS CHECKLIST Done and completedOn goingNot StartedSUPPLIESEnsure an adequate supply, for all healthcare personnel, of:• Impermeable gowns (fluid resistant or impermeable),• Gloves,• Shoe covers, boots, and booties, and• Appropriate combination of the following:o Eye protection (face shield or goggles),o Facemasks (goggles or face shield must be worn with facemasks),o N95 respirators (for use during aerosol-generating procedures)• Other infection control supplies (e.g. hand hygiene supplies).xConduct a detailed inventory of available supply of PPE suitable for standard, contact and droplet precautions.Ensure Ebola PPE supplies are maintained in triage, ED, and all patient care areas.
14 INFECTION CONTROL PREPAREDNESS CHECKLIST Done and completedOn goingNot StartedASSESSConduct spot checks and inspections of triage staff to determine if they are incorporating screening procedures and are able to initiate notification, isolation, and PPE procedures for your hospital.xSpot-check frequently to be sure standard, contact and droplet infection control and isolation guidelines are being followed, including safe putting on and removing PPE.
15 How will you strengthen your IPC? Administrative supportChecklists/AuditEbola coordinator:Appointed staff member to oversee adherence to the infection control measures in your facilityThe professional in charge of infection control in the facilityThe focal person to coordinate Ebola activities and advise-WHO 2014
16 Breaking the Chain of Infection Activity/Discussion:In what ways can we break the chain of infection for Ebola in healthcare?
17 Breaking the Chain of Infection Reservoir: Patient infected with EbolaSignage and screening at entrances to healthcare settingsEarly identification of possible casesSeparation: Isolation or cohorting of possible casesCare and monitoring of people exposedMeans of Escape from the patient: Blood and body fluidsSafe handling of human remainsSymptomatic treatment of patients
18 Breaking the Chain of Infection Mode of Transmission: Direct contact with blood and body fluids of or contaminated surfaces/equipmentDecontamination of equipmentRegular and rigorous environmental cleaningLinen and waste managementSpatial separationStrategies to reduce aerosolsMeans of Entry: Non-intact skin, mucous membranes, sharps injuryHand hygieneStandard Precautions including respiratory etiquettePPE: correct use of physical barriers for careSharps safetySafe processing of lab samplesSafe handling of body fluidsHost Susceptibility:Future - Vaccines?
20 When are Standard Precautions Needed? Basic essential component of infection controlApplied to every patient1st line of protection from Ebola transmission in health facilitiesEbola symptoms are non-specificApply to ALL patients
21 Standard Precautions Include Hand hygieneGloves before anticipated contact with body fluids, mucous membrane, non-intact skin and contaminated itemsGown and Eye protection before procedures and patient-care activities likely to involve contact with or projection of blood or body fluids.Best practices for injection safetySafe handling and disposal of sharp instrumentsSafe cleaning and disinfection of the environmentCorrect re-processing of reusable equipmentAdequate laundry and waste managementWHO 2014
22 KEY PRINCIPLES FOR EBOLA Prior to working with Ebola patients, all healthcare workers involved in the care of Ebola patients must have received repeated training and have demonstrated competency in performing all Ebola-related infection control practices and procedures, and specifically in donning/doffing proper PPE.While working in PPE, healthcare workers caring for Ebola patients should have no skin exposed.The overall safe care of Ebola patients in a facility must be overseen by an onsite manager at all times, and each step of every PPE donning/doffing procedure must be supervised by a trained observer to ensure proper completion of established PPE protocols.
23 How well are standard Precautions per WHO standards currently implemented in your facility?
24 “Ebola is an unforgiving and a frightening disease “Ebola is an unforgiving and a frightening disease. But it can be defeated if we work together in solidarity and with effective coordination”UN Deputy Secretary General Jan Eliasson
25 ResourcesWHO 2014 Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on EbolaWHO 2011 Aide-Memoire Infection Control: Core components of infection prevention and control programmes in health careWHO Standard Precautions in Health Care