1. Certificate of Competence in Administrating Intravenous Injections 1 Paola Griffiths

2. Overview Infections Control Hospital Acquired Infections Cycle of Infection Common Infections Risk Elements Hand washing Aseptic technique Sharps 2

3. Infection Control Healthcare Associated Infections are infections that are acquired in Hospitals or as a result of healthcare interventions. There are a number of factors that can increase the risk of acquiring an infection, BUT high standards of infection control practice will minimise the rise of occurrence. http://www.hpa.org.uk http://www.epic.tvu.ac.uk/EPIC2 guidelines http://www.epic.tvu.ac.uk/EPIC 3

4. Hospital Acquired Infections (HAIs) In recent years HAIs have received media attention, funding and in depth investigation. Appears a recent phenomena but in 1740 Sir John Pringle, a physician in the British Army introduced sanitary reforms in military hospitals. Florence Nightingale in the Crimean War set out to raise standards of cleanliness and reduce wound infections In 2007 Chapman suggested that up to 10% of patient acquire a HAI. 4

5. Cycle Of Infection 5

6. Infection Agent: What is the organism? Bacteria, virus, parasite, or fungi? The type of organism informs you of the types of disinfectants, antiseptics and antimicrobials to use. Is it aerobic or anaerobic? The Reservoir: Where do you find the organism or what is the source of the infection? A reservoir can be environmental, the hospital setting or the water supply, or in a living organism, a rodent, bird or even snail. Humans are the only reservoir for many human pathogens. 6

7. Common Infection Agents Virus - can only grow and reproduce within a living cell i.e. Influenza Bacteria- single cell micro-organism can live independently or on host i.e. Streptococci Fungi- uni or multi cellular i.e. Candida Prion-is composed of protein in a misfolded form i.e. Bovine spongiform encephalopathy 7

8. Cycle Of Infection Portal of Exit: How does the organism leave the reservoir? Does it leave in faeces, blood or mucus; in contaminated water. Transmission: How is the organism transmitted from one host to the next host? Can it be passed human to human, it is transmitted by respiratory droplets, blood contact or other secretions? Is it transmitted on the hands of health care workers or the hospital ventilation system? Hand-to-mouth is a common mode for gastrointestinal pathogens. 8

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10. Cycle Of Infection Portal of Entry: How does the organism enter the body? Does it come through inhalation, a break in the skin or mucus membrane, an insect bite, contaminated food? Portal of entry tells you what type of personal protective equipment (PPE) to use to keep health care workers, family and visitors safe. Susceptible Hosts: Who is most vulnerable to this organism? Paediatrics, the elderly, and the immune suppressed (due to genetics, transplant drugs, malnutrition, or viral infection like HIV). 10

11. Personal Protective Equipment Air Bourn- Face Mask Fluids- Gloves, Goggles, Face Mask and Aprons 11

12. Cycle Of Infection 12

13. Six Links The interaction between the 6 elements of the chain determine whether an infection will results 13

14. Healthcare Workers Deal with large number of patients Handling tasks (clean and soiled) Patients with different needs and illnesses Post surgical Immune suppressed patients Interventional procedures 14

15. Risk Elements Follow the Infection Control Policy and Procedure in place of work Hand washing Personal Protective Equipment (PPE) Asceptic techniques Safe Disposal of Sharps 15

16. Hand Washing 16 Hands main source of spread of infection Radiographer duties often require brief contact with large number of patient- Potential risk of cross-contaimination

17. Hand Washing –When? (5mins) Before and after all invasive procedures When moving from one patient to another After using the toilet Before handling food or drink After handling any body fluid After removing protective gloves Before starting and after finishing your shift 17

18. Breaking the Chain of Cross Infection Remove watches and rings Wet hands and apply soap Rub hands and wrists for 10-15 secs Include fingers tips, thumbs and webs Through rinse and dry 18

19. Areas most commonly Missed 19

20. Gloves Always used for IV Injections Must be worn as single use items Must be put on immediately before patient contact or treatment Are not an alternative to hand hygiene Must be disposed of as clinical waste Don’t need to be sterile, just a good fit! 20

21. Aseptic techniques Wash hands and wear gloves Don’t touch any part of devices entering patient or connected to syringe. Don’t allow any contact with non sterile areas Clean area with alcohol wipe Clean up any blood spills with suitable decontaminating fluid. Wash hands 21

22. Handling Sharps Don’t dispose sharps for anyone else Don’t re-sheath needles Don’t separate needle from syringe, discard as a whole unit Use a tourniquet Wear gloves Don’t balance any items on the patients tummy..... 22

23. Risk of Infection from Needle stick The average risk of transmission of blood borne viruses following a single percutaneous exposure from an infected person, in the absence of appropriate post exposure prophylaxis Hepatitis B virus (1 in 3) Hepatitis C (1-50) HIV (1 in 300) 23

24. Needle stick injuries –what to do Encourage the wound to bleed (hot water) Wash with soap and running water Dispose of the contaminated item Inform line manager Compete the needle-stick notification paperwork or incident report May require blood sample to be taken May require prophylactic anti-virals if source to be shown inoculation risk. 24

25. Sharps Disposal Used sharps container (BS 7320 standard) Keep within arms reach during procedure for access Not over fill Stored out of reach of children Put together correctly. Signed for all stages Send for clinical waste disposal 25

26. Overview Infections Control Hospital Acquired Infections Cycle of Infection Common Infections Risk Elements Hand washing Aseptic technique Sharps 26

27. Thank you Any Questions? 27 Paola Griffiths