Infection Prevention & Control (IPC) Communicable Disease Control – Population, Public and Indigenous Health Infection Prevention & Control (IPC) September 3, 2019

Infection Prevention & Control Communicable Disease Control – Population, Public and Indigenous Health Infection Prevention & Control Hand hygiene is the single most important action that decreases the spread of infection Hand hygiene is done with: - Alcohol-based hand rub (ABHR) - Regular liquid soap, water and disposable hand towels

Hand hygiene Alcohol-based hand rub (ABHR) Approved AHS product Communicable Disease Control – Population, Public and Indigenous Health Hand hygiene Alcohol-based hand rub (ABHR) Approved AHS product Use sufficient ABHR to rub all surfaces of hands (2-3 pumps) including between fingers and the base of the thumbs for a minimum of 15 seconds Regular liquid soap, water and disposable hand towels Wet hands, apply soap, rub all surfaces for minimum 15 seconds Rinse with clear, running water Recommended if hands are visibly soiled Apply AHS approved hand creams to maintain skin integrity Glove use is not a substitute for hand hygiene

Four Moments of Hand Hygiene Communicable Disease Control – Population, Public and Indigenous Health Four Moments of Hand Hygiene Before each client contact or contact with their environment Before clean/aseptic procedures (such as immunization) After blood and body fluid exposure risk (such as after immunization) After contact with the client or their environment AHS Hand Hygiene Policy and Procedure https://extranet.ahsnet.ca/teams/policydocuments/1/clp-hand-hygiene-ps-02-policy.pdf https://extranet.ahsnet.ca/teams/policydocuments/1/clp-hand-hygiene-ps-02-01-procedure.pdf Policy states staff and medical staff wearing casts, dressings or splints that hinder Hand Hygiene can not provide direct client care Policy states that artificial nails, nail enhancements, and chipped nail polish should not be worn. Natural nails should be clean, healthy and not to exceed 6 mm or 0.25 inches. Rings limited to plain bands.

Hand hygiene at large immunization sites Communicable Disease Control – Population, Public and Indigenous Health Hand hygiene at large immunization sites Examples only, not limited to these occasions: Start and end of shift Before and after contact with the client Before handling immunization supplies (entering vaccine bags), including the set up of immunizing stations After vaccine administered and before handling other equipment, such as papers and pens

IPC for vaccine administration Communicable Disease Control – Population, Public and Indigenous Health IPC for vaccine administration Clean and disinfect clinic table/ work surface with appropriate low-level disinfectant (e.g., accelerated hydrogen peroxide, quaternary ammonium compounds) - This is a two step procedure - clean first, and then disinfect - Always start the disinfection stage with a clean cloth Cover table/work station with a large clean drape Use a small drape in front of immunizing staff as a clean work area - avoid placing papers/pens, computers on this area Place appropriate puncture resistant biohazard container for use at point of contact to dispose of sharps immediately after use

Preparing for immunization in large public clinic sites Communicable Disease Control – Population, Public and Indigenous Health Preparing for immunization in large public clinic sites Maintain small drape as the clean surface for the immunization station (needles, syringes, swabs, etc) When documenting ensure the clean surface is not contaminated by either paperwork or computer. When station not in use: - Drape with a clean drape (e.g., coffee times, meal times) Drapes used to cover the immunization stations can be reused for the day - Ensure they are folded so the inside portion maintains a clean field

Preparing for immunization at large public clinic sites Communicable Disease Control – Population, Public and Indigenous Health Preparing for immunization at large public clinic sites During the clinic: Immunization station and tables are cleaned and disinfected at the start of the clinic and at the end of the clinic, not at the beginning and end of staff shifts Cleaning and disinfection of the station during the shift needs to be done only if the area becomes dirty/contaminated/wet At that time, the area would be cleaned, disinfected and set up At the end of the day, for sites that are only there for the day: Clean and disinfect station per IPC Guidelines but not set up for the next day  For sites where the campaign is ongoing & stations used next day: Area cleaned, disinfected & set up with fresh supplies and draped in preparation for the next day.

Cleaning of blood and body fluids Communicable Disease Control – Population, Public and Indigenous Health Cleaning of blood and body fluids Appropriate Personal Protective Equipment (PPE) must be worn Gloves must be worn and if there is the possibility of splashing, further PPE (gown, mask and eye protection) may be required Clean area by blotting blood/body fluids with disposable towels, discarding in a regular plastic-lined waste container In addition, for non porous surfaces, clean area with soap & water once clean-up is completed, tie garbage bag and place in regular garbage After initial cleaning, disinfect with a fresh solution of bleach (1 part bleach:9 parts water) or use a low level disinfectant Thoroughly clean equipment (e.g. mop &handle, pail) before re-use Wash hands with soap and running water