Infection Control

Standard Precaution Guidelines Good Hand Hygiene- consistent & appropriate Use the right PPE for the job Gloves Face/Eye Protection Gowns/Protective Apparel 3. Clean & disinfect the environment; use of PPE during cleaning 4. Know and use transmission based precautions 5. Bloodborne pathogens concerns (HIV, HBV, HVC) Handling body substances & sharps with care to avoid exposure to bloodborne pathogens Annual review of safety devices to mitigate risk Use respiratory hygiene & cough etiquette to minimize the spread of germs

Hand Hygiene Who- Anyone who may come in contact with blood or body fluids What- Alcohol based gel or hand-washing with antimicrobial soap When- Always before/after patient contact, wear gloves when performing invasive procedures, or before making contact with patient skin (if in precautions) and before contact with non-intact skin or contaminated inanimate objects/surfaces Where- Anywhere there is risk of coming into contact with blood or body fluids Why- Because good hand hygiene practices are the single most effective means of preventing the spread of infection

Hand Washing & Alcohol Gel Hand Washing Use tepid water, wet hands and apply antimicrobial soap Use good friction cleaning front and back of hand, paying attention to nails and between fingers for 15-20 seconds Pat hands dry with paper towels and turn off faucet with a paper towel Always use hand washing when hands are visibly soiled Using Alcohol Gel/Foam Apply appropriate amount of foam/gel into palm of hand Rub hands together using good friction to all surfaces, paying attention to nails and in between fingers Rub hands together until product is evaporated and hands are completely dry CDC recommends that after 4 uses of the gel/foam, that hand washing be done

Personal Protective Equipment It is important to use the appropriate personal protective equipment (PPE) for the job to be done Wear PPE when contact with bloodborne pathogens (BBP) is anticipated When removing PPE, avoid exposure by removing most contaminated PPE to least contaminated PPE Dispose of PPE properly and always wash hands after removing PPE Protect clothing, skin, and especially mucous membranes of the eyes, nose and mouth from BBP

Bloodborne Pathogens Exposure OSHA requires hospitals to have a BBP plan to mitigate the risk associated with BBPs; of particular concern are HIV, HBV, & HCV Considerations in BBP Plan include: Routine disinfection and cleaning Proper body substance & sharps handling Safe injection practices Respiratory hygiene and cough etiquette Proper management of occupation exposures

Routine Environmental Disinfection & Cleaning Routine disinfection and cleaning of environmental surfaces with hospital approved sanitizers is critical in preventing spread of contaminants and pathogens Staff who do environmental cleaning should wear the appropriate PPE during cleaning

Body Substance & Sharps Handling Dispose of contaminated items into appropriate containers, avoiding contact with clothing and environmental surfaces Consider all needles and catheters and sharps and dispose of them into red biohazard containers; empty container when the content reaches the “fill” line marked on the container

Safe Injection Practices Never re-use or re-cap needles Clean ports/vial with alcohol before using Treat all needles and catheters as sharps and dispose of properly

Respiratory Hygiene & Cough Etiquette In waiting areas, signage should be posted requesting patient to inform caregivers of respiratory S/S It is recommended that asymptomatic visitors not stay in the same area and that symptomatic patients be at least 3 feet from patients without respiratory symptoms Patients with symptoms should be provided a mask, tissues, and alcohol hand gel and be asked to use clean hands, cover mouth when coughing and dispose of tissues properly Healthcare workers should use mask and use hand gel before and after caring for respiratory patients

Contact Transmission Person to person touch Direct or Indirect contact Transmitted by inanimate objects Needles Unwashed Hands Gloves that were not changed

Contact Precautions Examples: MRSA, VRE, HSV, Impetigo, Scabies, & C-Diff Use on patients known or suspected to be “infected” or colonized Place in a private room or cohort cases of “same” organism Dedicate patient care equipment Precautions on transport Hand Washing

Droplet Transmission Droplets carry infectious organism Through coughing, sneezing, talking, suctioning, singing Can involve direct and indirect contact

Droplet Precautions Examples: Flu, Meningitis, Pneumonia Use on patients known or suspected to have infections caused by microorganism transmitted in “droplets” Droplets can be propelled 3 feet Dedicate patient care equipment Precautions on transport Special ventilation is not required Place in a private room or cohort infections of the same organism

Airborne Transmission Tiny particles evaporated in the air or on dust particles Can stay suspended in air for long periods of time Can be inhaled by susceptible host and cause infection

Airborne Precautions Examples: TB, Chickenpox, Measles, SARS Requires placement in a negative pressure room Must wear an N-95 mask, gown, and gloves per OSHA User must do “fit check” of mask before entering the room S/S of TB can appear months or years after initial exposure