Infection Control, Standard Precautions & Tuberculosis

The information presented here meets… Occupational Safety & Health Administration (OSHA) safety mandates Center for Disease Control (CDC) infection control standards Joint Commission on Accreditation of Healthcare Organizations (JCAHO) environment of care requirements, clinical nursing concepts and skills Corporate compliance through the Office of the Inspector General Centers for Medicare & Medicaid Services (CMS) standards, quality, and customer service

OSHA - Occupational Safety & Health Administration requires organizations to have standards in place to reduce hazards in the work place. Required standards include… –Bloodborne Exposure Control Plan –TB Exposure Control Plan Both of these plans can be found in the Meditech Library –Policies & Procedure Manuals cabinet

Health System workers are at risk of being exposed to diseases such as… Hepatitis B Hepatitis C AIDS Tuberculosis

Hepatitis B - Hepatitis C Hepatitis B Viral Infection Caused by Hepatitis B Virus (HBV) Affects the liver Hepatitis C Viral Infection Caused by Hepatitis C Virus (HCV) Results in inflammation of the liver

AIDS Viral infection Caused by Human Immunodeficiency Virus (HIV) Affects the immune system

Hepatitis B, Hepatitis C, and AIDS are spread to other people by… Needle sharing Sexual activity Blood products Mother to baby Human bite

In Health Care, the most common ways you can get an infection in the work setting are… Sharp object injury such as a needlestick. Splash to mucous membranes of the eyes, nose, or mouth or non-intact skin.

The greatest occupational hazard for Health System workers is a… Sharp object injury such as a needlestick!

The types of tasks you do in your job influences your Risk of Exposure. Job classifications in which you might have contact with blood or other possibly infectious materials are listed in the Infection Control Manual in the Meditech Library. Exposure Determination Lists

Standard Precautions Engineering Controls Work Practice Controls Barriers Standard precautions help keep us covered!

Standard Precautions STANDARD PRECAUTIONS

Body fluids which spread bloodborne disease... Blood Semen Vaginal secretions Breast Milk Standard precautions are to be used in contact with any body fluid. Remember - anything wet!

Engineering and Work Practice Controls Engineering Controls are things that take away or isolate bloodborne hazards at work. –Puncture resistant sharp containers –Red bags to dispose of hazardous medical waste –Needleless IV systems Work Practice Controls are designed to reduce the chance of being exposed by recommending the way a procedure is done. –Safe handling of sharps –Not eating or drinking in work areas –Cleaning up spills of blood or broken glass correctly –Correct hand hygiene

Handling Sharps Safely Take precautions during use, cleaning, or disposal. Do not recap, bend, break, or cut a contaminated needle. Use proper disposal methods. Use a safe needle device or needleless system. Use safe handling techniques, especially during surgery. used A used sharp is a dangerous dangerous sharp!

Hand Hygiene Very important for all Health System workers to wash their hands with soap and water or use an alcohol-based waterless (foam) antiseptic agent. Waterless (foam) antiseptic agent should be used only when hands are not visibly soiled or contaminated with proteinaceous (bloody) material. Hand hygiene is the single most effective way to prevent the spread of infection in the work setting!

Steps for washing hands with soap and water... 1.Use soap. 2.Wash for 15 seconds. 3.Rinse your hands well under running water. 4.Dry hands thoroughly with a paper towel. 5.Turn off the faucet with a paper towel.

It’s also important to know when to use correct hand hygiene. Before you leave work to go home. Before lunch and work breaks. After lunch and work breaks. Before and after patient/ customer contact. After using the restroom.

Personal Protective Equipment (PPE) provides barriers to prevent contact with body fluids. Gowns Gloves Protective eyewear Masks Mouth to mouth resuscitation barriers

How do you know when to use personal protective equipment? Wear gloves when you anticipate being in contact with blood or body fluids. Wear protective eyewear, masks, and gowns in addition to gloves when you think splashing of blood or body fluids could occur.

Safety controls and barriers work together BarrierWork Practice Control Engineering Control Gowns & GlovesHandle soiled linen as little as possible Place used linens in plastic bag

How can you help yourself? Know when you are at risk of contact with blood and other body fluids. Use engineering controls, safe work practices, and barriers to prevent exposures. Remove barriers before leaving the work area and wash hands after barrier removal.

What do you do if you’re exposed to body fluids? Get the proper first aid as soon as possible. If working at the Hospital, go to Employee Health in Pangborn Hall. If working at another Health System site, go to at the Downsville Center, Downsville Pike, Hagerstown. Go to Express Care/Emergency Dept. at the hospital if Employee Health or is closed. Complete an Employee Medical Referral & Accident form and tell your supervisor.

If you’ve been exposed to an HIV source on the job… Drugs are available to help decrease the chance of getting an HIV infection. That’s why it’s so important to get immediate treatment.

Hepatitis B Vaccine is strongly recommended for health care workers. Free to you as an employee. Includes three injections over a six month period. Has some possible side effects.

Other Immunizations Recommended for Health System Workers... Influenza MMR (measles, mumps, rubella) Tetanus Varicella (chicken pox) is highly recommended for healthcare/childcare workers.

It’s important for all Health System workers to report any personal illnesses and keep up with their immunizations. To help keep themselves healthy. To help prevent the spread of disease both at home and at work. To help keep our work environment safe for everybody!

Infections to Report to Your Supervisor Chickenpox Hepatitis Tuberculosis (TB) Conjunctivitis (“pink eye”) Diarrhea Shingles Skin Infections (example - impetigo)

Tuberculosis Control Tuberculosis (TB) is a serious health threat!

TB germs are spread through the air in droplets when a person with active TB disease coughs, sneezes, or speaks. You become infected when you inhale or breathe in an infected droplet. Tuberculosis Control

TB Infection TB Disease (also called Active TB) It’s important to recognize the difference! There are two forms of TB…

People with a positive PPD test (TB skin test) have been exposed to the TB germ. They… –Have a TB Infection –Do not look or feel sick –Cannot infect others –May or may not develop TB Disease (Active TB) –May take medication to prevent TB Disease from developing TB Infection

TB Disease (Active TB) May have these symptoms… –A cough for more than two weeks –Coughing up blood –Night sweats –Fever –Loss of appetite –Weight loss

Most important to remember: A person with TB Disease (Active TB) can infect others!

Engineering Controls Work Practice Controls Barriers TB Exposure Control Plan - outlines the steps the Health System takes in preventing TB transmission.

All PPD skin test negative individuals will have a repeat PPD test according to the following schedule: –Every Year Emergency and Radiology Departments clinical staff and physicians Respiratory Care Department clinical staff and Bronchoscopists Ambulatory Services clinical staff Laboratory microbiology and surgical pathology staff and Pathologists –Every Five Years All other job classifications, medical staff and allied health professionals TB Screening Program

You may be at a higher risk of contracting an infectious disease if you are receiving chemotherapy or have an HIV infection.

Use correct hand hygiene Practice standard precautions Get immunized Wear barriers Follow safe work practices Handle sharps properly Report illnesses and injuries Get a TB skin test according to the schedule for your department and job classification Infection control is everybody’s job!

Graphic images used in this presentation include the following sources… Clip Gallery and Clip Gallery Live, 2006 Microsoft Corporation. All rights reserved. LifeART images, copyright 2006, Lippincott, Williams & Wilkins. All rights reserved. Corbis Doctors & Medicine, copyright 2001, Corbis Corporation. PhotoDisc Health and Medicine, Vol 18, copyright 1995, PhotoDisc, Inc. PhotoDisc Health & Medicine 2, copyright 1999, PhotoDisc, Inc. PhotoDisc The Object Series Back to Business, Vol 31, copyright 2000, PhotoDisc Inc.