1. Infection Control Induction Program GRICG March 2009

2. What is an infection?  An infection occurs when invading microorganisms cause ill health Viruses Bacteria Fungi Prions Pain, tenderness, swelling, redness, pus fever

3. Microbial Reservoirs  Microbes can survive in many environments On or in people, as normal flora On or in people who have infections Animals (zoonoses)- normal flora or infections Contaminated food or fluids Contaminated articles Contaminated environment

4. Infection Transmission Direct contact with another person can transmit their microbes to you Indirect contact is when a third person or an article transmits the microbes from one person to another Droplet transmission occurs when large respiratory droplets (which travel less than 1 metre), are coughed onto someone else

5. Infection Transmission Airborne transmission occurs when fine spray is coughed into the air (can travel suspended in air more than 1 metre) Vector transmission occurs when living animals/ insects transmit infections Contaminated food Contaminated water

6. 1.Pathogenic microbes 2.A reservoir where the microbes can survive (people, food, water, articles) 3.An exit point (body fluids, respiratory droplets) 1.Suitable place of entry (respiratory tract, broken skin, bowel) 2.Susceptible host (non-immune, debilitated, other medical problem) 3.Adequate dose of microbes (to cause infection) Transmission Route (direct contact, airborne, or contaminated article) Seven Requirements of Infection Transmission

7. Prevent Infection Transmission  Standard precautions Used for ALL patient contacts  Additional precautions Used in addition to standard precautions when more stringent precautions are required  Airborne transmission – Tb, chicken pox  Droplet transmission - influenza  Multi Resistant Organisms  Gastroenteritis

8. Additional Precautions Single room with ensuite Dedicated toilet – infectious diarrhoea Cohorting if single room not available Special ventilation requirements – positive/negative pressure Additional use of protective barriers – Tb particulate mask: 1um filtration Rostering of immune HCWs to care for infectious patients Dedicated patient equipment Restricted movement of patients and HCWs

9. Standard Precautions  Routine infection control measures to be used at all times for all patient care

10. Hand Hygiene  Staff hands are the most common vehicle for infection transmission Own resident hand flora Transient hand flora – organisms picked up from contact with persons or articles Infectious hand conditions – dermatitis, paronychia

11. Alcohol/ Chlorhexidine Hand rub Hand Hygiene Refers To:  Hand washing using soap/skin cleanser  Decontamination using alcohol hand rub  Decontamination using 4% Chlorhexidine

12. Alcohol Hand Rubs  Improve hand hygiene compliance  Kill bacteria on hands more readily  Cause less skin irritations and dryness  Decrease patient infection rates when used before and after every patient contact

14. Correct Application  Don't forget areas around and under your fingernails  If your hands are visibly soiled, wash with soap and water rather than alcohol rub Austin Health

15. A MOMENT is when there is a perceived or actual risk of pathogen (germ) transmission from on surface to another via the hands.

17. Perform Hand Hygiene 1. Before and after direct patient contact 2. After removing gloves 3. Before handling invasive devices 4. After contact with body fluids, mucous membranes, non intact skin & wound dressings

18. Perform Hand Hygiene Contd 5. If moving from contaminated to clean body site 6. After contact with inanimate objects in immediate vicinity of patient 7. Before handling medications or preparing food

19. Respiratory (Cough) Etiquette

20. Glove Use  Used when contact with body fluids is anticipated  Single use – must be discarded after patient contact  Must wash hands after removal of gloves

21. Mask Use Danger Zone for absorption of viruses  Eyes  Nose  Mouth  Single use item  Use when splash with body fluids is anticipated  N95/P2 for airborne diseases  Replace when moist  Dispose of directly into waste bin

22. Linen Management Do not over fill bags (3/4 full) No sharps into soiled linen Prevent seepage Use gloves to handle moist linen

23. Waste Management  Waste should be segregated at point of generation  Place clinical waste in yellow containers or bags bearing biohazard symbol  Do not over fill bags or containers  Do not compact by hand  Follow state and national guidelines or codes

24. Environmental Cleaning  Deposits of dust, soil and microbes on surfaces are a potential source of infection Neutral detergent used for routine cleaning Disinfectants may be required in some situations – gastro, MROs All cleaning equipment should be stored dry Surfaces should be cleaned regularly and immediately following blood and body fluid spills

25. Single Use Policy  Any items marked by manufacturer as single use should be discarded after use  Single use vials or ampoules must be used wherever these are available  Multi dose vials must only be used on the same patient then discarded  Items marked “Single Patient Use” must only be re-used on same patient then discarded

26. Safe Handling of Sharps  Always use safety devices when they are available  Use appropriate sharps containers  Discard used sharps immediately  Do not pass sharps by hand between HCWs  Avoid recapping needles  Do not force sharps into container  Do not over-fill sharps containers

27. Occupational Exposure  First aid – immediate washing of area  Eye splashes – rinse thoroughly  Report incident promptly  Evaluation of exposure  Follow-up action, counselling  Blood tests if required  Ensure full documentation of incident

28. Staff Health  Good personal hygiene  Seek prompt diagnosis and treatment of personal illness (away for 48 hours - gastro)  Staff immunisation Hepatitis B Influenza MMR Pertussis Varicella zoster

29. Food Hygiene  Hand washing, glove use  Regular cleaning of serving and storage areas  Pest and dust control  Date and cover prepared food in fridge  Maintain safe food temperatures Hot food - >60 o C Cold food - <5 o C

30. INFECTIOUS WASTE Blood and Body Substance Spills  Don personal protective equipment  Confine and contain the spill  Treat waste as infectious  Clean spill site according to hospital policy  Carpet – clean with neutral detergent and arrange carpet cleaner as soon as possible  Use a chlorine based disinfectant as directed by your hospital policy

31. Take Care …………. …. of yourself and your patients Questions or Queries? Infection Control Phone Number:…………………………..