1. Infection Prevention and Control: 365 Days a Year; Back to Basics Presented by: Cynthia Arseneau, RN, BSN, BSHNU Manager of Clinical Education Programs

2. Outline How do diseases spread? How do we prevent the spread of diseases? – Routine Practice and Additional Precautions – Cleaning and Disinfection – Vaccination Why does all of this matter?

3. Chain of Transmission

4. Infectious Agent Bacteria Parasites Fungus

5. Reservoirs Are places where an infectious agents live and can reproduce in such a manner that can be transmitted – People – Food – Environment – Animals

6. Portal of Exit

7. Means of Transmission

8. Portal of Entry How the infectious agent gets into a person Open skin Mucous membranes – eyes, nose, mouth Gastrointestinal system Do NOT touch!

9. Susceptible Host Characteristics that affect susceptibility: – Age – Nutritional status – Disease history – Underlying illness – Stress and fatigue – Working shift work – Lack of sleep

10. ROUTINE PRACTICE http://www.infectionlandscapes.org/2011/08/gut-infections.html

11. Routine Practice Legislated under “Work Safe BC” occupational health and safety act Consider all residents including body fluids, blood, secretions, excretions, and specimens as potentially infectious Minimum standards to be used by all healthcare providers to protect the residents and staff from potentially pathogenic (disease causing) organisms

12. Clean Your Hands Alcohol based hand rub is best method It is fast and simple Use soap & water if hands are visibly soiled

13. How you clean your hands makes a difference!

14. Effective Hand Hygiene! wet hands first with warm water apply 1-2 pumps (3 to 5 ml) of soap to hands lather and rub hands together for at least 15 seconds, covering all surfaces of your hands and fingers weave fingers and thumbs together and slide them back and forth ensure to get in between fingers and at nails

15. rinse hands thoroughly with warm water use a single-use paper towel to blot hands dry Effective Hand Hygiene! use paper towel to turn off water faucet

16. What About Alcohol-Based Hand Rubs? If hands are not visibly soiled or contaminated with blood or body fluids, use alcohol-based hand rub for routinely cleaning your hands Alcohol-based hand rubs are more effective in reducing the number of bacteria on hands than plain soap and water It is fast and simple Product must contain a minimum of 70% aclohol in order to be effective against noro-like viruses (Norwalk)

17. Tips on Using Alcohol Based Hand Rub  apply 1 pump (loonie size) of the alcohol gel to the palm of one hand, and rub hands together  cover all surfaces of your hands and fingers, including areas around/under fingernails  continue rubbing hands together until alcohol dries  if you applied a sufficient amount of alcohol hand rub, it should take at least 10 -15 seconds of rubbing before your hands feel dry

18. Wear Gloves When performing tasks that might contaminate your hands Remove & discard gloves when task completed Clean your hands

19. When Not to Wear Gloves

20. Wear a Mask and Eye Protection For all coughing patients Especially if within 2 meters (6 feet) of the client/resident Use a fluid resistance mask with a visor or mask and goggles Eye glasses do not count as eye protection

21. Wear a Personal Protective Equipment (PPE) as part of your routine: If your clothing MIGHT get contaminated Add mask & goggles if RISK of facial contamination Discard disposable gown, gloves, and mask in garbage

22. Just Clean Your Hands After removing gloves or body fluid exposure risk Before & after directly touching a client/resident and/or their environment Before administering or assisting with medications If hands are visibly dirty After using the washroom or coughing

23. What Is the Difference?? Routine Practice vs. Additional Precautions

24. 4 Types of Additional Precautions 1.Contact 2.Droplet 3.Droplet/Contact 4.Airborne

25. CONTACT PRECAUTIONS Gown and gloves are suggested for ALL direct care given to a resident in their living space Disposable gowns and gloves are to be removed and discarded in the garbage Perform hand hygiene before and after PPE

26. DROPLET PRECAUTIONS Used when a resident has a non-febrile respiratory illness A fluid resistant mask with visor is suggested whenever you will be within 2 meters of the resident Hand hygiene is to be performed before and after using PPE

27. DROPLET and CONTACT Precautions Used when resident has a febrile respiratory illness like Influenza or if resident is vomiting Fluid resistant mask with visor, gown, and gloves are suggested for all direct care given to resident Hand hygiene MUST be performed before and after using PPE

28. CLEANING AND DISINFECTION What is the difference between?

29. Cleaning of Equipment Cleaning equipment between use is almost as important as hand hygiene Clean first then Disinfect Contact time and friction make the difference Methods of disinfection – Cloth with cleaner applied to it – Pre-moistened wipes (OxivirTb® Wipes, Cavi® Wipes) Ensure wipes are not expired!

30. Vaccination 100 years ago infectious diseases were the leading cause of death in the world In Canada now less than 5% of deaths are related to infectious diseases Vaccination plays a huge role in decreasing the number of deaths related to infectious disease http://www.immunize.cpha.ca/en/default.aspx

31. Vaccination Cholera Diphtheria Hepatitis A Hepatitis B Herpes Zoster (shingles) Human papillomavirus (HPV) Influenza (the flu) Invasive Haemophilus Influenzae Disease Invasive Meningococcal Disease Invasive Pneumococcal Disease Japanese Encephalitis Measles Mumps Pertussis (whooping cough) Poliomyelitis (polio) Rabies Rotavirus Rubella (German Measles) Smallpox Tetanus Tick-Borne Encephalitis Tuberculosis (BCG Vaccine) Typhoid Varicella (chickenpox) Yellow Fever http://www.phac-aspc.gc.ca/im/vpd- mev/index-eng.php

32. Breaking the Chain Interrupting 1 or more links breaks the chain of transmission This can be accomplished by: – the use of routine practice – additional precautions – essential cleaning of equipment between residents

33. Breaking the Chain con’t cleaning high touch surfaces 2 meter spatial separation respiratory etiquette wound care/dressing changes hand hygiene

34. VIDEO Why Don’t We Do It In Our Sleeves?

35. What do you do when you are sick? If you have the following you should stay home: Fever Vomiting Diarrhea *If you have vomiting and/or diarrhea you should stay home for 48 hours after your last episode of vomiting and/or diarrhea because you are still contagious

36. Why does all this matter?

37. What does an outbreak mean for our residents? Physical and social isolation to their suites/rooms if they are sick Restrictions All large group activities are usually cancelled for the duration of outbreaks With every outbreak a sick resident has in increased risk of hospitalization and/or death

38. The End! Always remember that what you do and how you do it affects our residents lives in many ways!