Infection Control Print 5th

download report

Transcript Infection Control Print 5th

INFECTION CONTROL

THE INFECTION CONTROL STAFF

INTEGRIS BAPTIST

V. Ramgopal, M.D., Hospital Epidemiologist • Gwen Harington, RN, BSN, CIC, Infection Control Specialist • Kathy Knecht, RN, Surveillance Coordinator

INTEGRIS SOUTHWEST

D. Chansolme,

M.D.,

Hospital Epidemiologist • Becky Lewis, RN, Infection Control Specialist

Who can Place a Patient in Isolation

Attending MD to order isolation as indicated by the

Centers for Disease Control Guidelines.

Hospital Epidemiologist and Infection Control

Specialist have authority to isolate and/or transfer any patient to a private room as indicated.

By using CDC Guidelines, the licensed nurse

responsible for the patient can institute isolation if notified that the patient has a positive culture for resistant organisms, i.e., MRSA, VRE, or Clostridium difficile.

Physician order is necessary for the discontinuation

of isolation.

Criteria for Placing Isolation

Patients diagnosed with resistant organisms need to

remain in the same location unless they are occupying a semi-private room, need to be transferred to an ICU bed, or need to be transferred from an ICU bed to a patient-care floor.

Patients previously admitted with a positive culture

of a resistant organisms should be placed in isolation immediately upon readmission.

Reference: Policy #IC-112 Readmissions with

Resistant Organisms.

PERSONAL PROTECTIVE EQUIPMENT

This equipment is

located in Barrier Boxes throughout each medical center and in the each patient room. The equipment is provided to protect employees against exposure to blood

and body fluids.

BLOODBORNE EXPOSURE

• Report IMMEDIATELY to your supervisor.

• Complete exposure incident report.

• Go to Employee Health Services

ASAP.

If after hours or on weekend,

contact House Supervisor.

If regular clinic hours and

unable to go immediately, contact EHS by phone to report incident and begin patient testing.

BLOODBORNE PATHOGENS & TUBERCULOSIS EXPOSURE CONTROL PLANS

• These plans are updated annually and are located in the following places: – Infection Control

Master Manual

Integris IntranetInfection Control

website

The Public Folders

PATIENT PLACEMENT FOR TUBERCULOSIS Any patient with positive AFB smear, probable or known Tuberculosis, must be placed in negative pressure room.

IBMC

Negative pressure rooms are located on East Tower floors 7, 8, 9, & 10 East; there are two rooms in 901 ICU. The only exception on the West Tower is in the 9West Cardiac suites; this area has one negative pressure room.

ISMC

Negative pressure rooms are on floors 6, 7, and 10 and in the ICU. Jim Thorpe Rehab Hospital has one isolation room on the 2 nd and 3 rd floors. Contact Infection Control or Environmental Health and Safety for any problems or questions.

FIT TESTING OF TUBERCULOSIS MASKS

Must be fit-tested

for mask when entering the room for patients with known or suspected Tuberculosis. All fit testing is done by employee health .

ISOLATION PRECAUTIONS IN A NUTSHELL

STANDARD PRECAUTIONS

• Use with ALL patients regardless of diagnosis or presumed infection. Use when there’s a chance of contact with: – bloodany body secretions or

excretions

broken skinmucous membranes

STANDARD PRECAUTIONS

Hand WashingBEFORE and AFTER patient contact – BEFORE putting on or taking off gloves – AFTER touching blood or other body substances, contaminated patient equipment, broken skin, or mucous membranes – BETWEEN different procedures on the same patient – BEFORE leaving the patient’s room – Wash your hands for 15 seconds if using soap and water.

– When using alcohol foam rub your hands together until hands are completely dry.

– http://www.hhs.gov/ash/initiatives /hai/training/

STANDARD PRECAUTIONS

Wearing Gloves

BEFORE any procedure that may involve contact with blood or other body substances, broken skin, or mucous membranes.

BEFORE touching any potentially contaminated object.

CHANGE gloves after touching infective material such as fecal material and wound drainage.

STANDARD PRECAUTIONS

Wearing Face and

Eye Protection

– Use a mask and face and eye protection when the possibility exists that blood or other body fluids may be splashed or sprayed

STANDARD PRECAUTIONS

Wearing Gowns – Use a gown if splashing or spraying of blood, body fluids, secretions or excretions is possible.

STANDARD PRECAUTIONS

Handling Patient-Care EquipmentHandle patient-care equipment that is soiled with blood, other body fluids, secretions or excretions in a way that prevents contact with skin and mucous membranes.

Handle patient-care equipment in a way that prevents contamination of clothing and the spread of micro organisms to other patients and the environment.

– Appropriately dispose of single-use equipment.

Sterilize or disinfect reusable equipment according to policy.

– Properly clean and disinfect equipment that is shared by more than one patient.

Standard Precautions

• Any piece of contaminated equipment that will not be immediately cleaned as part of room turnover should be covered with a blue bag labeled as “soiled”. • Equipment that has been cleaned and decontaminated should be covered with a clear bag. Even if it will be used

within a short time.

STANDARD PRECAUTIONS

SharpsNever recap used

needles

Deposit sharps in

the sharps container immediately after use

Call

housekeeping to come and replace the sharps container when it is half full

STANDARD PRECAUTIONS

Handling Linen – Do not put linen on the floor. – Drape an open plastic bag over a chair and place dirty linen in the bag.

– After removing bag with dirty linen from a patient’s room place it in the covered dirty linen bin on your unit.

3 CATEGORIES OF ISOLATION PRECAUTIONS

TO BE USED IN ADDITION TO STANDARD PRECAUTIONS

CONTACT PRECAUTIONS

This category is

used for patients known to be infected or colonized with important microorganisms that can be transmitted by direct contact with the patient.

CONTACT PRECAUTIONS

Common Conditions That Require Contact Isolation:

MRSA (all body sites) C. DIFFICILE MAJOR ABSCESSES CELLULITIS, DECUBITI VRE (all body sites) LICE SCABIES RSV

CONTACT PRECAUTIONS

Private room necessary.

Gloves MUST be worn when entering patient’s room.

Gown MUST be worn when entering patient’s room, if you anticipate your clothing will have substantial contact with patient, environmental surfaces, or items in patient’s room.

Transport: limit movement and transport of patient from the room for essential purposes only.

Patient-Care Equipment: dedicate the use of non critical patient-care equipment to a single patient to avoid sharing between patients. In unavoidable, clean and disinfect before using on another patient.

AIRBORNE PRECAUTIONS

This category is

used to prevent the spread of infectious small particles that remain suspended in the air and can be widely dispersed by air currents.

AIRBORNE PRECAUTIONS

Common Conditions That Require Airborne Isolation:

TUBERCULOSIS VARICELLA (Chickenpox)

AIRBORNE PRECAUTIONS

• Private room with NEGATIVE air pressure. KEEP

DOOR CLOSED.

• Wear respiratory protection when entering the room of those patients with known or suspected pulmonary tuberculosis. YOU MUST HAVE BEEN FIT-TESTED

BEFORE YOU WEAR RESPIRATORY PROTECTION AND ENTER THE ROOM OF A PATIENT WITH KNOWN OR SUSPECTED PULMONARY TUBERCULOSIS.

• Patient transport: limit transport and movement to essential purposes only. If moving patient is necessary, place a SURGICAL MASK on the patient.

DROPLET PRECAUTIONS

This category is

used to prevent the spread of large particles that can be created by certain medical procedures or by coughing, sneezing, or talking.

DROPLET PRECAUTIONS

Common Diagnosis That Require Droplet Isolation:

INFLUENZA PERTUSSIS HAEMOPHILUS INFLUENZAE B MENINGITIS, PNEUMONIA AND SEPSIS NEISSERIA MENINGITIDIS MENINGITIS, PNEUMONIA AND SEPSIS

DROPLET PRECAUTIONS

Private room necessary • Mask MUST be worn when working within 3 feet of the patient • Patient transport: limit transport and movement to essential purposes only. If moving patient is necessary, patient MUST wear a SURGICAL MASK

IF YOU HAVE ANY QUESTIONS, PLEASE CALL INFECTION CONTROL IBMC @ 949-3785 ISMC @ 636-7614