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Infection Control Induction Program 2013 Objectives of orientation education • • • • • Hand hygiene Standard & transmission based precautions Staff health/immunisation Waste management Occupational exposure Infection Control Team • Chantal Rayner • Jenny Lukeis • Staff Health Nurse . • A MOMENT is when there is a perceived or actual risk of pathogen (germ) transmission from on surface to another via the hands. 5 Moments for Hand Hygiene Hand hygiene Opportunities • Before starting work each day • After coughing, sneezing, touching your hair or touching your face. • After going to the toilet ( soap & water ) • Before and after glove use • Before and after working with food • After mopping, sweeping, removing garbage or using the telephone • Before and after meal breaks ( Soap & water ) Soap & water: • It is recommended that the AHG is used to decontaminate the hands at all times except 1. 2. 3. 4. When the hands are visibly soiled Before meal breaks After using the toilet When the build up of emollients are obvious Hand Care • Caring for the skin on the hands is important- intact skin is a natural defence against infection • Dry or cracked skin can harbour microorganisms. • Cuts and abrasions are to be covered by a water resistant occlusive dressing • Moisturiser should be used 3-4 times per shift • Moisturiser provided by the hospital only SWH Hand Hygiene Project • Hand Hygiene Project • Commenced in 2006- 10% (mean) • SWH current compliance rate is 68% ( October 2012 ) Target compliance rate 70% Microbial Reservoirs • Microbes can survive in many environments – On or in people, as normal flora – On or in people who have infections – Contaminated food or fluids – Contaminated articles – Contaminated environment Environmental Cleaning • • • • Public area Patient care area Patient care equipment Office spaces TUFFIES & TUFFIE 5’s All purpose general cleaning For everyday use A one step wipe For disinfection when a pt has GASTRO, VRE, MRSA or any multi-resistant bugs TUFFIE 5 DRESS CODE POLICY • Wrist watches and bracelets are not permitted in the clinical area • Rings – wedding ring or one plain flat band only • Chains – one plain unadorned chain only • Earrings – small sleepers or studs only • Facial studs are not permitted • No nail polish or artificial nails permitted • No Lanyards permitted INFECTIONS What is an infection? • An infection occurs when invading microorganisms cause ill health – Viruses – Bacteria – Fungi – Protozoa – Prions Pain, tenderness, swelling, redness, pus & fever STANDARD & TRANSMISSION BASED PRECAUTIONS Prevent Infection Transmission • Standard precautions – Used for ALL patient contacts • Transmission Based Precautions – Used in addition to standard precautions when more stringent precautions are required • Airborne transmission – Tb, chicken pox • Droplet transmission – Influenza, flu • Contact transmission- Gastro, VRE, MRSA Use of Standard Precautions Minimises the risk of cross-infection from: – HCW to patient. – Patient to HCW. – Patient to patient. To be used for all patients regardless of infectious status or perceived risk. Standard Precautions • Cleaning hands at the 5 moments of hand hygiene • The use of protective barriers or PPE • Appropriate handling & disposal of sharps & other infectious waste • Use of correct aseptic technique Transmission Based Precautions • Use for patients known or suspected to be infected or colonised with infectious agents that cannot be contained with standard precautions alone. Transmission Base Precautions •Contact •Droplet •Airborne Contact Precautions Influenza • • • • MRSA VRE Gastro Abscess ( Draininghard to contain) • Conjunctivitis •Influenza •Lice •Norovirus •Rotavirus •Scabies •Chicken pox *contact & & airborne precautions virus Contact precautions Single room if possible, with ensuite Cohort with same infection if necessary Gloves should be worn when entering the room Gown if clothing or forearms will have direct contact with patient or contaminated environment – remove before leaving the room Remove gloves and gown, wash hands before leaving patient room FOOD SERVICES STAFF •Gel hands •Deliver / Collect tray •Gel hands STAFF HEALTH/ IMMUNISATIONS Staff Health • The hospital provides an immunisation program for staff. • Staff Health Clinic • Staff Health Nurse- to be appointed • Each fortnight clinic will run- bookings on 55631433 • Details recorded staff database & medical record Immunisation • The following is a list of immunisations recommended for Health Care Workers. • From “Immunisation Guidelines for H.C.Ws” Department of Human Services-2007 Hepatitis B • • • • For all staff 3 injections (baseline, 1 month & 5 months) Blood test one month post 3rd injection A booster is no longer recommended Diphtheria/Tetanus - ADT • 10 yearly boosters is no longer recommended. • Recommend booster at 50 yrs of age Pertussis ( Whooping Cough) • Single booster dose is recommended for all health care workers, especially those in contact with infants Measles/ Mumps/ Rubella • Recommended 2 doses of MMR • Born after 1966 should have evidence of receiving 2 doses Poliomyelitis • No longer administered orally • Infanrix administered IM Varicella Zoster Virus (Chicken Pox) • Attempt to have documented history of all Health Care Workers • Check Serology • Then vaccinate Mantoux Testing (Tuberculosis) • BCG no longer given as it is only 50 % affective, and TB not prevalent in Aust. • Screening (mantoux test) within 6 weeks of commencement of work ( direct patient contact workers ) Appointments for Staff Immunisation • RING EXTENSION 31433 The Importance of Influenza Immunization for Healthcare Workers Get a Flu Shot Every Year • The flu viruses change frequently • A new flu vaccine is made each year to protect against the new strains of flu viruses • If the viruses change after you’ve had your injection, you won’t get as sick Getting a flu shot every year protects you and those around you The Flu: Now You Know • The flu is a serious contagious illness.1 • The most effective prevention is to get the yearly flu shot.1 • SWH is committed to providing flu vaccinations and making it as easy as possible for you to get vaccinated. Influenza is Very Contagious Influenza is Very Contagious A sneeze transmits flu at 167km/h covering a distance of 5 metres in 1/10th of a second! Individuals are contagious from the day before the onset of symptoms to about 5 days after the first symptoms Influenza and how it affects you None Incubation 24 to 72 hours High Contagion (Cross Infection) Fever>39°C Cough, aches Shivering Headaches Symptoms 3 to 7 days General weakness Possible complication Recovery up to two weeks Respiratory (Cough) Etiquette Single Use Policy • Any items marked by manufacturer as “single use” should be discarded after use • 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 Waste Management Waste Management Aims: • • • • Reduce environmental impact To minimise the generation of waste Reduce disposal costs to the organisation Ensure that OH & S obligations are not compromised Categorisation of Waste • • • • • • • Sharps Clinical/ Infectious Confidential Anatomical Cytotoxic Pharmaceutical Recycling Sustainability Victoria • SWH Environmental Management Committee • Meet Quarterly • Covers waste, water, energy, procurement, fleet management • Working on SWH environmental management plan Linen Management Do not over fill bags (3/4 full) • No sharps into soiled linen • Prevent seepage • Use gloves to handle moist linen OCCUPATIONAL EXPOSURE MANAGEMENT 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 Infection Control Policy Manual • Available on the SWH intranet under prompt ‘Infection Control’ Use it as a resource For example: • Staff Health and Vaccinations • The management of needle stick or other occupational exposure • Management of patients with VRE, MRSA, TB • Environmental cleaning Take Care …………. • …. of yourself and your patients Don’t forget……… send us an e-referral Chantal Rayner & Jenny Lukeis ext 31597 pager 597 #