Transcript Document 7242150

Infection Control for the
Safety Monitor
Anne Lawrence
Nov, 2006
Role of the Safety Monitor as a
Team Member
• Objectives
• 1. Understand the concept of quality as it relates
to health care.
• 2. Understand how each department works
together to provide quality care.
• 3. Discuss how attitude is important to the work
environment.
• 4. Discuss the impact of attitude on personal
health, safety and productivity.
Quality Care
• Who’s Job is it?
- any and all health care workers.
• Why?
- it is important to patients and residents.
- important to families and communities.
- we promise as an organization.
- we are the organization / team that provide the
care.
Why is your attitude so important?
Because ….
it affects how you look,
what you says and
what you do…
Attitude
it affects how you feel both
physically and mentally.
And
it largely affects how successful
you are in achieving your purpose in
life.
WHAT COULD BE
MORE IMPORTANT?
What About You?
Is the Glass half
full or half empty?
Attitude
… a POSITIVE Attitude
makes everyday life Better!
… LIFE more meaningful!
… PROBLEMS easier to handle!
… GOALS more attainable!
… MISTAKES less disastrous!
… the FUTURE more exciting!
Attitude
SO…
The Quality of your life depend on YOUR
attitude – towards yourself and others –
which only YOU can change.
Start practicing POSITIVE THINKING
to create a POSITIVE ATTIUDE
RIGHT NOW.
Infection Control and Employee
Health
Infection Control/Employee Health
• Objectives
- Have a basic understanding of the role of
Infection Control/ Staff Health
- Understand the importance of a healthy
lifestyle and good personal hygiene.
- Understand the importance of reporting
occupational injuries.
Infection Control
• What does this mean?
Any Ideas?
Infection Control
Preventing illnesses acquired at a
health care facility.
Hospital acquired infections are known
as nosocomial
infections.
examples: urinary tract infections, surgical infections,
respiratory infections, foodbourne illness, hepatitis and
AIDS.
Why is Infection Control Important
It is vital to the patient’s well being, and
yours, too.
Infections can lengthen the hospital stay,
cause inconvenience, loss of income, pain
and even death.
Who Is Responsible?
Who do you think?
- the Infection Control department?
- doctors?
- nurses?
- administration?
- anyone else?
Infection Control
• Involves consultation & teaching staff re
isolation and care of infected patients.
• Involves monitoring of patients and staff
for infectious or contagious diseases.
Infections may be transmitted “ from
employee to patient” or “ from
patient to employee”
Focus of IC
• Education
teachings re disease process
and prevention.
policy development.
• Surveillance
data collection.
• Control measures
cleanliness of
environment.
waste management
proper use & cleaning of
equipment.
Staff Health
• Starts with being healthy.
• Prevention of disease in staff
On orientation – health assessment
- immunization record
- blood work for immune
status
(measles, rubella,
varicella)
- Health Record
Immunization
•
•
•
•
•
•
Tetanus/Diptheria
Hepatitis
Rubella vaccine if not immune
Varicella vaccine if not immune
Influenza vaccine
PPD (Tuberculine Testing)
Job Related Illnesses
• Infectious Contacts
Exposure to:
Tuberculosis – skin testing/
CXR/ 3 month follow up.
Chicken Pox – varicella
titre – if non reactive off
work from day 10-21 post
exposure.
Job Related Illnesses
• Exposure to Blood and/or Body Fluids
* Hepatitis B * Hepatitis C * HIV
-
6% - 30%
0.5% - 10%
0.1% - 0.3%
Work Restrictions
• Diarrhea – individual assessment
- may be excluded from pt care
- food service workers – no food
handling until symptoms
resolve.
Influenza – during communicable period,
employees may be excluded
from direct patient care.
Work Restrictions
• Herpes Simplex – individual assessment.
May be excluded from
direct patient care.
Conjunctivitis – draining sore eyes.
Employee maybe excluded from direct pt
care.
Sore hands – individual assessment.
Health Record
• Confidential
• All information collected in
one file
• Updated
• Copies available
Staff Health and Safety
NO SCENTS IS GOOD SENSE
Please do not wear perfumes or any
scented
products to work. Scented products contain
chemicals which can cause serious
problems
for many people with lung disease &
allergies.
Employee Health
• No clinic available
• report to ext. 5297 if you
are at work and sick.
• If you have vomiting
and/or diarrhea.
• If you have open sores.
• If you have possibly been
in contact with a
communicable disease.
Reporting Incidents
• All accidents, injuries or
near misses should be
reported ASAP.
• Complete the form.
• Notify your manager.
• Notify staff health if there
has been an exposure to
blood or body fluids.
The Chain of Infection
Objectives
• Describe the chain of infection.
• Have a basic knowledge of microbiology.
• Explain the factors that allow
microorganisms to grow and how to
eliminate or control these factors.
The Chain of Infection
Definitions
• Infection – process by which a susceptible
host (person) is invaded by a pathogenic
(or infectious) agent that grows and
causes harm.
• Types – localized, primary, secondary,
mixed, cross droplet, airbourne, &
generalized.
• Others – waterbourne, foodbourne,
terminal and septic.
Definitions con’t
• Antibodies – a protein
that is produced in the
body in response to
invasion by a foreign
agent (antigen) and that
reacts specifically with it.
• Inflammation – tissue
response to injury or
destruction of the cells.
(Injury or infection)
Definitions con’t
• Bacteria – can be harmful or helpful.
- Comes in a variety of shapes.
- Reproduce every 20 minutes.
Virus - smaller than bacteria.
- parasitic in nature.
- can remain inactive for long periods of
time
Fungi – vegetable organism (classed with
mushrooms and mold)
What allows microorganisms to
grow and cause infections?
• The microorganism must enter the body.
• There must be sufficient numbers to cause
a disease.
• Must be capable of destroying healthy
tissue.
• The host must not have immunity to the
disease.
• The route of transmission is appropriate.
Chain of Infection
Infectious Agent
Susceptible Host
Reservoir
Portal of Entry
Portal of Exit
Mode of Transmission
Standard Precautions &
Transmission Based Precautions
Objectives
• Understand the importance of isolation
precautions in the health care setting.
• Understand the importance of wearing
PPE.
• Understand how to properly don and
remove PPE.
Hospital-based Infections
• Each year nearly 200,000
patients in Canada get an
infection while hospitalized.
• Of these patients, about 8,000
will die as a result of their
infection!
• Estimated cost - $1 billion a
year.
Community and Hospital Infection
Control Association of Canada
Transmission of infection within a hospital
requires three elements:
• Source
• Host
• Transmission
Source
• Patients
• Personnel
• Visitors
• Incubation period of a disease
• Colonized by an infectious agent
• Chronic carriers of an infectious agent
Other sources
• Patient’s own endogenous flora
• Inanimate environmental objects (ie.,
equipment and medications)
Host
• Resistance to pathogenic microorganisms
>
>
>
>
age
underlying diseases
certain treatments
breaks in first line of defense
Standard Precautions
Prevents the spread of microorganisms.
Applies to ALL patients.
Transmission based precautions are
added if needed.
Reduces the spread of infection within the
hospital setting.
Applies to:
Blood
All body fluids except perspiration
Non-intact skin
Mucous membranes
If it is wet and sticky and not yours…
DO NOT touch it without gloves!
Do it right every time!
You won’t have to
question yourself
when a patient is
diagnosed as
infectious!
Transmission Based
Precautions
Designed for patients infected with highly
transmissible diseases or pathogens.
Additional precautions beyond Standard
Precautions are needed to interrupt
transmission in hospitals.
Used either singularly or in combination,
but always with Standard Precautions.
Transmission
• Five main routes of transmission
> Contact
> Droplet
> Airborne
• > Common vehicle
• > Vectorborne
• These routes do not usually play a
significant role in typical nosocomial
infection.
Mode of Transmission
In medical care facilities, hands are the
major instrument for the transmission of
most bacteria.
Hand-washing
In health care, nurses
and doctors wash only
30% of the required
time between patient
contacts and
procedures!
Trivia Time!!!
• How may people
stop to wash their
hands after using
the washroom?
More Trivia!!!
• How many diseases
can be spread by not
washing your hands?
Prevention of Infection
• Hand washing
Use plain soap and water.
Alcohol hand wash is 99.9% effective
(wash with soap and water if hands are
visibly soiled).
Handwashing
Happy Birthday
Contact Transmission
Involves skin-to-skin contact and physical
transfer of microorganisms to a
susceptible host from an infected or
colonized person.
Indirect contact transmission involves
contact with a contaminated object i.e., a
side-rail or light switch in the patient’s
environment.
Examples of diseases:
Gastrointestinal infections (Norwalk Virus)
Scabies
Clostridium difficile
Multi-resistant organisms (MRSA/VRE)
Important points:
Bring only the supplies you need into the
room.
Always wear a gown and gloves.
Remove personal protective equipment
immediately when finished.
Wash hands.
Just because you can’t see it,
doesn’t mean that it isn’t there!
Droplet Transmission
Involves contact of the eyes or mucous
membranes of the nose and mouth of a
susceptible person from a person who has
the disease or who is a carrier.
Droplets are generated primarily during
coughing or sneezing.
Requires close contact since droplets
travel only short distances, 3 feet or less.
Examples of diseases:
Meningitis
Influenza
Meningococcal Disease
•
•
•
•
•
Caused by a bacteria
Spread by close contact
Droplet Precautions
Chemoprophylaxis
Treatment
Important Points:
The door can be open.
Always wear a mask (when working within
3 feet of the patient), gown, and gloves.
Remove personal protective equipment
immediately when finished.
Wash hands.
Airborne Transmission
Occurs by spread of airborne droplets or
dust particles containing the infectious
agent.
Organisms can be widely spread and may
become inhaled by or deposited on a
susceptible host in the same room.
Examples of diseases:
Tuberculosis
Varicella (Chicken
Pox)
SARS
Did I Mention Handwashing???
Hand washing
• Good hand hygiene
is still the easiest,
cheapest, and best
way to protect
everyone’s health!
Questions?
Guidance for the
Selection and Use of
Personal Protective
Equipment (PPE) in
Healthcare Settings
PPE Use in Healthcare Settings:
Program Goal
Improve personnel safety in the
healthcare environment through
appropriate use of PPE.
PPE Use in Healthcare Settings
Personal Protective Equipment
Definition
“specialized clothing or equipment worn
by an employee for protection against
infectious materials” (OSHA)
PPE Use in Healthcare Settings
Types of PPE Used in
Healthcare Settings
• Gloves – protect hands
• Gowns/aprons – protect skin and/or clothing
• Masks and respirators– protect mouth/nose
– Respirators – protect respiratory tract from
airborne infectious agents
• Goggles – protect eyes
• Face shields – protect face, mouth, nose, and
eyes
PPE Use in Healthcare Settings
Factors Influencing PPE Selection
• Type of exposure anticipated
– Splash/spray versus touch
– Category of isolation precautions
• Durability and appropriateness for the
task
• Fit
PPE Use in Healthcare Settings
Gloves
• Purpose – patient care, environmental
services, other
• Glove material – vinyl, latex, nitrile,
other
• Sterile or nonsterile
• One or two pair
• Single use or reusable
PPE Use in Healthcare Settings
Gloves
• Purpose – patient care, environmental
services, other
• Glove material – vinyl, latex, nitrile,
other
• Sterile or non-sterile
• One or two pair
• Single use or reusable
PPE Use in Healthcare Settings
Do’s and Don’ts of Glove Use
• Work from “clean to dirty”
• Limit opportunities for “touch
contamination” - protect yourself,
others, and the environment
– Don’t touch your face or adjust PPE with
contaminated gloves
– Don’t touch environmental surfaces except
as necessary during patient care
PPE Use in Healthcare Settings
Do’s and Don’ts of Glove Use
(cont’d)
• Change gloves
– During use if torn and when heavily soiled
(even during use on the same patient)
– After use on each patient
• Discard in appropriate receptacle
– Never wash or reuse disposable gloves
PPE Use in Healthcare Settings
Gowns or Aprons
• Purpose of use
• Material –
– Natural or man-made
– Reusable or disposable
– Resistance to fluid penetration
• Clean or sterile
PPE Use in Healthcare Settings
Face Protection
• Masks – protect nose and mouth
– Should fully cover nose and mouth and
prevent fluid penetration
• Goggles – protect eyes
– Should fit snuggly over and around eyes
– Personal glasses not a substitute for
goggles
– Antifog feature improves clarity
PPE Use in Healthcare Settings
Face Protection
• Face shields – protect face, nose, mouth,
and eyes
– Should cover forehead, extend below chin
and wrap around side of face
PPE Use in Healthcare Settings
PPE Use in Healthcare
Settings:
How to Safely Don, Use,
and Remove PPE
Key Points About PPE
• Don before contact with the patient,
generally before entering the room
• Use carefully – don’t spread
contamination
• Remove and discard carefully, either at
the doorway or immediately outside
patient room; remove respirator outside
room
• Immediately perform hand hygiene
PPE Use in Healthcare Settings
Sequence* for Donning PPE
• Gown first
• Mask or respirator
• Goggles or face shield
• Gloves
*Combination of PPE will affect sequence – be practica
PPE Use in Healthcare Settings
How to Don a Gown
• Select appropriate type and size
• Opening is in the back
• Secure at neck and waist
• If gown is too small, use two gowns
– Gown #1 ties in front
– Gown #2 ties in back
PPE Use in Healthcare Settings
How to Don a Mask
• Place over nose, mouth and chin
• Fit flexible nose piece over nose bridge
• Secure on head with ties or elastic
• Adjust to fit
PPE Use in Healthcare Settings
How to Don a Particulate
Respirator
•
•
•
•
•
•
Select a fit tested respirator
Place over nose, mouth and chin
Fit flexible nose piece over nose bridge
Secure on head with elastic
Adjust to fit
Perform a fit check –
Inhale – respirator should collapse
Exhale –check for leakage around face
PPE Use in Healthcare Settings
How to Don Eye and Face
Protection
• Position goggles over
eyes and secure to the
head using the ear pieces
or headband
• Position face shield over
face and secure on brow
with headband
• Adjust to fit comfortably
PPE Use in Healthcare Settings
How to Don Gloves
• Don gloves last
• Select correct type and size
• Insert hands into gloves
• Extend gloves over isolation gown cuffs
PPE Use in Healthcare Settings
How to Safely Use PPE
• Keep gloved hands away from face
• Avoid touching or adjusting other PPE
• Remove gloves if they become torn;
perform hand hygiene before donning
new gloves
• Limit surfaces and items touched
PPE Use in Healthcare Settings
PPE Use in Healthcare
Settings:
How to Safely Remove
PPE
“Contaminated” and “Clean”
Areas of PPE
• Contaminated – outside front
• Areas of PPE that have or are likely to have
been in contact with body sites, materials, or
environmental surfaces where the infectious
organism may reside
• Clean – inside, outside back, ties on
head and back
• Areas of PPE that are not likely to have been in
contact with the infectious organism
PPE Use in Healthcare Settings
Sequence for Removing PPE
• Gloves
• Face shield or goggles
• Gown
• Mask or respirator
PPE Use in Healthcare Settings
Where to Remove PPE
• At doorway, before leaving patient room
or in anteroom*
• Remove respirator outside room, after
door has been closed*
* Ensure that hand hygiene facilities are available at
the point needed, e.g., sink or alcohol-based hand
rub
PPE Use in Healthcare Settings
How to Remove Gloves (1)
• Grasp outside edge near
wrist
• Peel away from hand,
turning glove inside-out
• Hold in opposite gloved
hand
PPE Use in Healthcare Settings
How to Remove Gloves (2)
• Slide ungloved finger
under the wrist of the
remaining glove
• Peel off from inside,
creating a bag for
both gloves
• Discard
PPE Use in Healthcare Settings
Remove Goggles or Face
Shield
• Grasp ear or head
pieces with ungloved
hands
• Lift away from face
• Place in designated
receptacle for
reprocessing or
disposal
PPE Use in Healthcare Settings
Removing Isolation Gown
• Unfasten ties
• Peel gown away from
neck and shoulder
• Turn contaminated
outside toward the
inside
• Fold or roll into a
bundle
PPE Use in Healthcare Settings
• Discard
Removing a Mask
• Untie the bottom, then
top, tie
• Remove from face
• Discard
PPE Use in Healthcare Settings
Removing a Particulate
Respirator
• Lift the bottom
elastic over your
head first
• Then lift off the top
elastic
• Discard
PPE Use in Healthcare Settings
Hand Hygiene
• Perform hand hygiene immediately after
removing PPE.
– If hands become visibly contaminated during PPE
removal, wash hands before continuing to remove
PPE
• Wash hands with soap and water or use
an alcohol-based hand rub
* Ensure that hand hygiene facilities are available at
the point needed, e.g., sink or alcohol-based hand
rub
PPE Use in Healthcare Settings
Hand Hygiene
• Perform hand hygiene immediately after
removing PPE.
– If hands become visibly contaminated during PPE
removal, wash hands before continuing to remove
PPE
• Wash hands with soap and water or use
an alcohol-based hand rub
* Ensure that hand hygiene facilities are available at
the point needed, e.g., sink or alcohol-based hand
rub
PPE Use in Healthcare Settings
Occupational Exposure
• We will talk about
What is an
exposure?
What to do if an
exposure occurs.
Occupational Exposure
• We will discuss
HIV/AIDS
Hepatitis B & C
What they are.
How they are spread.