INFECTION PREVENTION Infection Prevention is Everyones Responsibility CYCLE
INFECTION PREVENTION Infection Prevention is Everyone’s Responsibility!
CYCLE OF TRANSMISSION
INFECTION CONTROL FACT Everyday, 1 in 20 hospitalized patients has an infection caused by medical care. Healthcare associated infections create an economic burden of as much as $45 billion for citizens and businesses each year. 70% of these infections are preventable
STANDARD PRECAUTIONS Standard precautions are meant to reduce the risk of transmission of bloodborne and other pathogens from both recognized and unrecognized sources. Apply standard precaution to all: � Patients � Contaminated equipment and surfaces Use good judgment to determine when personal protective equipment (ppe) in necessary
HAND HYGIENE
HAND HYGIENE
IT’S ALL ABOUT THE HANDS Skin around fingernails harbors high concentration of bacteria. � Fact: Microbial count is higher underneath the fingernails than anywhere else on your hands Keep your natural nails short (fingertip length) Remove chipped nail polish No cosmetically enhanced nails � This means acrylic or dip nails � Fact: More likely to harbor harmful microorganisms
STANDARD PRECAUTIONS
C. DIFF PROTOCOL A stool for C. diff should be performed on patients with clinically significant diarrhea defined as 3 or more loose stools per day for the past 24 hours. � The goal of testing stool for C. diff within 48 hours of admission is to prove it is NOT a hospital acquired infection (HAI). � Testing is only performed on loose or watery stool (specimens that take the shape of the container). � Patients for whom a C. difficile test is ordered is placed in Enteric Contact Precautions. If the test is negative, precautions may be discontinued.
C. DIFF PROTOCOL CONT. (EXCEPTIONS) The test should not be performed on patients who have had laxatives administered within the previous 24 hours, since this is an alternate explanation for diarrhea, it is preferable to stop the laxative and observe the patient. Approval from the physician is needed to test a patient who is on a laxative but has very profuse diarrhea (>5 episodes in previous 24 hours). Do NOT order multiple tests. When the initial test is positive, the Microbiology department will not accept another stool specimen for C. diff testing for 7 days.
ENVIRONMENTAL CLEANING Keeping the patient environment clean is everyone’s responsibility! Focus is on high-touch surfaces and any surface that is visibly contaminated. Use only hospital approved disinfectants. � Allow to “sit” on surface for correct length of time before using item again
PPE FOR EXPANDED PRECAUTIONS • Expanded Precautions include – Contact Precautions – Droplet Precautions – Airborne Infection Isolation
TUBERCULOSIS If you suspect a patient has TB they are to be placed in a Negative Airflow room � *Door must remain closed to ensure negative pressure ppe = N-95 Respirator for staff entering the room, gown and gloves If a patient is to be transported to other areas a surgical mask shall be worn by the patient during transport. � *Transport is not preferred. Notify the Infection Control nurse and the Community Health Department Tests to anticipate the patient will receive are: � � � TST Sputum Cultures for AFB Chest X-Ray
TUBERCULOSIS TB testing via tuberculin skin test (TST) will be conducted for all employees at MRHC on hire and if suspected contraction of TB Employees will complete an annual TB evaluation via Net Learning. Fit mask testing for direct care employees is completed on hire and if physical changes occur such: � Weight loss, weight gain of 30# � Employee cannot remember mask they wear � Facial hair � Facial surgery
SAFE INJECTION PRACTICES Protect yourself: Use safe sharp devices and report non-safe sharps Never recap a sharp using two hands Dispose of all used sharps immediately in appropriate containers Get your Hep B vaccine Protect your patient: o Clean access diaphragms of medication vials o Never enter a vial with used syringe or needle o One syringe, one needle, one patient o Single-dose vial = one patient, one time o Never leave a needle in a vial
NEEDLE STICK FACTS Serious or fatal infections like HIV, Hepatitis B and C have been acquired from needle sticks HIV Risk of HIV infection from sharps injury is about 0. 3% or 1 in 300 � Hep B Risk of Hep B infection from sharps injury is 6 to 30% depending on hep B antigen status of source individual � Hep C Risk of Hep C infection from sharps injury is approximately 1. 8% �
WHAT TO DO IF YOU HAVE A BLOOD OR BODY FLUID EXPOSURE? Immediately report your injury to your supervisor; do not wait until the end of your shift Do not apply pressure to the wound, allow it to bleed freely Wash the wound with soap and water Obtain a patient sticker of the source patient and place on the Exposure Protocol so that they can be evaluated for an infection Go to the ER to seek a medical assessment, take Exposure Protocol Form with you Follow the directions for any necessary blood tests, vaccinations or medications to prevent infection Document the incident in RL Solutions Follow up with the Infection Control nurse to review source patient and employee laboratory results.
FORM TO BE USED FOR SHARPS/BODY FLUID EXPOSURE
WHAT GOES INTO A SHARPS CONTAINER? Needles (safety or otherwise) Procedure Needles (LP) Prefilled cartridges with needle IV Catheter Stylets Safety Butterfly Medication vial adapters (IV spikes) Ampules Broken Vacutainer tubes & Vials Slides Pipettes Capillary Tubes Bovie Needles Blades Scalpels Suture Needles Lancets
WHAT DOES NOT GO INTO SHARPS CONTAINERS? Oral Syringes (empty) Syringes without needles attached (see appropriate waste policies) Intact glass Gauze Culturettes Stopcocks IV tubing (all) Tape Paper/plastic wrapping Paper Intact vacutainer tubes & vials Specimen cups Gloves
DISPOSING OF MEDICAL WASTE Be mindful of what you’re putting in the “red” trash bins. � Cannot remove once the item is in the bin � MRHC pays by the pound, so every ounce counts Replace sharps containers when ¾ full � Only for syringes and other sharps � No medication vials, used gauze or alcohol wipes
MEDICAL WASTE DOES NOT INCLUDE: Paper Unused medical products or waste Ppe (worn but not soiled) Food products and waste Garbage Empty IV bags, bottles and tubing without needles Empty urine cups Stool Containers Foley bags/tubing Diapers Chux Exam gloves Empty collection bottles and bags Band Aids Disposable Basins Disposable Bedpans Disposable Urinals *All solid waste (regular trash) will be disposed of in regular clear plastic bags in containers located throughout the organization
ADDITIONAL PRECAUTIONS Bag all unused linen Eat and drink only in designated areas Follow appropriate cleaning and disinfecting procedures Use only hospital approved disinfectant Eliminate cardboard in patient care areas
INFECTION PREVENTION AND CONTROL Exposure Control Plan located in Policy Tech Ebola/Highly Infectious Disease in Policy Tech Influenza Vaccination Policy
WHY DO WE VACCINATE FOR THE FLU?
Thank you! http: //www. health. gov/hcq/trainings/partnering-to-heal/index. html
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