Infection Control 101
Infection Control Nosocomial vs. HAIs Standard Precautions/Body Substance Isolation (BSI) Protective environment to prevent HAIs PPE (latex precautions) Biohazard Waste Transmission-based Isolation Precautions
Nosocomial vs. Healthcare Associated Infections (HAIs) Nosocomial - Infections acquired 72 hours after admission to a hospital HAIs infections associated with healthcare delivery in any setting
Standard precautions/bsi Infection control process that apply to all patients, regardless of suspected or confirmed infection status Based on the principle that all blood, body fluids, secretions, excretions excluding sweat, non-intact skin and mucous membranes may contain transmissible infectious agents
Standard precautions Hand hygiene PPE depending on the anticipated exposures Proper cleaning, disinfection or sterilization of equipment 4 Additional Areas of Practice
Handwashing Single most important tool against spread of infection Soap and water Alcohol-based hand gels Limmer, First Responder: A Skills Approach, 7 th ed. 2007 by Pearson Education, Inc. Upper Saddle River, NJ
PPE Personal Protective Equipment Eye protection Gloves (clean vs. sterile) Gown Masks Hairnets, booties, and surgical caps
Sterile Technique 1. Pouring liquid in a sterile container, do not touch the rim 2. Put on sterile gloves 3. Do not cough, sneeze, or talk over sterile field 4. Never leave a sterile field unsupervised
Donning Sterile Gloves 1. Obtain pair of sterile gloves in your hand size. 2. Inspect glove package for signs of contamination 3. Remove jewelry and scrub hands. 4. Dry your hands. 5. Peel open the sterile package. 6. Grab the inner part of the glove and slide in hand
Donning Sterile Gloves 7. Pull glove to wrist 8. With sterile glove hand, grab the under part of the cuff and slide hand into glove. 9. Pull glove to wrist. (Do not touch inside of glove)
Donning Sterile Gloves 10. Flip cuff and pull over gown. 11. Slide completed sterile glove hand under the cuff of the other hand and flip cuff and pull over gown. 12. Interlock hands to prevent touching an unsterile area.
Removing Gloves 1. Pinch at the wrist area of the glove and pull glove off. 2. Use inside of the discarded glove to pinch the other glove or Slide hand under the glove and pull glove off
Removing Sterile Gloves 4. Make sure you do not touch the contaiminated part of the glove. 5. Discard glove in proper bag. 6. Wash hands.
Cleaning equipment Limmer, First Responder: A Skills Approach, 7 th ed. 2007 by Pearson Education, Inc. Upper Saddle River, NJ Washing with soap and water Disinfection For items that come in contact with intact skin Clean using alcohol or bleach Sterilization For items that contact body fluids or mucous membranes Clean with chemicals or superheated steam
Procedure for cleaning equipment Discard disposable equipment in biohazard container Clean reusable equipment Disinfect or sterilize equipment based on patient contact Limmer, First Responder: A Skills Approach, 7 th ed. 2007 by Pearson Education, Inc. Upper Saddle River, NJ
Biohazard Waste Defined Any solid or liquid waste which may present a threat of infection to humans. It may include specimen containers, blood soaked bandages or dressings, and bloody gloves. Materials and substances found in laboratory and hospital waste which may contain disease-causing agents, such as tissue specimens, cultures, culture dishes and slides, body fluids, blood or blood products, sharps, and needles.
Red Bag Waste Disposal Absorbant materials saturated with blood or bloody fluids, such as bandages, gauzes, sponges, lap sponges; Non-absorbant disposable devices contaminated with blood or blood-contaminated body fluids, such as filled suction container liners, transfusion bags, IV tubing, drainage tubes; Blood, blood products, excretions, secretions, tissue and body parts contaminated with blood.
Sharps Container Waste Sharps Needles Scalpels Blades Glass or plastic slides Culture tubes, dishes Disposable Razors, Disposable Scissors, Broken glass ampules
Red Bag and Sharps Containers Sharps containers must be leak-proof, rigid, puncture-resistant, and not easily opened once sealed. They must be labeled BIOHAZARD with International Symbol. Must also be labeled with Facility address and phone number. (When Container 3/4 full, place DATE on container and replace). The Red Infectious Waste Bag must be plastic, impervious to moisture, strong enough to resist ripping, tearing or bursting. Bags must be securely tied when placed in storage. Must be labeled BIOHAZARD with International Symbol. Must also be labeled with Facility address and phone number.
Point of Origin The healthcare professional generating the waste is responsible for its safe and proper disposal, and segregation at point of origin Biohazard waste mixed with chemical waste must be handled and disposed of as hazardous waste; waste contaminated by chemotherapy waste, must be handled and disposed of as chemotherapy waste. Waste contaminated with radioactive material must be handled and disposed of as radioactive waste. Biohazard Waste storage closets shall be visibly marked and inaccessible to the public.
Protect Yourself... When handling, transporting and disposing of Biohazard Red Bag or Sharps Containers Waste: Keep bags AWAY from your body when carrying Wear latex, vinyl or rubber gloves UNDER heavy duty reusable work gloves Practice good hand hygiene: Wash with soap and water and/or use Alcare regularly and before break, eating, smoking, drinking, going home. Wear a face shield or goggles when tossing bags into biohazard bin and outdoor dumpster Cover bin in transit Wear a disposable apron if chance of contamination of clothing Report any stick or splash to Employee Health Nurse ASAP Ask about getting a Hepatitis B Vaccine
Standard precautions/bsi Four added areas of practice: Respiratory Hygiene/Cough Etiquette Safe Injection Practices (re-emphasized) Use of masks for insertion of catheters or injections into the spinal or epidural spaces Use of a set of prevention measures termed Protective Environment, to prevent HAIs (e.g., measures to decrease fungi in the environment; spatial distance >3 ft)
Transmission-based ISOLATION Contact Droplet Airborne Protective
CONTACT PRECAUTIONS Gloves and gowns are required for ALL direct and indirect contact Strict Handwashing technique Handwashing + Alcohol Hand Rinse Additional PPE as indicated Visitors MUST wash hands BEFORE leaving.
DROPLET PRECAUTIONS Private room door closed Regular masks when within 3 feet of patient Contact with infective material will need: Gloves Gowns
DROPLET PRECAUTIONS HANDWASHING After touching Patient After touching Potentially contaminated items Before taking care of another patient Contaminated items Discard Bag and Label before being sent for decontamination and reprocessing
AIRBORNE PRECAUTIONS Private room Negative Pressure Required (AIIR = Airborne Infection Isolation Room) HEPA Masks required at ALL times Contact with infective items/material require Gowns Gloves Handwashing After touching patient After handling potentially contaminated items Before caring for another patient
AIRBORNE PRECAUTIONS Pts. wear mask when leaving the room Contaminated Items Discard Bag and Label before decontamination/reprocessing
Protective Isolation Used with immune compromised/susceptible patients Private room full PPE Pts. wear mask when leaving the room
Preventing Disease Transmission Reporting exposures Any exposure to blood or body fluids Ryan White CARE Act Limmer, First Responder: A Skills Approach, 7 th ed. 2007 by Pearson Education, Inc. Upper Saddle River, NJ Notification of patient disease status Designated officer Allows sharing of information in a patient s medical record
Let s Practice