infection prevention and control induction...

Infection Prevention and Control

Induction Program

GRICG

May 2015

What is an infection?

� An infection occurs when invading microorganisms cause ill health

� Viruses

� Bacteria

� Fungi

� Parasites

� PrionsPain, tenderness,

swelling, redness, pus fever

Microbial Reservoirs

� Microbes can survive in many environments

� On or in people, as normal flora

� On or in people who have infections

� On or in animals as normal flora or infections

� Contaminated food or fluids

� Contaminated articles

� Contaminated environment

Three Elements of Infection Transmission

. Elderly personHealthcare worker

Visitor

PersonObjectFoodWater

HandsEquipment

FoodWater

Methods of Reducing the Spread of Infection

Successful infection prevention and control

involves implementing work practices that prevent transmission of infectious agents through a two-tiered approach:

Standard Precautions

Transmission-Based Precautions

Tier One

Standard Precautions

� Routine infection control measures to be used at all times for all patient care

Standard Precautions

� Hand hygiene

� Respiratory hygiene and cough etiquette

� Personal protective equipment

� Use of aseptic non-touch technique (ANTT)

� Appropriate reprocessing of reusable items/single use

� Appropriate handling and disposal of sharps

� Use of environmental controls

� Appropriate waste management

� Appropriate handling of linen

Tier Two

Transmission Based Precautions

.

Infection Transmission

Contact Transmission

1. Direct contact with another person can transmit their microbes to you – hands, injection or ingestion

2. Indirect contact is when a third person or an article transmits the microbes from one person to another – equipment or environment

Infection Transmission

Airborne transmission occurs when fine spray is coughed into the air (can travel suspended in air more than 1 metre)

Droplet transmission occurs when largerespiratory droplets (which travel less than 1 metre), are coughed onto someone else

Special Disease Event: All 3 modes of

transmission . A special disease event is an infectious disease of high consequence such as a pandemic or large outbreak commencing outside or within Australia involving a virus or bacteria currently not endemic in Australia. Instructions for PPE requirements will be given at the time of this event.

Transmission Based Precautions

� Single room with ensuite

� Cohorting if single room not available and dedicated toilet

� Special ventilation requirements

� Additional use of protective equipment

� Rostering of immune HCWs to care for infectious patients

� Dedicated patient equipment

� Restricted movement of patients and HCWs

Transmission Based Precautions

Transmission Based Precautions

Table Notes

Precaution Signage

.

Standard Precautions

� Hand hygiene

� Respiratory hygiene and cough etiquette

� Personal protective equipment

� Use of aseptic non-touch technique (ANTT)

� Appropriate reprocessing of reusable items/single use

� Appropriate handling and disposal of sharps

� Use of environmental controls

� Appropriate waste management

� Appropriate handling of linen

These are discussed individually on the next slides

Hand Hygiene

� Staff hands are the most common vehicle for infection transmission

� Own resident hand flora

� Transient hand flora – organisms picked up from contact with persons or articles

� Infectious hand conditions – dermatitis, paronychia

Alcohol/

Chlorhexidine

Hand rub

Hand Hygiene Refers To:

� Hand washing using soap/skin cleanser

� Decontamination using alcohol hand rub

� Decontamination using 4% Chlorhexidine

Alcohol Hand Rubs

� Improve hand hygiene compliance

�Kill bacteria on hands more readily

�Cause less skin irritations and dryness

�Decrease patient infection rates when used before and after every patient contact

http://www.hha.org.au/LearningPackage/olp-home.aspx

Online Learning Packages Available

StandardMedical

Nursing/MidwiferyAllied healthNon Clinical

Student Health Practitioners

Respiratory Hygiene and Cough

Etiquette

����If you cough or sneeze cover your mouth with a tissue

����Dispose of soiled tissue in the rubbish bin

����If you do not have a tissue cough or sneeze into the inside of your arm

����Clean your hands afterwards

Personal Protective Equipment

Gloves, Gowns, Masks, Eyewear

Special Disease Event – additional double gloves, knee high shoe covers, face shield and hood

Glove Use

� Used when contact with body fluids is anticipated

� Single use – must be discarded after patient contact

� Must wash hands after removal of gloves

Mask Use

Danger Zone for Absorption

� Eyes

� Nose

� Mouth

� Single use item

� Use when splash with body fluids is anticipated

� N95/P2 for airborne diseases

� Replace when moist

� Dispose of directly into waste bin

PPE for Standard Precautions

The PPE used in standard precautions are used

alone or in combination and include:

� aprons and gowns

� surgical masks

� protective eyewear (goggles or face shields), and

� gloves.

Sequence for putting on PPE

The sequence for putting on PPE is as follows:

1. perform hand hygiene

2. put on gown or apron

3. put on surgical mask

4. apply protective eyewear such as goggles or face shield, and lastly

5. apply gloves.

Sequence for removing PPE

The sequence for removing PPE is as follows:

1. remove gloves

2. perform hand hygiene

3. remove protective eyewear such as goggles or face shield

4. remove gown or apron

5. Perform hand hygiene

6. remove surgical mask, and lastly

7. perform hand hygiene again.

Aseptic Technique

Aseptic Technique Risk Assessment

Aseptic Technique in Practice

Single Use Policy

� Any items marked by manufacturer as single use should be discarded after use

� Single use vials or ampoules must be used wherever these are available

� 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

Safe Handling of Sharps

� Always use safety devices when they are available

� Use appropriate sharps containers

� Discard used sharps immediately

� Do not pass sharps by hand between HCWs

� Avoid recapping needles

� Do not force sharps into container

� Do not over-fill sharps containers

� Segregate correctly

Environmental Cleaning

�Deposits of dust, soil and microbes on surfaces are a potential source of infection

� Neutral detergent used for routine cleaning

� Disinfectants may be required in some situations – gastro, MROs

� All cleaning equipment should be stored dry

� Surfaces should be cleaned regularly and immediately following blood and body fluid spills

INFECTIOUS

WASTE

Blood and Body Substance Spills

� Don personal protective equipment

� Confine and contain the spill

� Treat waste as infectious

� Clean spill site according to hospital policy

� Carpet – clean with neutral detergent and arrange carpet cleaner as soon as possible

� Use a chlorine based disinfectant as directed by your hospital policy

Waste Management

� Waste should be segregated at point of generation

� Place clinical waste in yellow containers or bags bearing biohazard symbol

� Do not over fill bags or containers

� Do not compact by hand

� Follow relevant jurisdiction legislation, guidelines or codes of practice.

Linen Management

• Do not over fill bags (3/4 full)

• No sharps into soiled linen

• Prevent seepage

• Use gloves to handle moist linen

Food Hygiene

� Food safety training required

� Hand washing, glove use

� Regular cleaning of serving and storage areas

� Pest and dust control

� Date and cover prepared food in fridge

� Maintain safe food temperatures

� Hot food - >60oC

� Cold food - <5oC

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

Staff Health

� Good personal hygiene

� Seek prompt diagnosis and treatment of personal illness (away for 48 hours - gastro)

� Staff immunisation

� Hepatitis B

� Influenza

� MMR

� Pertussis

� Varicella zoster

Take Care ………….

…. of yourself and your patients

Questions or Queries?

Infection Control Phone Number:…………………………..