basic ic nsg students 9-4-13(1)

8/19/2019 Basic IC Nsg Students 9-4-13(1)

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ASIC INFECTION

CONTROL

2013

September 4, 2013

Healthcare Epidemiology Department

Infection Control is in yor Hands!


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Susan V. Donelan, "!D!, "edical Director

Francina Singh, #$, %Sc$, "&H, CIC, Director

Terrie Gardiner, %S, 'dministrati(e 'ssistant

)Department *elephone $mber+

444-7430

) Department a- $mber+ 444-8875

Infecion !onrol "raciioners# ./ith phone e-tension beeper

ran Ed/ards, #$,"S$, CIC 420 5 3613437

%ob 8arcia, %S, "*.'SC&, CIC, 462045 361239

%arbara :ran;,


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rea#i"g the Chai" o$

I"$ectio"




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I"$ectio%& Age"t




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Re&er'oir&




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(ortal o$ E)it




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*ea"& o$ Tra"&mi&&io"




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(ortal o$ E"tr




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S%&cepti+le Ho&t




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) Inade>ate edcation of personnel

) ailre to recogni;e a potentially infected patient or

ssceptible host

) 'bsent 5 inappropriate barriers

) $ac% of ade&uae hand 'ashing

) ?nrestricted infected healthcare /or@ers . HC=

) Inade>ate disinfection 5 sterili;ation of instrments 5e>ipment

(ri"cipal Ri Factor& $or

Tra"&mi&&io"




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) "inimi;e de(elopment of infections in patients and HC=s

) &re(ent cross A transmission +

&atient &atient

&atient HC=

,oal& o$ I"$ectio" Co"trol




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Tra"&mi&&io" + Co"tact Ro%te

– Direct #otes) Hands ofhealthcare/or@ers

– Indirect #otes ) In(asi(eandnonin(asi(ee>ipment

– Droplet #ote) "eningitis) Inflen;a) # S B




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Hands of Healthcare/or@ers

)#espiratory inf-)Entero(iral inf-

A Co-sac@ie, echo, polio

)Hepatitis ', E

)Diarrheal diseases

A (iral, parasitic, bacterial

)#esponse

A a(oid pt pt contact

A se barriers, /ash hands

!irect Tra"&mi&&io"




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In(asi(e non in(asi(e e>ipment)Hands of HC=s spread organisms

)rganisms can also be carried on inanimate obects

)Contamination can occr after only brief contact

I"direct - Fomite

Tra"&mi&&io"




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) alls to floor /ithin 13 feet

) "ost respiratory (irses

A #SB 5 inflen;a A most childhood e-anthemas

A strep pharyngeal infections

) #esponse

A single room A mas@ /ithin 3 feet

e.g: Meningitis, Infuenza, RSV

Aero&ol .!roplet/ Tra"&mi&&io"




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• Droplet nuclei remain suspended

in air

– TB, measles, VV

• Response:

– negati!e pressure room– surgical mas" on pt. #or tra!el

– seropositi!e $%&

– respirator on $%& '(en

indicated

)g: *ulmonar+ TB, Varicellac(ic"en po-, disseminated

oster, Measles Ru/eola

Negative pressure roomrequired

Air+or"e Tra"&mi&&io"




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Tra"&mi&&io" + ehicle Ro%t

e

)Salmonella

)Hepatitis '

)Hepatitis %

)Hepatitis C

)HIB




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0ector Bor"eTra"&mi&&io"

)


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!e$i"itio"&

Infection+

Is the state in /hich the body isin(aded by an infectios agent/hich nder fa(orable conditions,mltiplies and prodces inrioseffects!

Coloni;ation+

Is the presence of a microorganismin5or on a host /ith gro/th and

mltiplication of the microorganism, /ithot any o(ertclinical e-pression at the time it isisolated, which can be

transferred to others.




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Combination of:) ?ni(ersal &recations and Disease Specific &recations

) ?ni(ersal precations. to be sed in the care of all patients– History rational– &ersonal protection cabinets

) &rotecti(e barrier materials A

8o/ns, glo(es, srgical mas@s, face shields 5 goggles– Safety de(ices– Disposal of sharps

S&tem o$ I&olatio" at S H




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Disease S(ecific Isolaion#

) Isolation codes) Isolation cards carts

) ello/ cards, chart binders stethoscopes

) "# cards

S&tem o$ I&olatio" at S H




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I&olatio" Card .$ro"t/




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) D $* =#I*E '$ #ES?


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F "easles, Baricella .Chic@en &o- F "#S' 5 B#E! F Combination of mltiply resistant organisms not coded else/hereD F "eningitis, "mps, Inflen;a, #bella, &ertssis F Clostridim difficile, Salmonella, Shigella, Campylobacter, E!coli, #ota(irs

/ F ther %lood %orn &athogensI F BIS'5B#S'Bancomycinintermediate5resistant Staphylococcs ares$ F


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F $egati(e &ressre #oom, Immne Healthcare =or@er .HC= F Single #oom, 8o/n58lo(es *o Enter #oom! F Single #oom, 8o/n58lo(es *o Enter #oom, Srgical "as@ =ithin 3 eetD F Single #oom, Srgical "as@ =ithin 3 eet, Immne HC= If 'pplicable F Single or doble #oom, Shared bathroom .se toilet seat co(er as barrier

/ F Standard &recationsI 12TIF6 /$T/! "IDI2$2G6 )/D+ IDIT$6 .See Help$ F Sr(eillance C5S on 'dmission to #5 "#S', Standard #oom &lacement&ending C5S 1 V F Single #oom, 8o/n58lo(es *o Enter #oom2 F Doble #oom, Standard &recations Contact HED .See Help

" F Single #oom, Srgical "as@ =ithin 3 eet F Single #oom, 8lo(es *o Enter #oom, 8o/n58lo(es5ace Shield or 'll&atient ContactT F $egati(e &ressre #oom, it*ested #espirator *o Enter #oom F $egati(e &ressre #oom If Disseminated Goster, Immne HC= .See Help

E)pla"atio" o$ (roced%re&




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Integrating &atient Safety

8oal

Natio"al (atie"t Sa$et ,oal




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educe he ris% of healh care - ac&uired infecions

)/I+

#e>irements+

1!Comply /ith crrent =H or CDC hand hygienegidelines to redce the transmission by staff to patients ofinfectios agents, thereby decreasing the incidence of H'I!

2!"anage as sentinel e(ents all identified cases ofnanticipated death or maor permanent loss of fnctionrelated to a H'I!


4




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educe he ris% of healh care - ac&uired infecions )/I+

#e>irements .contined+

3! Implement e(idencebased practices to pre(ent H'I de

to mltidrgresistant organisms in acte care hospitals!

4! Implement best practices or e(idencebased gidelines topre(ent centralline associated bloodstream infections!

7! Implement best practices for pre(enting srgical siteinfections!

! Implement best practices for pre(enting catheterassociated rinary tract infections!


4




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) 2 million nosocomial infections 5 year in ?S'

) 90,000 deaths associated /ith nosocomial infections

) 0 of the bacterial infections are cased by bacteriaresistant to 1 drg commonly sed to treat

) Some bacteria are resistant to all appro(ed drgs

) Some re>ire treatment /ith e-perimental to-ic drgs

) J 122 million cost associated /ith treating antimicrobialresistance among single pathogen

Fact& o" No&ocomial

I"$ectio"&




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) 1980 Staphylococcus aureus methicillin penicillinpreparations

) 1980 K pneumoniae 3rd generation cephalosporins,cefta;idime

) 1990 Enterococcus to (ancomycin

) 1992 Mycobacterium tuberculosis to mltiple drgs

Emerge"ce o$ Re&i&ta"ce




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) "ethicillin resistant staphylococcus aureus S ) +

) Bancomycin resistant enterococcus V ) V +

) &enicillin resistant streptococcus "S" ) " +

) #esistant gram negati(e rods G1 ) 1 +) Bancomycin resistant staphylococcus aureus VS ) I +

) Bancomycin intermediate ssceptiblestaphylococcus aureus VIS GIS ) I +

) 'll S$ prodcing organisms . e-tended spectrm beta lactamase

*%ltipl5re&i&ta"t Orga"i&m&

S H




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) 'ntimicrobial sage fre>ent, intermittent,infre>ent prolonged

) Srgical procedre

) In(asi(e de(ices

) E-foliati(e dermatitis

) &rocedres bypassing natral defenses

(atie"t Ri Factor&




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S%r'i'al Time $or

(athoge"&

aceria#

"#S' 160 days

B#E 30 days

C! difficile ears .spore forming

Viruses# Inflen;a '

%

16 hors

#SB hors

#ota(irs 10 days

Hepatitis % 30 days .dried blood




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– Hands of HC=s spreadorganisms

– rganisms can also becarried on inanimateobects

– Contamination can occr

after only a brief contact

Ha"d Hgie"e




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) #nning /ater

) 'de>ate amont of soap to create

lather ) riction and thoroghness

) *ime spent F 10 A 17 seconds

) =hen K %efore and after e(ery patient contact

(ri"ciple& o$ Ha"d6a&hi"g




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"ay be sed as a sbstitte+

) =hen hands are not (isibly soiled) Hands mst be /ashed /ith soap and /ater after

7 applications of gel 5 foam!

)D $* se /hen patient is on isolation forclostridium difficile diarrhea .not reliably effecti(ein destroying spores

Ha"d Hgie"esing lcohol-*ased /and gelfoa9




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) 'pply 1!7 A 3!0 ml of gel5foam to the palm of one

hand and rb hands together!) Co(er all srfaces of hands and fingers inclding

areas in bet/een fingers, arond and nderfingernails!

) Contine rbbing hands together ntil alcoholdries!

Ha"d Hgie"e (roce&&sing lcohol-*ased /and gelfoa9




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The&e are ANNE! i" all direct

a"d i"direct healthcare 6or#er&7

8per the C!C9




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And this is why…."d thi& i&

6h:;




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Occ%patio"al Sa$et a"d Health

Admi"i&tratio"

OSHA Bloodborne Pathogen




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*he ccpational Safety and Health

'dministration .SH' has issed astandard to pre(ent the transmission of%loodborne &athogen that is designed toprotect yo! It /as finali;ed on December ,

1991, 'mended ctober 2002.

OSHA STAN!AR!




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It details /ays employees and employer can/or@ together to redce yor ris@ of

contracting a bloodborne pathogen on the ob! 'll employees are co(ered by the standard if it is

reasonably anticipated they cold be e-posedto bloodborne pathogen as a reslt of obdties!

OSHA Sta"dard .co"t;/




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SH' re>ires all employers ha(e a(ailable toemployees an ccpational E-posre Controlplan!

*he e-posre control plan also contains a copy ofthe #eglatory *e-t of the standard and obcategori;ation!

'll training records mst be held for three years!

OSHA Sta"dard .cont!




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) Available to all employees 24x7

o

!he9isr: $a*o D1;s office

SB1H E)po&%re Co"trol (la"




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'll employees /ith a potential ris@ of e-posre tobloodborne pathogens be trained in pre(enti(e

measres+) 't initial hire

) 'nnally

Trai"i"g Re


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) !lean affected area immediately!

) 1oif: yor sper(isor immediately!

) !o9(lee an Incident5'ccident form .to be signed bysper(isory!

) I99ediael: report to Employee Health Ser(ice!"onri 6 a!m!4 p!m! .4

) ll oher i9es, re(or o he 9ergenc: oo9 )4-


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http://uhmc-iweb1.uhmc.sunysb.edu/familyviolence/http://uhmc-iweb1.uhmc.sunysb.edu/PSF/http://uhmc-iweb1.uhmc.sunysb.edu/intranet/pubs/hand_wash_psf.pdfhttp://uhmc-iweb1.uhmc.sunysb.edu/ptsafety/printableVer.asp?id=1800http://sbumconline.uhmc.sunysb.edu/training/lms/


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)" guidelines

Slidesho/ for %&& gidelines

$eedlestic@ E-posed ) Inry5Illness #eporting orm .for Hospital Employees) Inry5Illness #eporting orm .for # Employees) Sharps Inry


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1! 'll nonHIB testing conseling and prophyla-is /ill beadministered by the Department ha(ing first contact /ith

employee!2! *he Employee Health =ellness .EH= 5 Emergency

Department .ED /ill determine if HIB e-posre mayha(e occrred or cannot be e-clded!

3! Shold HIB conseling and poste-posre prophyla-is.&E& be re>ired or desired by the employee, it /ill beadministered as per CDC recommendations

S H E)po&%re Co"trol (la"

?e: "oins




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4! a *he blood5body flid form mst be completed at initial(isit!

If first contact is /ith the ED, then the completedform mst be for/arded to the EH=!

b *he employees /ill be referred to EH= for HIBconseling and testing on the ne-t /ee@day!

>e (oi"t& .co"t;/




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basic ic nsg students 9-4-13(1)

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