Infection Control

Chapter 11 Intro to HST

•  All health care workers must understand basic infection control

•  Key terms –  Pathogen: germ –  Microorganism: small, living organism that is not

visible to the naked eye •  Found everywhere in the environment

–  Non-pathogen: normal part of the body that helps maintain normal body processes

Work place Precautions

•  One of the main ways pathogens spread à blood and body fluids – HBV, HCV, HIV (AIDS)

•  Practice extreme caution when area, object, or person is contaminated with blood or body fluids

•  Bloodborne Pathogens Standard –  Est. 1991 by OSHA –  Mandated in all health

care facilities –  Legal consequences if

regulations not implemented and followed

Regulations

•  Develop written exposure plan – Update annually

•  ID employees who have occupational exposure

•  HBV vaccine – For those with exposure – Must sign release if refuses to accept

•  Provide PPE •  Provide hand washing facilities and

supplies •  Maintain sanitation of worksite

–  Immediate decontamination –  Infectious waste disposal

•  No eating, drinking, smoking, applying cosmetics, etc. in potentially contaminated areas

•  Appropriate containers for waste –  Example: sharps

container •  Biohazard signs posted •  Confidential medical

evaluation and follow-up for exposure

•  Training related to regulations –  No cost to employees –  During working hours

Needlestick Safety & Prevention •  Act passed by congress in November

2000 •  800,000+ sticks/year •  Employer requirements

–  Id and use safer medical devices – Annual updates of Exposure Control Plan –  Input from employees involved in direct

patient care – Maintain sharps injury log

Standard Precautions •  Must use at ALL times •  Developed by CDC •  All body fluids and patients considered

potential sources of infection •  Must be used with contact of

– Fluids, secretions, and excretions – Mucous membranes – Nonintact skin – Tissue or cell specimens

Handwashing •  Most important way

to prevent the spread of disease

•  Purpose: –  Prevent and control

spread of pathogens from person to person

–  Protect health care worker from diseases

Times to Wash Hands

•  When arriving and before leaving work

•  Before and after patient contact

•  Anytime hands become contaminated during procedure

•  Before applying and after removing gloves

•  Before and after handling specimens

•  After contact with soiled item

•  After picking up anything off floor

•  After using restroom •  After you cough,

sneeze, or use a tissue •  Before and after any

contact with mouth or mucous membranes (eating, cosmetics, etc.)

Basic Principles of Hand Washing

•  Use soap as a cleansing agent •  Use warm water •  Use friction to help remove pathogens

from skin surface •  Clean all surfaces of the hands •  Point fingertips down while washing •  Use dry paper towels to turn water on

and off •  Clean nails

Gloves •  Must be worn when

–  Contact with blood, body fluids, etc.

–  Handling and cleaning contaminated objects

–  Invasive procedures –  Performing venipuncture

•  Change after contact with each patient

•  Carefully remove gloves, wash hands

•  Never wash or reuse gloves

Gowns

•  Wear during any procedure that is likely to cause splashing

•  Prevents contamination of clothing •  Dispose of contaminated gowns

properly •  Wash hands after removing

Masks, Eyewear, Face Shields •  Wear anytime

splashing likely to occur

•  Prevents exposure of mouth, eyes, etc. to pathogens

•  Use once then discard –  Guidelines

Sharp Objects

•  Use extreme caution •  Needles

– Never bend / break after use – Never recap – Place in sharps container after one use

•  Never empty or reuse container •  Follow disposal guidelines

Cleanup Procedures •  PPE should be used •  Wipe up spills immediately

–  10% bleach solution •  Disinfect furniture and equipment •  Waste / Linen •  Follow agency policy •  Biohazard bags •  Linen in laundry bag •  Soak in disinfectant PRN before

laundering

Accidents Happen… •  Report any injury,

cut, stick, splashing of fluids

•  Follow agency policy to determine action

•  Documentation –  Record care given –  Follow-up to incident –  ID ways to prevent

similar incidents