Occupational Safety & Health Administration (OSHA) Training

Infection ControlBlood Borne PathogensTuberculosis Awareness

Employee Health

Why does this matter to me?

“Clinic staff infect patients by re-using drug vials” “New mom recovering from

flesh-eating bacteria”

“Denver Dentist Could Have Infected Thousands”

“Hospital Acquired Infections Costly, Preventable”

“N.H. Hospital Facing Legal Action Over Hepatitis C Outbreak”

“Man Eats Face off unconscious person, wanted brains”

Overview

Responsibilities: Individual Supervisory

Chain of Infection Model Standard & Transmission Based Precautions Infection Control Policies & Procedures

Infection Control Program Bloodborne Pathogens Exposure Control Plan Tuberculosis Exposure Control Plan

Individual Responsibilities

• Review• Review Section OI• Adhere to standard IC practices/procedures• Report all suspected Healthcare Associated

Infections (HAI’s)

Bottom line: We can’t do infection control without YOU.

You are the Infection Control Program!

In the event of contagious zombie infection, it is your responsibility to trip the person next to you and run!

Unit Manager/Supervisory Responsibilities

Ensure personnel know & comply with all infection control policies/practices

Ensure all personnel complete unit-specific:– Orientation/Initial Training– Annual/Refresher Training– Ongoing/In-service Education as required

Review section Infection Control OI annually (if one exists) Appoint section IC Coordinator (if desired)

– Complete appointment letter and route through IP

Healthcare-Associated Infections Formerly Nosocomial Infections

An infection that occurs in a patient, staff member, or visitor in a hospital or other healthcare facility that was not present or incubating at the time of admission or entry to the facility.

Complete Facility/Community Acquired Infection Report to

Infection Prevention: Ask patients if they have any history of infections i.e. MRSA ,VRE, c-diff, etc.

“ Chain of Infection” Model

1. Reservoir

4. Portal of Entry

5. Susceptible Host

2. Portal of Exit

3. Means of Transmission

“ Chain of Infection” Model

1. Zombie is hungry 2. Virus in saliva

3. Bite wound

4. Saliva and blood mix

5. Host re-animates into zombie

HAND HYGIENE

can break the “chain”

**Single most effective way to prevent infection** is to destroy the brain

Standard PrecautionsStandard precautions MUST be used on all patients, all of the time when there may be contact with blood and/or body fluids.• CDC• OSHA• AAAHC• HSI• NPSG• NOTAMS

Transmission Based Precautions

•Contact

•Droplet

•AirborneDon’t get

bitten

Contact PrecautionsUsed for patients known or suspected to be infected or colonized with epidemiological important microorganisms that can be transmitted by direct or indirect contact.

Some diseases requiring Contact Precautions are:

MRSA (Methicillin Resistant Staphylococcus Aureus) RSV (Respiratory Syncytial Virus) Norovirus C-diff (Clostridium Difficile)

Droplet PrecautionsUsed for patients known or suspected to be infected with micro-organism transmitted by larger droplets which are generally confined to a four foot dispersal area and do not remain airborne for long.

Some diseases requiring Droplet Precautions are:

Neisseria meningitis RSV (with active cough/sneeze) Influenza Adenovirus Pertussis

Airborne PrecautionsFor patients with known/suspected infections with microorganisms transmitted by airborne droplet nuclei that stay aloft for long periods of time. This type of Precautions calls for the use of N-95 masks and special ventalation. The does not maintain rooms capable of housing a patient in Airborne Precautions. Arrange for transfer ASAP.

Some diseases requiring Airborne Precautions are:

Tuberculosis Rubeola (Measles) Varicella (Chicken Pox) Disseminated herpes Zoster Some bioterror agents (Anthrax, Small Pox)

Personal Protective Equipment (PPE)

ALWAYS USE APPROPRIATE PPE!

Mask, eye protection, gown and gloves

Remove and dispose of properly in hazardous waste.

Scrubs are not PPE!

ALWAYS USE YOUR HEAD!

Think about probable exposure VS possible exposure

Zombie ControlPolicies

& Procedures

Infection Control

Hand Hygiene Sharps Disposal Hepatitis B Vaccine Hazardous waste Linen Cleaning/Instruments

Hand Hygiene

Hand wash:

at least 20 seconds

NO nails more than 1/4 in. beyond fingertips

NO artificial nails in patient care areas

Will not prevent zombification

HAND HYGIENE

Alcohol based hand rubs:

Increases Compliance & improves condition of hands

Replaces hand washing if hands are not visibly soiled,If soiled, use soap and water for washing

Will not prevent zombification

Sharps Disposal

DO NOT recap “dirty” needles Dispose of “potential” sharps Dispose of at point of origin! Empty when ¾ full Reconsider risky work practices

Human Immunodeficiency Virus(HIV)

HIV : a viral disease -spread through contact with infected blood,

unprotected sex with an infected partner, or from mother to child during pregnancy. HIV can also be spread to babies through the breast milk of infected mothers.HIV: acts by killing/damaging cells of the immune system, destroying the body's ability to fight infections.

-may get life-threatening diseases and opportunistic infections, caused by viruses or bacteria that do not normally infect healthy people.

Hepatitis

Hepatitis B: is a serious disease caused by a virus that attacks the liver. The virus, which is

called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.  

Hepatitis C: is a liver disease caused by the Hepatitis C virus (HCV), which is found in

the blood of persons who have the disease. HCV is spread by contact with the blood of an infected person.

Hepatitis B VaccineThree doses:1) Initial dose2) 1 months later3) 6 months later

The vaccine is safe and has a published sero-conversion efficacy of >95%. HBV vaccine is required for all active duty medical personnel who have a reasonably anticipated exposure to blood and other potentially infectious materials. Although civilians can not be made to receive the vaccine, it is generally a condition of employment. It is offered free of charge.

Regulated Medical Waste

The MTF is charged by the poundNo routine trash in RED/BIOHAZARD bagsNo sharps in RED/BIOHAZARD trashNo linen in RED/BIOHAZARD trash Only biohazardous waste in RED/BIOHAZARD trash

Ensure all zombie parts are disposed of properly, to ensure they do not re-animate

Regulated Medical Waste

Any liquid or semi-liquid blood or other potentially infectious materials Contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed Items that are caked with dried blood or other potentially infectious materials (OPIM) and are capable of releasing these materials during handling Pathological and microbiological wastes containing blood or other potentially infectious materials

Linen

DON’T: -Separate soiled linen

-Wear scrubs outside or home

-Throw away linen

DO:-Use gloves when handling

-Separate clean & dirty linen areas

Area Cleaning

Use appropriate cleaning products and concentration. Use only from approved list in

No shipping containers in patient supply areas

Instrument Cleaning

No scrubbing of instruments in any areas other than Sterile Processing and Distribution (SPD) or Dental Instrument Processing Center (DIPC) Must be transported in puncture-resistant container with Biohazard label.

Blood Borne Pathogen Exposure Procedures

Wash/flush area for 5 minutes Notify supervisor immediately Get treatment immediately

– CDC recommends just hours Paperwork – Complete a Forward to Safety

– Include device brand & type involved (OSHA requirement) Notify Public Health

– Required to complete paperwork.

Tuberculosis Exposure Control Plan

Report to PH on arrival to TB screening is initial and event relatedRespiratory Protection Program

– Managed by Bioenvironmental Engineering– Base wide program– Physical Assessment for all at risk personnel

(N-95 “just in time” fit testing)TB Risk assessment done annually by Public Health Isolation requirements not available at PH conducts exposure/contact investigation

TB Awareness

Prolonged cough 3 weeks Chest pain, night sweats or fevers No appetite Weight loss Weakness or fatigue Coughing up blood History of exposure or travel to high risk

area

Documentation

Employee training must be documented on AF Form 55

“Infection Control/OSHA BBP/TB”

Patient and Family Education must be completed and documented IAW unit policy.

Summary: Responsibilities Chain of infection Standard Precautions