Transcript Infection Control Powerpoint

Student Online Orientation
Infection Control
Exposure Control Plan
Blood borne pathogen plan
TB exposure control plan
Isolation
Exposure Control Plan Manual
Found on Presence Health Intranet online
– via POLICY and PROCEDURES
– Under Infection Control category
Pres-Net
policy & procedures
infection control
3
Blood Borne Pathogens
What are Blood Borne Pathogens?
Viruses and bacteria that require blood or body fluids to live
–
–
–
–
–
–
HIV
Hepatitis C
Hepatitis B
Delta Hepatitis
Syphilis
Malaria
5
HIV Hepatitis B, C and delta, syphilis and malaria can live
in a variety of body fluids:









Blood and blood products
Cerebral spinal fluid
Pleural fluid
Pericardial fluid
Peritoneal fluid
Semen
Vaginal fluid
Amniotic fluid
Synovial fluid
6
Blood Borne Pathogens are Spread by fluids entering the
body through:






Cuts, scrapes or other breaks in the skin
Needle-stick injuries
Splashes into the mouth nose or eyes
Oral, vaginal or anal sex
Using infected drug needles
Pregnant women who are infected with these
pathogens may pass them to their babies
7
How do you know if someone has one of these viruses?
You Don’t!
Patient with Hepatitis B or C may or may not have symptoms
and will not be diagnosed unless they become jaundiced
(yellow)
– THEY ARE STILL CONTAGIOUS
Signs and Symptoms of Hepatitis B and C
– Loss of appetite
– Tired feeling
– Low grade temperature
– Vague abdominal pain and discomfort
– Diarrhea
– vomiting
– yellow skin or eyes
8
HIV
Signs and Symptoms
– Flu-like symptoms in the beginning
– May have more frequent bouts of flu, and colds
– Fever, diarrhea and fatigue
Eventually Develop AIDS, and will be diagnosed
– It can take up to 10 years or longer before a person is sick enough
to be diagnosed with HIV, in the meantime they are contagious.
9
Standard precautions / universal precautions were
developed by OSHA and the CDC to provide a means to
protect health care workers
Standard/ Universal Precaution
– A system that outlines safeguards or barriers designed to protect healthcare workers
• Personal protective equipment
• Engineering control
• Housekeeping
• Work practice controls
Personal Protective Equipment (PPE)
– Located in every patient room in beige box on the wall
(except Behavioral Health Unit)
•
•
•
•
•
•
Gloves
Gowns
Masks
Shielded masks
Goggles
Ambu bags
10
Standard / Universal Precautions require…
Personal Protective Equipment
FOR EACH AND EVERY PATIENT
You will wear gloves
– If there is a possibility that you are going to touch or come in
contact with anyone’s blood, body fluids or mucous membranes
You will wear a mask and goggles or a shielded mask
– if there is a possibility of blood or body fluids splashing or coming in
contact with your eyes, nose or mouth
You will wear a gown
– If there is a possibility that you might have your clothing soiled with
someone’s blood or body fluids
11
Standard/ Universal precautions require…
Engineering Controls
Biohazard Labels
Containers
– Sharps Containers
Safety Needles
– Needless IV systems
– Safety scalpels
12
Safety Equipment is only as
good as the people who use it.
When safety equipment is provided
– Use it
– Activate the safety mechanisms as soon as you are done with the
procedure
13
Standard/Universal Precautions require…
housekeeping
Proper disposal of sharps and broken glass
Never reach into trash
Dispose of sharps containers when 2/3 full
Clean up blood/ body fluids using the proper equipment and
according to policy
14
Standard/ universal precautions require…
work practice controls
Never bend break or recap a needle
Minimize splashing of fluids during collection or disposal
Don’t eat or drink in work areas
Wash you hands or skin after contact with body fluids or objects
that might be contaminated
15
Hepatitis B Vaccine
Hepatitis B is the only Blood Borne Pathogen we can protect
against
If you have not been vaccinated for Hepatitis B, we would
encourage it due to potential exposure in a healthcare setting
– See your personal physician or community health clinic
16
PSMH Blood Borne Pathogen Plan
WHAT is an Exposure?
– Anytime blood or body fluids come in contact with a worker's eyes,
nose, mouth or skin through a needle stick, splash or other type of
exposure
17
PSMH Blood Borne Pathogen Plan
What should You do if you have an Exposure?
– Wash the affected area thoroughly with warm water and soap at
once!
– For mouth or eye exposure thoroughly rinse out you mouth with
water or mouthwash
– Flush eyes with water or saline solutions
Immediately House Operations Manager (HOM)
notify your supervisor/institution to follow their specific protocol
The source will be tested for HIV, Hep B and Hep C
– You will be notified of results
– Presence Health recommends you remain on site until rapid HIV is
resulted
– If source is HIV positive you will be sent for immediate care and
consultation in the emergency department
– .
18
PSMH Blood Borne Pathogen Plan
For more information or further questions
– Employee Health Nurse 815-937-2262
– Infection Control Coordinator 815-937-2235
19
Exposure Control Plan
TB
PSMH TB Exposure
What is TB?
– Tuberculosis (TB) is a disease caused by bacteria called
Mycobacterium tuberculosis
– The bacteria usually attack the lungs, but can attack any part
– It can be fatal if not treated properly
How is TB Spread?
– When an infectious person coughs, laughs, talks or sings and
expels the small bacteria into the air and someone near by breaths
it into their lungs
21
PSMH TB Exposure Control Plan
Patients are screened when they enter the hospital for TB with
the following questions:
–
–
–
–
–
–
–
Cough lasting longer than 2-3 weeks?
Low grade temperature?
Night sweats?
Cough up blood?
Unexplained weight loss?
Loss of appetite?
Feel weak?
22
PSMH TB Exposure Control Plan….
if the patient TB screen is positive:
If Physician feels the TB screen is positive
– Patient will be transferred to a “negative Pressure Isolation”
– put on “Airborne Isolation” precautions
• Requires room with special ventilation
• Door kept shut at all times
• Requires a N95 Particulate Filter Respirator Mask for persons entering
the room, that has been fit tested.
23
PSMH TB exposure Control Plan
TB Screening
– 2 step PPD (Mantoux Testing) documentation is required prior to
clinical rotation and anytime a healthcare worker or volunteer is
exposed to MTB
– Anyone who test positive for the first time is sent to the Kankakee
County Health Department for evaluation, possible chest x-ray and
treatment
– Treatment is provided by the Kankakee County Health Department
24
PSMH TB Exposure control plan
A POSITIVE TB Test (PPD, Mantoux)means:
– You have come in contact with the TB germ
– You are NOT infectious unless you have signs/ symptoms of TB
– You cannot give TB to anyone at this stage
25
PSMH TB exposure Control Plan
In 2015/ 2016 PSMH is considered at LOW risk for contact with
Mycobacterium TB. A risk assessment is done annually.
– Therefore yearly TB testing may or may not be required
– Staff, Volunteers, and Students will be tested if they are exposed to
a patient with active infectious TB
26
PSMH Infection Control
Isolation Guidelines
PSMH Isolation Guidelines
How Do I know if a patient requires Isolation?
– The first policy under Isolation in the exposure control manual is
called Isolation Guidelines (also in the Infection Control Policy Manual Online)
• Lists conditions and bacteria requiring isolation
• Lists the type of isolation required
• Lists the duration of isolation required
28
PSMH Isolation Guidelines
3 types of isolation used at PSMH
– Airborne
• Used for TB, Chickenpox(Varicella), disseminated herpes, Smallpox,
SARS, or Avian Flu
– Droplet
• Used for whooping cough, (pertussis), influenza, pneumonic plague,
diphtheria, mycoplasma pneumonia, mumps, rubella, haemophilus
influenza type b, (pneumonia and sepsis) Bacterial Meningitis
– Contact
• Used for Diarrhea infection
– Salmonella, shigella, hepatitis A, Toto Virus, Clostridium Difficile,
and undiagnosed diarrhea
• Respiratory Infection
– RSV, enteroviral infections in infants/ children
• Skin infections
– Impetigo, scabies, zoster(chickenpox, Shingles)
• Multidrug resistant organisms
– MRSA, VRE, ESBL’s, C-Diff
29
AIRBORNE Isolation
Requires a private room equipped with negative air flow, the door must
remain closed.
For TB : EVERYONE is required to wear an N95 particulate filter mask
when entering room
– For Chicken Pox, Disseminated Herpes(shingles in more than
one nerve or in an immune-compromised patient):
• If immune to chicken pox you may enter the room without a N95
particulate filter respirator mask
• If you are not immune a N95 particulate filter respirator mask is
required, and fit tested
30
DROPLET Isolation
Standard precautions
as well as the requirement of a surgical mask worn by everyone
who enters the room
31
CONTACT Isolation
Multi drug resistant Organisms
– Requires GOWN and GLOVES be worn by EVERYONE upon
entering the room EVERYTIME they enter the room.
– Volunteers are not to enter any Isolation rooms
32
CONTACT Isolation for Clostridium Difficile:
Hand Hygiene
– USE soap and water
– DO NOT use waterless alcohol hand sanitizers
C-Diff is a spore forming bacteria
– It is difficult to kill
33
PSMH Infection Control
Hand Hygiene is the
single most important
thing you can do to
protect your patients,
yourself and your family!
Hand Hygiene Saves lives
-Washing hands with soap and water
-Cleansing hands using an alcoholbased hand rub
-Preventing the spread of germs and
infections
Hand Hygiene is the #1 way to prevent the spread of
infections
Wet hands with warm water and apply soap
– A nickel or quarter sized amount of soap to your hands
Rub hands together for 20 seconds
– Rub all over the top of hands and in between fingers and under
fingernails
Rinse hands well under running water
Dry your hands using a paper towel and use a paper towel to
turn off the faucet and open the door if needed
36
Hand Hygiene
Perform Hand Hygiene
–
–
–
–
–
–
–
–
–
–
Before patient contact as you walk into patient room
Before any invasive tasks
Before starting your shift
Before doing vital signs
Before dispensing meds
After contact with wounds, mucous membranes, blood and body
fluids, secretions, excretions and other potentially infectious
material
After contact with equipment or surfaces that may be contaminated
After removing gloves and other PPE
After patient care
After your shift before leaving work
37
All Equipment must be cleaned after use between patients
Germicidal Wipes
– Need to have a wet contact time of 2 minutes on the surface then
be allowed to air dry to kill the bacteria and viruses
• Lift equipment, glucometer, beside tables, stethoscopes BP cuffs, med
pass areas, pill crushers, crash cart, counters, keyboards, mouse,
telephone, pens, kitchen counter, microwave, refrigerator
Bleach
– Need to have a wet contact time of 4 minutes on the surface then
be allowed to air dry to kill the bacteria and viruses
• C-diff , and if patient has diarrhea use bleach to clean equipment and
surfaces
38