Transcript here - St Josephs Catholic Primary School

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INFECTION CONTROL MATTERS
Presented by: Linda Newsham
Aim of presentation
• Principles of Infection Control
• Spread of infection
• Hand hygiene
• Childhood illnesses
• Cleaning and disinfection
• Outbreak management
Principles of Infection Prevention and Control
“The general principles of Infection Prevention
and Control are based on the use of
practices and procedures that prevent or
reduce the likelihood of infection being
transmitted from a source to a susceptible
individual.”
Methods of spread
• Airborne
• Contact: Direct
Indirect
• Ingestion
• Vectors
Airborne transmission
Droplet infection
• Inhaling droplets of moisture containing viruses, bacteria,
etc, from an infected person who has coughed or
sneezed.
• Touching surfaces covered by droplets (as above) or from
the person’s hands and then touching our own face or
eyes:
– surfaces include door knobs, telephones, toys, flush
handles.
Dust and skin scales – small particles may remain airborne
for some time. Larger ones can settle on horizontal surfaces.
Faecal-oral transmission
Directly from person to person
• Eating contaminated food or drinking contaminated water:
– sucking fingers, thumbs, biting finger nails, smoking a
cigarette with dirty hands;
– hands can become contaminated from touching pets,
farm animals, raw meat and poultry, soiled clothing,
toilets etc.
Contact transmission
Direct – person to person
• By SKIN to SKIN contact:
– giving care to children;
– holding hands.
• By HEAD to HEAD contact:
– children playing;
– adults having head contact with children,
Indirect:
– via food and water;
– via fomites (inanimate objects);
– via the environment (contaminated secretions;
excretions, soil and dust).
Blood and body fluid transmission
• By blood or certain body fluids from an infected person,
getting into the body of another person:
– through cuts or damaged skin;
– through mucous membranes (eyes, mouth);
– by injection through the skin e.g. body piercing, tattoos,
IV drug use, blood transfusion.
• Vertical transmission – mother to baby
Hand
washing
When should hands be washed
Regularly throughout the day and especially at these
times:Before:
• Preparing food
• Eating
• Providing physical care
Between
• Handling raw foods (meat, fish, poultry and eggs) and
touching any other food or kitchen utensils
When should hands be washed
• Touching rubbish/waste bins
• Going to the toilet
• Changing nappies/clothing
• Caring for the sick, especially those with
upset stomachs
• Coughing or sneezing
• Handling and stroking pets or farm
animals
• Gardening – even if you wear gloves
• Cleaning cat litter boxes etc.
How to wash your hands
• Wet hands before applying soap as this prevents irritation.
• Rub hands together for about 15 seconds, making sure both
sides of the hands are washed thoroughly: especially around
the thumbs, between fingers and fingertips
• Rinse with clean water.
• Dry hands thoroughly preferably using a paper towel.
Handwashing
1
2
3
Palm to palm.
4
Backs of fingers to opposing palms
with fingers interlocked.
5.3
Right palm over left dorsum
and left palm over right dorsum.
5
Palm to palm
fingers interlaced.
6
Rotational rubbing of right thumb
clasped in left palm and vice versa.
Rotational rubbing, backwards and forwards
with clasped fingers of right hand in left palm
and vice versa.
Conditions
Chickenpox
• Caused by a highly infectious virus characterised by blisters.
• Droplet spread e.g. via coughing
and sneezing or by direct contact
with blister fluid.
• Incubation period 13-17 days.
• Infectious 4 days before onset of
rash until 5 days after appearance
of first spots. May return to school
after 5 days of spots appearing and
when well.
• Pregnant women should seek
antenatal advice – first 20 weeks
and last 3 weeks.
Threadworm
• Tiny white worms that live in the bowel.
• Common symptom, itching round the back passage at night
(most active time) where they leave bowel and lay eggs on
surrounding skin.
• Spread by inadequate hand washing after using toilet. Eggs
also get into carpets, bed linen, etc.
• Incubation may be between 2-6 weeks.
• Return to school as soon as they have received treatment.
Ringworm
• Not a worm but a fungus,
characterised by circular patch of red
itchy skin that increases in size.
• Can occur on scalp, body, groin,
hand, foot or nail.
• Spread by direct or indirect contact
with an infected person. May also be
acquired by contact with infected
animals (cats, dogs, horses).
• Use separate face cloths, towels,
combs, etc. Keep area well ventilated
and dry.
• No exclusion once treatment begun;
usually antifungal tablets or cream
(depending on area)
Hand, foot and mouth disease
• Caused by a virus (coxsackie virus).
Usually affects children under 10yrs.
• Sore throat, fever and blisters inside
the mouth and throat. May have
blisters on palm, fingers and soles.
• Spread by close contact with
discharges of nose or blisters of
someone in acute phase. Can also
be passed by contact with faeces.
• Incubation usually 3-5 days. No
treatment required.
• Exclusion whilst unwell or obvious
blisters.
Conjunctivitis
• Inflammation of the clear membrane that covers the white
of the eye. Can be bacterial or viral cause.
• Spread person to person by direct contact with infected
discharge by sneezing, on hands, towels and wash cloths.
• Ointments/drops required for bacterial infection (never
share!).
• Exclude until treated or appears normal again.
Impetigo
• A skin infection caused by certain
bacteria.
• Commonly affects the face, starting
with redness that develops into
weeping spots and then crusts.
Lesions should be left open to air.
• Infectious whilst spots discharging
pus. Spread by direct contact with
the skin and by sharing towels etc.
Also carried in nose of 20-30%
population and passed on by hand
contact.
• Exclude until spots healed or
crusted over or after 24hrs antibiotic
treatment.
Viral gastro-enteritis
• Caused by 2 main virus types:
- norovirus;
- rotavirus (mainly under fives).
• Sudden onset of vomiting and or diarrhoea.
• Very infectious from spray created when ill.
• Usually short-lasting = 24/48hrs.
• Exclude from school until 48hours after last symptoms.
• Thorough cleaning of wide area after illness episodes and
isolation can reduce spread.
TB
• An infection affecting the lungs as well as other body
systems and lymph glands.
• Infectious only in the lung form from coughed up sputum
(phlegm).
• Close, prolonged contact needed to get infected.
• Easily treated with cocktail of antibiotics.
• Some immunity from BCG vaccination.
Scabies
• A skin infection with the scabies
mite.
• An allergic reaction to the mite
gives a very itchy rash.
• Rash can take up to 6 weeks to
appear, but the person is infectious
throughout this time.
• All contacts need to be treated at
the same time.
• Itching can continue for 2-3 weeks
after successful treatment.
Viral hepatitis A
• Hepatitis is an inflammation of the liver.
• Hepatitis A is caught by swallowing the virus (contaminated
food, water and from hands soiled with faeces).
• After 6 weeks, lethargy, jaundice, nausea, pain in abdomen.
• No treatment, usually full recovery.
• Vaccination can protect contacts and travellers.
Viral hepatitis B
• Hepatitis B is caught by contact with infected blood or
sexual fluids which get into the bloodstream.
• 12 weeks later, flu-like illness, jaundice, pain and
sometimes organ failure.
• Some people become infectious carriers.
• Can lead to chronic liver problems and cancer.
• Vaccination can protect contacts and those with
life-style risks.
Viral hepatitis C
• Hepatitis C is caught by contact with infected blood which
gets into the blood stream.
• Mild flu-like illness may develop 6-10 weeks later. Often no
symptoms.
• Can cause slow liver damage over many years.
• Can lead to cirrhosis and liver cancer.
• No vaccination available.
Measles
• Caused by a virus, rare in this
country since introduction of MMR
vaccine.
• Fever, conjunctivitis, cough and/or
spots on cheeks or inside mouth. 3-7
days later red, blotchy rash appears
which lasts 4-7 days. Complications
of pneumonia can occur. Incubation
7-14 days.
• Spread by contact with coughing
and sneezing, sometimes by dirty
handkerchiefs etc.
• Exclude until 5 days after onset of
rash.
• GP to notify to CCDC.
Mumps
• Caused by a virus.
• Fever, swelling of one or more
salivary glands in the neck. Adult
males can develop orchitis.
• Mumps virus can cause meningitis
and deafness.
• Passed from one person to another
via droplets (sneezing, coughing) or
direct contact with saliva.
• Incubation normally 18 days but can
be 12-25 days.
• Exclude for 5 days from the onset of
the swelling.
• GP to notify CCDC
Rubella (german measles)
• Caused by virus which causes mild fever and a rash.
• Virus can be passed to an unborn child that can cause
serious birth defects.
• Fever, swollen neck glands, possible conjunctivitis and fine
rash.
• Spread by direct contact with sneezing or coughing and
contact with dirty handkerchiefs, etc.
• Incubation period 16-18 days.
• Exclude for 5 days from the onset of the rash.
• GP to notify CCDC.
Fifth disease (slapped cheek disease)
• Caused by a virus. Usually mild.
• More than half of all adults have
been affected in the past and are
now immune.
• Red rash on cheeks, followed by
lace-like rash on the body and limbs
for up to 3 weeks.
• Infectious before onset of rash.
Mostly spread by droplets.
• Return to nursery when feeling
well.
• Pregnant women should seek
advice ASAP especially if in first 20
weeks.
Meningitis
• Meningitis is an inflammation of the brain membranes.
• Caused by different bacteria, viruses and TB.
• Meningococcal bacteria make toxins (poisons) which
cause serious illness and sometimes death.
• Spread into the bloodstream causes septicaemia and
damage to blood vessels and organs.
Colds
• Although feeling unwell they can carry on with normal
activities.
• Useful things to do:
Keep warm
Rest
Fluids
Take things easy until symptoms subside
Influenza
• Commonly called flu, this is an infection of the airways –
nose, throat, windpipe and lungs, caused by the flu virus.
• 3 types: A, B, C. most outbreaks A.
• Worldwide.
• Incubation 1-3 days.
• Infectious – 1 day before and up to 5 days after onset of
symptoms.
• New vaccine every year – vulnerable individuals and age
groups.
• Exclusion – no recommendations but advised to stay away
until well.
• Complications – secondary bacterial infections such as
bronchitis and pneumonia
Reduce droplets!
• Remind staff and children to cover noses and mouths with
a tissue when sneezing or coughing.
• Discourage nose picking!!
• Provide adequate waste bins.
• Encourage prompt disposal of tissues.
• Hand washing after coughing or sneezing.
Raising Children’s Awareness
• Teach the importance of regular hand washing and
supervise, especially after going to the toilet and before
eating.
• Cleaning teeth.
• Wiping noses and disposing of tissues.
• Covering mouths when coughing or sneezing.
Cleaning and Disinfection
• Cleaning schedules.
• Storage areas.
• Equipment – colour coded NPSA.
• Detergent wipes.
• Provide suitable hand washing facilities and ensure regular
use!
• Ensure disposable gloves and aprons are available for
carrying out first aid.
• Toys daily wipe stored in cupboard wash weekly.
• Regular change of sand, water and clay etc.
Outbreaks
• Monitor normal sickness and absence and report if rates
are abnormal.
• Inform EHO,HPA, Community IPC Team.
• Make a list of all affected individuals inc. staff with dates of
onset and symptoms and send copy to EHO and IPC.
• Contact EHO/IPC daily to update.
• Activate enhanced cleaning procedures.
• See guidance in updated policy.
For further details please contact
Linda Newsham
Lead Nurse Infection Control
[email protected]