Transcript Universal_Precautions

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Infection Prevention & Control
Prevention Strategies
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Isolation Precautions
•. Used to reduce transmission of
microorganisms
• Designed to protect both staff
and individuals from contact with
infectious agents
• Includes:
□ Standard precautions
□ Transmission-based precautions
Sharps
Injury
Prevention
Hand Hygiene
Textiles and
Laundry
Standard
Precautions
Cleaning of Care
Equipment
Respiratory Hygiene /
Cough Etiquette
Care of
Environment
Personal
Protective
Equipment
Hand Hygiene: How and When
Soap and water
Alcohol-based hand rub
When to use Use when hands are visibly dirty,
contaminated, or soiled
Use for routinely
decontaminating hands if hands
are not visibly soiled
How to use
(properly)
1. Apply to palm of one hand,
rub hands together covering
all surfaces until dry
2. Manufacturer will instruct
how much to use
1. Wet hands with water, apply
soap, rub hands together for at
least 15 seconds
2. Rinse and dry with disposable
towel
3. Use towel to turn off faucet
Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
Hand Hygiene: Why and When
• Clean hands are the most important factor in
preventing the spread of disease and antibiotic
resistance in settings across the continuum of health
care.
• Before and after:
▫ Contact with a patient
▫ Treating a cut or wound
(Ex: changing dressings or bandages)
Guideline for Hand Hygiene in Health-care Settings.
MMWR 2002; vol. 51, no. RR-16.
Hand Hygiene: When
• Before:
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Putting on gloves
Preparing or eating food*
Touching your eyes, nose, or mouth
Handling/administering medication
Insertion of invasive devices
* Wash hands with
soap and water
• After:
▫ Contact with blood, body fluids, mucous membranes, secretions,
excretions, or non-intact skin
▫ Removing gloves
▫ Touching surfaces or objects in the patient’s environment that may be
contaminated (bed rails, bedside tables, light switches, etc.)
▫ Handling garbage
▫ Using the restroom*
▫ Blowing your nose, coughing, or sneezing
Safe Injection Practices: Fingerstick Devices
Single-use devices
• Disposable
• Prevent reuse through an auto-disabling feature
• Appropriate for settings where assisted monitoring
of blood glucose is performed
Reusable devices
Single-Use Fingerstick Device
Source: CDC
• Often resemble a pen (“penlet”)
• Use not recommended due to problems that have been
observed, including:
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Failure to change disposable pieces
Failure to clean and disinfect properly
Links to multiple outbreaks of hepatitis B
Risk for occupational needlestick
Reusable Fingerstick Device
Source: CDC
• Only appropriate for people who do not require assistance with
blood glucose monitoring (BGM)
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Blood Glucose Monitoring Best Practices
• Fingerstick devices should never be used for
more than one person
▫ Select single-use devices that permanently
retract upon puncture
• Dedicate blood glucose meters to a single
patient, one person, if possible
▫ If shared, the device should be cleaned and
disinfected after every use, per
manufacturer’s instructions
• Insulin pens and other medication
cartridges and syringes are for single-use
only and should never be used for more
than one person
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OSHA Bloodborne Pathogens Standard
The Occupational Safety and Health Administration
(OSHA) Bloodborne Pathogens (BBP) Standard
describes important strategies that can reduce the
risk of infection on the job.
 Exposure Control Plan
 Engineering Controls
 Work Practice Controls
 Standard Precautions / Personal Protective Equipment
 Housekeeping
 Hepatitis B Vaccine
 Occupational Exposure Follow-up
 Training and Recordkeeping
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Respiratory Hygiene/ Cough Etiquette
Is used to decrease the transmission of
respiratory illness such as influenza & colds by:
1. Education regarding how respiratory
illnesses spread and prevention practices
including how to “cover your cough” and
proper hand hygiene methods
2. Availability and use of tissues and hand
hygiene products
3. Use of mask for person who is coughing
4. Spatial separation of the person with a
respiratory illness
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Droplet Precautions
• Are used in addition to standard precautions.
• Used for illnesses that can be spread to others by speaking,
sneezing, or coughing.
▫ Examples: influenza, the common cold
• These germs may through the air for approximately 3-6 feet
and can be breathed into the nose or mouth of another person.
• Hand hygiene is essential to avoid the spreading of germs.
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Cleaning of the Environment
Our environment contains
microorganisms that can
cause infection.
Cleaning and disinfecting
surfaces and objects such
as medical equipment can
decrease the spread of
these organisms to people.
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Common Terms
• Clean = remove all visible dust, soil, and any other
foreign material
• Decontaminate = remove disease-producing
microbes to make safe for handling
• Disinfect= kill or destroy nearly all diseaseproducing organisms, except spores using a
chemical or physical agent
• Sterilize = destroy microorganisms and spores
Adapted from the APIC, 2009 Infection Prevention Manual for Long-Term Care Facilities
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Breakdown of Cleaning
• Cleaning is the physical removal of all visible soil and
other foreign material (such as dirt, dust bunnies, and
body fluids) so you can get to the microbes
underneath. You can’t kill microbes if you don’t clean
first.
• One can clean without disinfecting, but one can not
disinfect without cleaning, therefore, one must clean
first to remove the materials.
• Transmission of infection may not be a failure of the
cleaning and disinfecting agents but rather a failure to
completely follow the cleaning and disinfecting
process.
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Cleaning Process
• Environmental Services should
approach cleaning in a orderly,
regularly scheduled method.
• Clockwise or counter-clockwise
• Working from top to bottom
• Cleanest to the dirtiest
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Disinfecting Agents
• Only use disinfectants registered with the U.S.
Environmental Protection Agency (EPA)
• Cleaners and disinfectants should be reviewed
for use, dilution, contact time, and shelf life
▫ Contact time: amount of time needed for the
chemical to come in contact with the
microorganism so that a significant number of
organisms are killed.
• Use appropriate disinfectant for situation
▫ For example: areas contaminated with
C. difficile or norovirus may need different
cleaners and disinfectants
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Preparing a Bleach Solution
• 1:10 Dilution
▫ 1 part bleach to 9 parts water
• 1 ½ cups bleach in 1 gallon water
• 1:100 Dilution
• 1 part bleach to 99 parts water
• 1/4 cup bleach in 1 gallon water
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Vaccinations
• A vaccine is a preparation that improves immunity to a
particular disease.
▫ Examples: influenza, tetanus, or pneumonia
• The vaccine typically contains an agent that resembles a
disease-causing microorganism.
• The vaccine stimulates the body’s immune response to
recognize the foreign invader, destroy it, and
"remember" it, so that the immune system can more
easily recognize and destroy any of these
microorganisms that may be encountered later.
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Why Vaccinate?
• Vaccines can help prevent some
diseases
▫ Save costs (resource reallocation)
 Lost time from work
 Treatment expenses
▫ Save lives
• Long-term protection in the
individual
• Help prevent outbreaks from
occurring
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Vaccination Recommendations
• May vary based on underlying medical conditions,
occupation, and age
▫ Special vaccination recommendations apply to healthcare
personnel to protect themselves and their patients against
disease
• Even if you were vaccinated as a child, you may need to
get vaccinated as an adult for certain diseases
▫ For example, it is recommended that you get a vaccination
for influenza every year
• Recommendations are updated and published every year
• CDC website for immunization schedules:
http://www.cdc.gov/vaccines/schedules/index.html
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Successful Vaccination Strategies
• Stress benefits of vaccination.
• Allay fears and misconceptions.
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Vaccines are safe!
Can’t “catch” the disease from the vaccine
Minimal side effects
Benefits outweigh the risks
• Find creative ways to increase staff influenza
vaccination rates.
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