Transcript No Slide Title

National
Needlestick njuries
Conference 2006
“Pointing Out the Future
for Irish Healthcare workers”
Infection Prevention & Control
Siobhan Prout, BSAP
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Education & Training
Tradition & Ritual
Modern Approach
Strategic Management
Siobhan Prout, BSAP
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The Prevention of Transmission of Blood-Borne Diseases in
the Health-Care Setting
“The most effective way of preventing transmission of
blood borne pathogens in the health-care setting is to
make the working environment as safe as possible”
Good infection prevention & control practices
Implementation of standard precautions
Provision of effective risk management policies
Siobhan Prout, BSAP
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Infection prevention & control practices
Health care workers require knowledge on
Source of micro-organisms
Susceptibility of the Host
Transmission methods of micro-organisms
Siobhan Prout, BSAP
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Source
• Patients- acute disease, incubation
period, colonised but asymptomatic or
chronic carriers.
• Endogenous flora
• Health care personnel
• Environment,
• Equipment, medications.
• Visitors
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Host
Factors effecting :
• age
• underlying disease
• medications e.g. antibiotics, steroids
• irradiation
• skin integrity
• indwelling devices
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Transmission
• Contact
• Droplet
• Airborne
• Common vehicle transmission
• Vectorborne
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Implementation of standard precautions
• Apply to all patients
receiving care, regardless
of their diagnosis or
presumed infection status
• Apply to;
• Designed to reduce the
risk of transmission of
blood-borne and other
pathogens from
recognised and
unrecognised sources
– blood
– all body fluids ( except
sweat)
– non-intact skin
– mucous membranes
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Implementation of standard precautions
Guidelines; Hand hygiene
• Promote hand hygiene as
a key component of
infection prevention &
control in the hospital &
community setting
• Addresses the resources
issues
– Facilities location & design
– Products available
– Education, promotion of
hand hygiene and audit of
practice
Siobhan Prout, BSAP
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Implementation of standard precautions
Personal protective equipment
• Appropriate use of gloves
• Cover cuts and abrasions
• Use of visor or goggles/safety spectacles
• Waterproof/repellent masks
• Plastic aprons/gowns
• Appropriate footwear
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Implementation of standard precautions
• Use safety devices
“an increased emphasis on precautionary measures
to protect the health and safety of health-care
workers….these measures should be taken with all
patients in all health-care facilities at all times by
all staff in both the public and private healthcare
sectors”
M. Harney, Tánaiste & Minister for Health & Children
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Implementation of standard precautions
Safety devices & technology; Phlebotomy
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Implementation of standard precautions
Safety devices & technology; Cannulation
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Implementation of standard precautions
Safety devices & technology; Subcutaneous
infusions
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Implementation of standard precautions
• Single use items disposed after use 2
• Safe use of sharps disposal units
• Prevention of surface contamination by blood
and body fluids
• Appropriate decontamination of spillages
• Routine and terminal cleaning equipment &
environment
• Patient linen storage and laundry segregation
• Patient placement and transportation
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Effective risk management policies
Risk management focuses on
• Active compliance of the healthcare
worker with Infection Prevention &
Control measures
• Analysis of the working environment,
conditions and practices that may
contribute to the risk of transmission of
BBV
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Effective risk management policies
Efforts to prevent inoculation injury are focused
on three main areas
• Altered behavior & improved safety culture
through ongoing education/training
• Utilisation of engineering controls
• Disease prevention through uptake of available
vaccination and medical prophylaxis
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Professional issues
• “Health care should be delivered with compassion
and dignity in compliance with best practice in
relation to safety and standards of care”
• Acceptance of responsibility and understanding
of accountability for own practice
• Knowledge updated by on-going education
• Documentation
• Evaluation of own practice through audit
process.
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Reason’s model on accident
causation
• Active errors : those having an
immediate effect
• Latent errors : conditions that lie dormant
until activated by active errors.
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Reason’s model on accident
causation
Organisational
Local management
Unsafe acts
Siobhan Prout, BSAP
Safeguards
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Reason’s Model on Accident
Causation
Danger
Organisational problems
Local Management
Unsafe Acts
Safeguards
Injury
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