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New Hire Orientation Infection Prevention It’s Everybody’s Business What Is An Infection? • Condition: resulting from the presence and invasion by microorganisms. Chain of Infection • • • • • • Infectious agent Reservoir Portal of Exit Means of Transmission Portal of entry Susceptible Host HANDWASHING • The most important measure you can use to prevent the spread the spread of infection. Hand Hygiene • Alcohol hand antiseptics (waterless hand rub) remove microbes from healthcare workers’ hands. • If hands are visibly soiled, soap & water hand washing is required. – Efficacy alcohol-based products may be reduced in the presence of substantial organic matter. It’s All About Hands • Skin around fingernails harbors high concentration of bacteria • Keep natural nails short • Remove chipped nail polish • No cosmetically enhanced nails – More likely to harbor harmful microorganisms Hand Washing Wash hands to prevent transfer of microorganisms : – Before & after patient contact – After gloves are removed – Between task on the same patient to prevent cross-contamination of different body sites Protect Your Hands • Hand washing = Dry skin • Use alcohol hand rub when hands are chapped – Emollients will help dry skin • Use lotion 4 times a day to restore & maintain hands BLOODBORNE PATHOGENS • Microorganisms present in human blood that can cause disease in humans • Examples: – Hepatitis B Virus (HBV) – Human Immunodeficiency Virus (HIV) – Hepatitis C Virus (HBC) BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN • 1). Protects the employee, patient or agent from bloodborne pathogens. • 2). Personal Protective Equipment & Training is available to all employees. • BBP Plan is located _____________. HEPATITIS B • Virus that affects the liver. • SYMPTOMS: – – – – – – – Lack of appetite. Dark urine. Jaundice. Nausea, vomiting. Abdominal pain. Diarrhea. Long term infection can result in liver cancer. TRANSMISSION OF HEPATITIS • • • • Spread through contaminated blood. Sexual activity. From mothers to babies at birth. Spread for weeks before the carrier shows symptoms. • Carriers can spread virus for entire life. HIV –HUMAN IMMUNODEFICIENCY VIRUS • Invades, damages certain white blood cells. • Immune system cannot respond to infection. • HIV infected individuals can get unusual infections or cancers that health persons do not get. • AIDS is a diagnosis based on symptoms & illnesses resulting from infection by HIV. TRANSMISISON OF HIV • Direct contact with blood, semen or vaginal secretions of an infected person • Sexual intercourse • Sharing of needles or other drug injection equipment • Occupation exposure: needle sticks or cuts • Infected mother to baby TUBERCULOSIS • Infectious disease caused by bacteria. • Usually affects lungs. • Other body parts can be affected. TRANSMISSION • Spread through air (droplet nuclei). • Sneezing, coughing, speaking, singing by individual with TB disease. • Sharing the same air space with persons with infectious TB disease. SYMPTOMS OF TB • • • • • • • Weak Weight loss Fever Night sweats Cough Chest pain Coughing up blood TB INFECTION VS. TB DISEASE • Have the organism in their body. • Have symptoms. • No symptom. • Are sick. • Bacteria is inactive. • Bacteria is active and multiplying. MULTI DRUG RESISTANT TB (MDR TB) • One or more drugs can no longer kill TB bacteria. • High risk persons for MDR TB: – Persons who did not take their TB meds. – Immunocompromised persons, i.e. cancer, HIV infection. – Persons previously treated for TB with an ineffective regimen of drugs. TREATMENT FOR TB • TB drugs for TB disease. • If infected may need to take TB drugs to prevent TB disease. • TB drugs are taken for 6-12 months. Standard Precautions • Apply standard precautions to all: –Patients –Contaminated equipment, surfaces & materials • Use judgement to determine when personal protective equipment is necessary Standard Precautions Wear gloves if likely to contact: – Blood – Body fluids – Secretions – Excretions – Mucous membranes – Contaminated items or surfaces Standard Precautions Wear protective fluid resistant gown or fluid proof apron when likely to soil skin or clothes with blood or body fluids Standard Precautions Wear face mask with eye shield or mask & eye protection during patient care activities that may generate splashes or sprays of blood or body fluids Standard Precautions • Prevent injury when using & disposing of needles or other contaminated sharp instruments • Immediately dispose of used sharps in puncture-resistant container • Do not recap using two-handed technique Standard Precautions • Keep work area clean • Minimize the splashing or spraying of blood or body fluids while performing procedures • Clean up spills of blood or body fluids promptly using gloves & approved disinfectant Standard Precautions Place used linen in a impermeable plastic linen bag & twist closed to prevent transfer of microorganisms to other patients, staff or the environment Standard Precautions • Remove gloves, gown, mask, eye protection before leaving work area • Gloves, gown, mask are not worn in halls, elevators, cafeteria, or gift shop Standard Precautions • Report occupational exposures to blood or body fluid – Needle stick or sharps injury – Splash to eyes, nose, mouth – Cut, scratch or bite Standard Precautions Clean re-useable equipment between patients to prevent transfer of microorganisms to other patients, staff or environment Standard Precautions • Use: –Mouthpieces –Resuscitation bags –Ventilatory device • As an alternative to mouth-to-mouth resuscitation methods Transmission Based Isolation • The spread of infection requires 3 elements: –Source –Susceptible host –Transmission Contact Isolation Standard Precautions Patients infected or colonized with: –Epidemiologically important microorganisms –Transmitted by direct contact with the patient –Indirect contact with room surfaces or patient care items Contact Isolation Standard Precautions Wear when entering room • Change gloves after contact with infective material • Remove gloves before leaving room & wash hands • Avoid contact with contaminated surfaces while leaving room Contact Isolations Standard Precautions • Wear when entering room if skin or garments will have substantial contact with: –Patient –Environmental surfaces –Items in patient room • Remove gown before leaving Contact Isolation Standard Precautions • Limit transport to essential purposes • Communicate precautions to appropriate departments • Maintain Contact Isolation Contact Isolation Standard Precautions • Dedicate non-critical equipment to Contact Isolation patient • Clean & disinfect equipment between patients to avoid spread of microorganisms to other patients, staff, or environment Droplet Isolation Standard Precautions Patients infected or colonized with • Microorganisms • Transmitted by droplet from coughing, sneezing, talking, or performing procedures Droplet Isolation Standard Precautions • Wear mask when working within three feet of patient • Limit transport to purposes essential • Minimize dispersal of droplets by masking patient if possible during transport Airborne Isolation Standard Precautions Patients infected with: • Pulmonary tuberculosis (TB) • Rubeola (measles) • Varicella (chicken pox) Airborne Isolation Standard Precautions • Tuberculosis - wear particulate respirator to enter room • Varicella & Rubeola - susceptible care givers not to enter room if immune caregivers are available – Susceptible = mask – Immune persons = no mask Airborne Isolation Standard Precautions • Place patient in a negative isolation room air-flow • Keep room doors closed & patient in room • Limit transport to essential purposes & minimize dispersal of droplets by masking patient