Download Infection Prevention and Control Programmes, Ms

National
Needlestick njuries
Conference 2006
“Pointing Out the Future
for Irish Healthcare workers”
Infection Prevention & Control
Siobhan Prout, BSAP
1
Education & Training
Tradition & Ritual
Modern Approach
Strategic Management
Siobhan Prout, BSAP
2
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
3
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
4
Source
• Patients- acute disease, incubation
period, colonised but asymptomatic or
chronic carriers.
• Endogenous flora
• Health care personnel
• Environment,
• Equipment, medications.
• Visitors
Siobhan Prout, BSAP
5
Host
Factors effecting :
• age
• underlying disease
• medications e.g. antibiotics, steroids
• irradiation
• skin integrity
• indwelling devices
Siobhan Prout, BSAP
6
Transmission
• Contact
• Droplet
• Airborne
• Common vehicle transmission
• Vectorborne
Siobhan Prout, BSAP
7
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
Siobhan Prout, BSAP
8
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
9
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
Siobhan Prout, BSAP
10
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
Siobhan Prout, BSAP
11
Implementation of standard precautions
Safety devices & technology; Phlebotomy
Siobhan Prout, BSAP
12
Implementation of standard precautions
Safety devices & technology; Cannulation
Siobhan Prout, BSAP
13
Implementation of standard precautions
Safety devices & technology; Subcutaneous
infusions
Siobhan Prout, BSAP
14
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
Siobhan Prout, BSAP
15
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
Siobhan Prout, BSAP
16
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
Siobhan Prout, BSAP
17
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.
Siobhan Prout, BSAP
18
Reason’s model on accident
causation
• Active errors : those having an
immediate effect
• Latent errors : conditions that lie dormant
until activated by active errors.
Siobhan Prout, BSAP
19
Reason’s model on accident
causation
Organisational
Local management
Unsafe acts
Siobhan Prout, BSAP
Safeguards
20
Reason’s Model on Accident
Causation
Danger
Organisational problems
Local Management
Unsafe Acts
Safeguards
Injury
Siobhan Prout, BSAP
21