Download handout - Mount Sinai Hospital

PREVENTING THE SPREAD OF INFECTION AT MSH
Mount Sinai Hospital has instituted a system of infection control practices which will prevent transmission of hospital
acquired infections to the patients and at the same time provide protection to the health care worker. This system has
been successful but it is dependent on co-operation from all personnel. This document has been prepared to advise and
guide you of the actions you must take to protect your patients, yourself and visitors.
1. Communicable Disease Surveillance policies are required by law for all persons carrying on activities in the
institution. In the event of an exposure there is need to provide timely information on your status, in order to
determine whether you or your patients may be at risk of infections.
You are required to have blood tests to determine your serologic status and:
a)
If you are susceptible, be vaccinated against:
 Rubella (German measles)
 Rubeola (Red measles)
b)
You shall know your own serologic status to:
 Varicella (Chickenpox)
If you are susceptible to varicella, report any exposure at home or work. Avoid caring for patients with
shingles, chickenpox or disseminated zoster.
It is also required that you participate in the Tuberculosis surveillance protocol:
 Tuberculosis (TB) requires initial screening, continuing annual surveillance and contact follow-up for all staff.
The following are highly recommended:
 Hepatitis B vaccine (to protect yourself)
 yearly influenza vaccine (flu shot) (to protect your patients)
Report to the Occupational Health and Safety Department (60 Murray Street, 416-586-4800x 1572 or x 6435) when you
have:
 suffered a needlestick or other sharps injury
 been exposed to blood or body fluids
 been exposed to (at home or work) someone with an infectious disease such as:
• meningitis
• chickenpox
• tuberculosis
 been asked to do so by Infection Control
 diarrhoea and/or vomiting while at work
 fever >38 C with respiratory symptoms or fever > than 38 C and feeling unwell or been diagnosed with pneumonia
2. Standards of patient care practice will minimize the risk of transmission of infections to patients. Routine Practises
(Body Substance Precautions) is a system of practice which requires all health care workers to consider all body
substances (blood, body fluids, secretions, excretions, drainage) from all patients as potentially infectious. The
following workplace standards will be maintained by all health care workers for contact with all patients all the time.
Hand Washing: Wash hands for 10 seconds before and after patient contact, after touching contaminated equipment or
surfaces, after examining a dirty body area (eg.wound) and before examining a clean body area (eg.eye) on the same patient,
and after removing gloves.
Gloves: Glove for anticipated contact with mucous membranes, non-intact skin, moist body substances and undiagnosed
rashes for ALL patients ALL the time. Wash hands after removing gloves. Report to Occupational Health if skin irritation
occurs.
Gowns, Masks and Goggles: Wear a cover gown, mask or goggles as necessary for procedures in which you are at risk of
being splashed with moist body substances from any patient.
Handling of Sharps: Discard sharps in disposal container provided. Avoid recapping needles. If recapping is necessary, use
a one-handed method of recapping to avoid injury. You are required to remove all sharps from procedure trays you have used.
Pass needles or sharp instruments in a way to avoid injury to others.
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Lab specimens:
Send specimens to the lab safely:
 assure that all specimen collection containers are closed securely
 put all specimens in zip-lock plastic bag, and the requisitions in the outer envelope of the bag
 Specimens sent to laboratories with needles attached will not be processed. If a specimen has
been collected using a needle and you are concerned about losing it, call the specific lab for
details
Diseases or infections spread by the Airborne Route: When patients are suspected or confirmed to have diseases spread
by the airborne route a room with a specific air handling unit is required.
Common diseases transmitted by the airborne route include:
• Tuberculosis
• Chickenpox
• Disseminated Herpes zoster (shingles)
Airborne isolation rooms in Mount Sinai are:
1807, 1618, 1418, 1215, 1202 and 1203 (for med/surg patients), 307 in emergency and 710 (for Obstetrical patients,
only)
Patients who are admitted through emergency, will be maintained in treatment room 307 (which is fitted with appropriate
ventilation), and must be transferred to one of the appropriate rooms within 12 hours.
Multidrug resistant organisms: are becoming more prevalent in health care institutions. The two resistant organisms of
greatest concern currently are Methicillin resistant Staphylococcus aureus (MRSA) and Vancomycin resistant
Enterococci (VRE). Both organisms are easily transmitted in the hospital, and both have occurred in Toronto health care
facilities. These organisms are more common in the United States and other countries than in Canada.
You can help control the spread of these organisms by:
1. Optimal handwashing
2. Cleaning shared equipment appropriately (e.g. wiping your stethoscope with alcohol between patients.)
3. Calling the Infection Control office at 3118, and leave a message when you admit anyone who has been hospitalized
outside of Canada in the last year (including a direct transfer from an out of country hospital). Infection Control will arrange
for epidemiological surveillance for MRSA and VRE for these patients.
4. Being aware that some of your patients, at any given time might be screened for MRSA or VRE as part of routine
surveillance for these organisms.
When a patient is identified as being infected or colonized with a multidrug resistant organism, specific precaution
standards will be initiated, managed and discontinued only by Infection Control.
5. Cleaning, Disinfection and Sterilization of Reusable Equipment and Material: Reusable patient-care materials,
devices or equipment can transmit organisms if not properly reprocessed according to accepted standards. For those
whose practice is on site at Mount Sinai, you are expected to comply with those standards approved by Infection Control.
The Infection Control Team is available to assist anyone requiring help in establishing standards in your area.
6. Reportable Diseases: Physicians are required by law to report cases of reportable communicable diseases to the City of
Toronto, Public Health Department by calling (416)392-7411, or by completing (and sending) a communicable disease
reporting form. These forms can be found on the nursing units or ordered from stores at 5001.
Infection Control can be reach on a 24-hour basis through locating at 5133.
You can reach one of the Infection Control Practitioners from Monday to Friday 0900-1700 hours through locating at 5133 or
directly by calling Karen Baguley at 4570, Wayne Lee at 3119 or Sarah Eden at 4765.
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