Download Infection Control

Infection Control
Student Orientation
Basic, but important, Principles of Cross
Transmission
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Presence of
microorganisms on
hands or in
environment does
not necessarily =
cross transmission
or infection
Infection is multifactorial requiring
many cross –
linkages
•Epidemiologic
Triangle:
Healthcare Associated Infections
• Healthcare associated infections (HAI) are
the 4th leading cause of death in the U.S.
after heart disease, cancer and stroke
• There are:
– 2 million annually
– >100,000 deaths annually
– 20-30% are preventable
How Do HAI Stack Up Against Other
Adverse Events?
Adverse Events
Hospital Acquired Infections
•
•5% of admissions have HAI
• > 100,000 deaths annually
• $4.6 billion excess $/yr
•$600/Urinary Tract Infections
(UTI)
•$5000/pneumonia
•Up to $50,000/Blood Stream
Infections (BSI)
•Increase Length of Stay
•1-4 days/UTI, 7-8 days/BSI
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3-7% of admissions
have an adverse
drug event
140,000-180,000
deaths annually
$2 billion annually in
excess costs
Cost > $3,000 each
Increase LOS by
average of 2.2 days
Sites of Healthcare Acquired
Infections
• Usual Causative Organisms
» Urinary tract:E. Coli, Enterococcus species
» Lower Respiratory (pneumonia or bronchitis)
Klebsiella, Pseudomonas
» Surgical Wounds: Staphylococci, Site dependent
» IV: Staphylococci, not aureus
Symptoms of Infection
• Abnormal labs
• Diarrhea vomiting
• Confusion mental
changes
• Respiratory secretions
• Abnormal breath
sounds
• Cloudy, painful, foul
smelling freq. Urination
• Temperature : <97
or >100.4 F.
• Chills/ sweats
• Cold extremities
• Redness, warmth,
swelling
• Rashes, boils
• Pain
Normal Body Defenses
• Mechanical: intact skin; mucous
production; cilia, digestive enzymes, skin
acidity etc.
• Nonspecific Responses: WBC phagocytic
response, fever, inflammation, nonspecific antibodies, t-cells for antigen
binding
• Specific Response: Production of antigenspecific antibody, immunoglobulins
The Hospitalized Patient: A Human at Risk
• Break in the barrier of the skin
• Tubes crossing mucous membranes
• Medications altering the natural barriers of
digestive pH/immune function
• Decreased ability to use lung capacity
• Foreign microbial environment
• Disease processes of immune system
Prevention of IV Catheter Related
Infection
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WASH HANDS
Wear Gloves
Cleanse Site: CHG, air dry
Do not re-palpate
Choose appropriate catheter
Prevention of Healthcare Acquired Pneumonia
• Patients at high
risk for
aspiration:
–Ventilated
patients
–Patients with
enteral tube
–Patients with
decreased gagreflex
Interventions:
–Maintain Head of Bed
@ 30-45 degree angle if
possible
–Routinely check
location of feeding tube
–Routinely assess
intestinal motility to avoid
distention: bowel
sounds, gastric volume
before tube feeding
Prevention of HA Pneumonia Cont.
• Prevent Gastric
Colonization
•Use agents for prophylaxis of
gastric ulcers which do not raise
the gastric pH
•Wear gloves during suctioning
or contact with respiratory
secretions
•Use only sterile fluid for
respiratory secretion removal
(none when possible)
•Replace gloves with clean pair
after contact with contaminated
body site and before contact with
respiratory tract.
Prevention of HA Pneumonia Cont.
• Postoperatively:
– Cessation of smoking
– Encourage coughing and deep breathing,
including use of incentive spirometer
– Early ambulation
– Pain control-analgesia and splinting
– High risk patients: abdominal, head, neck or
thoracic surgery and underlying respiratory
disease are at higher risk for pneumonia
Prevention of Surgical Site
Infections
•Preoperative measures Free of remote infections
Preparation of the surgical site: prep agent,
non-invasive removal of hair, prophylactic
antibiotics
Intraoperatively:
Sterile technique
Limit trauma
Limit traffic in room
Postoperatively:
Aseptic wound care
Wound healed in 48-72 hours
Sharps Injury Prevention:
• Protect yourself and others- Use Sharps
with Safety Features
• BE PREPARED
– Anticipate injury risks and prepare the
patient and work area with prevention in
mind. Use a sharps device with safety
feature whenever it is available.
Exposure
• The definition of Exposure is Blood or other
potentially infectious material in contact with
non-intact skin or mucous membrane
– needlestick or cut/poke with sharp blood bearing item
– splash to eyes, nose, or mouth
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What to do if you have an exposure to a bloodborne
pathogen
Wash or flush area of exposure for 15 minutes
Notify Manager/Director, Order Needlestick Profile
Call Employee Health or if after 4:30 PM,Weekend or
Holiday, Call Clinical House Supervisor
Fill out incident report
Standard Precautions: The Cornerstone
of Infection Control
• Mask
•
wear face masks and eye protection whenever there is a
possibility of blood splashing into your face
• Gloves
•
wear gloves whenever there is a possibility of coming in contact
with blood or other potentially infectious materials (body fluids
and tissues)
• Gowns
•
wear full-body gowns whenever there is a possibility of blood
splashing onto you
Contact Precautions
• GLOVES-worn whenever you enter the patient
room; remove on exiting room
• HANDWASHING-with soap and waterwhenever you remove gloves
• Private Room
• Dedicate Equipment
• Gown for substantial contact
Droplet Precautions
• Private Room
• Mask Needed
• Gowns, Gloves, and Patient Equipment
the same as for Standard Precautions
• Transport: Patient must wear mask
Airborne Precautions
• Negative Pressure Room
• Mask Required (for TB, N95 mask
necessary)
• Gowns, Eyewear, Gloves & Patient
Equipment same as for Standard
Precautions
• Transport: notify receiving unit; place
mask on patient
Stay Safe!!!!