Download Cynthia Arseneau

Infection Prevention and Control:
365 Days a Year; Back to Basics
Presented by: Cynthia Arseneau, RN,
BSN, BSHNU
Manager of Clinical Education Programs
Outline
• How do diseases spread?
• How do we prevent the spread of diseases?
– Routine Practice and Additional Precautions
– Cleaning and Disinfection
– Vaccination
• Why does all of this matter?
Chain of Transmission
Infectious Agent
Fungus
Parasites
Bacteria
Reservoirs
• Are places where an
infectious agents live
and can reproduce in
such a manner that
can be transmitted
–
–
–
–
People
Food
Environment
Animals
Portal of Exit
Means of Transmission
Portal of Entry
• How the infectious
agent gets into a person
• Open skin
• Mucous membranes –
eyes, nose, mouth
• Gastrointestinal system
Do NOT
touch!
Susceptible Host
• Characteristics that affect susceptibility:
– Age
– Nutritional status
– Disease history
– Underlying illness
– Stress and fatigue
– Working shift work
– Lack of sleep
ROUTINE PRACTICE
http://www.infectionlandscapes.org/2011/08/gut-infections.html
Routine Practice
• Legislated under “Work Safe BC” occupational
health and safety act
• Consider all residents including body fluids,
blood, secretions, excretions, and specimens as
potentially infectious
• Minimum standards to be used by all healthcare
providers to protect the residents and staff from
potentially pathogenic (disease causing)
organisms
Clean Your Hands
• Alcohol based hand rub
is best method
• It is fast and simple
• Use soap & water if
hands are visibly soiled
How you clean your hands makes a
difference!
Effective Hand Hygiene!

wet hands first with warm water

apply 1-2 pumps (3 to 5 ml) of soap to hands

lather and rub hands together for at
least 15 seconds, covering all surfaces of your
hands and fingers
 weave fingers and thumbs together
and slide them back and forth
 ensure to get in between fingers and
at nails
Effective Hand Hygiene!


rinse hands thoroughly with warm water
use a single-use paper towel
to blot hands dry
use paper towel to turn off water faucet
What About Alcohol-Based
Hand Rubs?
 If hands are not visibly soiled or contaminated with blood or body
fluids, use alcohol-based hand rub for routinely cleaning your hands
 Alcohol-based hand rubs are more effective in reducing the number
of bacteria on hands than plain soap and water
 It is fast and simple
 Product must contain a minimum of 70% aclohol in order to be
effective against noro-like viruses (Norwalk)
Tips on Using Alcohol Based Hand Rub
 apply 1 pump (loonie size) of the alcohol gel to the
palm of one hand, and rub hands together
 cover all surfaces of your hands and fingers, including
areas around/under fingernails
 continue rubbing hands together until alcohol dries
 if you applied a sufficient amount of alcohol hand rub,
it should take at least 10 -15 seconds of rubbing
before your hands feel dry
Wear Gloves
• When performing tasks
that might contaminate
your hands
• Remove & discard
gloves when task
completed
• Clean your hands
When Not to Wear Gloves
Wear a Mask and Eye Protection
• For all coughing patients
• Especially if within 2
meters (6 feet) of the
client/resident
• Use a fluid resistance
mask with a visor or mask
and goggles
• Eye glasses do not count
as eye protection
Wear a Personal Protective Equipment
(PPE) as part of your routine:
• If your clothing MIGHT get contaminated
• Add mask & goggles if RISK of facial contamination
• Discard disposable gown, gloves, and mask in
garbage
Just Clean Your Hands
• After removing gloves or
body fluid exposure risk
• Before & after directly
touching a client/resident
and/or their environment
• Before administering or
assisting with medications
• If hands are visibly dirty
• After using the washroom
or coughing
What Is the Difference??
Routine Practice vs. Additional
Precautions
4 Types of Additional Precautions
1.
2.
3.
4.
Contact
Droplet
Droplet/Contact
Airborne
CONTACT PRECAUTIONS
• Gown and gloves are suggested for ALL direct
care given to a resident in their living space
• Disposable gowns and gloves are to be
removed and discarded in the garbage
• Perform hand hygiene before and after PPE
DROPLET PRECAUTIONS
• Used when a resident has a non-febrile
respiratory illness
• A fluid resistant mask with visor is suggested
whenever you will be within 2 meters of the
resident
• Hand hygiene is to be performed before and
after using PPE
DROPLET and CONTACT Precautions
• Used when resident has a febrile respiratory
illness like Influenza or if resident is vomiting
• Fluid resistant mask with visor, gown, and
gloves are suggested for all direct care given
to resident
• Hand hygiene MUST be performed before and
after using PPE
What is the difference between?
CLEANING AND DISINFECTION
Cleaning of Equipment
• Cleaning equipment between use is almost as
important as hand hygiene
• Clean first then Disinfect
• Contact time and friction make the difference
• Methods of disinfection
– Cloth with cleaner applied to it
– Pre-moistened wipes (OxivirTb® Wipes, Cavi® Wipes)
• Ensure wipes are not expired!
Vaccination
• 100 years ago infectious diseases were the
leading cause of death in the world
• In Canada now less than 5% of deaths are
related to infectious diseases
• Vaccination plays a huge role in decreasing the
number of deaths related to infectious disease
http://www.immunize.cpha.ca/en/default.aspx
Vaccination
•
•
•
•
•
•
•
•
•
•
•
•
•
Cholera
Diphtheria
Hepatitis A
Hepatitis B
Herpes Zoster (shingles)
Human papillomavirus (HPV)
Influenza (the flu)
Invasive Haemophilus Influenzae Disease
Invasive Meningococcal Disease
Invasive Pneumococcal Disease
Japanese Encephalitis
Measles
Mumps
•
•
•
•
•
•
•
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•
•
Pertussis (whooping cough)
Poliomyelitis (polio)
Rabies
Rotavirus
Rubella (German Measles)
Smallpox
Tetanus
Tick-Borne Encephalitis
Tuberculosis (BCG Vaccine)
Typhoid
Varicella (chickenpox)
Yellow Fever
http://www.phac-aspc.gc.ca/im/vpdmev/index-eng.php
Breaking the Chain
• Interrupting 1 or more links breaks the chain
of transmission
• This can be accomplished by:
– the use of routine practice
– additional precautions
– essential cleaning of equipment between
residents
Breaking the Chain con’t
•
•
•
•
•
cleaning high touch surfaces
2 meter spatial separation
respiratory etiquette
wound care/dressing changes
hand hygiene
Why Don’t We Do It In Our Sleeves?
VIDEO
What do you do when you are sick?
• If you have the following you should stay
home:
• Fever
• Vomiting
• Diarrhea
*If you have vomiting and/or diarrhea you should stay
home for 48 hours after your last episode of vomiting
and/or diarrhea because you are still contagious
Why does all this matter?
What does an outbreak mean for our
residents?
• Physical and social isolation to their
suites/rooms if they are sick
• Restrictions
• All large group activities are usually cancelled
for the duration of outbreaks
• With every outbreak a sick resident has in
increased risk of hospitalization and/or death
The End!
Always remember that what you do
and how you do it affects our
residents lives in many ways!