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Safety now
Thalassemia Center
Protect
Yourself
• Know blood borne pathogens
• Follow standard precautions
• Get the Hepatitis B vaccine
• Know what to do in case of
an exposure
What Fluids
ARE
• Blood or any body fluid
Considered a visibly contaminated with
blood
Risk for
Bloodborne •
Pathogenes •
•
(BBP)
Semen
Vaginal secretions
Spinal, pleural, peritoneal
pericardial, amniotic and
synovial fluids
• Breast milk (not all agree)
• Saliva from dental
procedures
What Fluids
ARE NOT
Considered a
Risk for BBP
 Urine
 Sweat
 Nasal discharge
 Saliva (non dental)
 Feces
 Tears
 Vomit
But ALWAYS use gloves
when cleaning up any of
these fluids
Concentration of HBV in Body Fluids
High
Blood
Serum
Wound exudates
Moderate
Semen
Vaginal Fluid
Saliva
Low/Not Detectable
Urine
Feces
Sweat
Tears
Breast Milk
How Are They
Spread?
• contaminated fluids in contact with
open skin (cuts, abrasions)
• contaminated sharp objects that cut
or puncture the skin
• contaminated splash with eyes,
mouth, or nose
• sharing needles
• sexual contact
Hepatitis B
Virus
•
•
•
•
•
•
100 times more infectious vs.
HIV
Can live on dried surfaces for
one week
6-30% chance of infection from
an exposure (puncture wound)
85-90% of those infected will
recover in 6-8 weeks
10-15% will become carriers
and develop chronic liver
disease
Vaccine preventable – 3 doses,
highly effective
Hepatitis
C Virus
• Risk for exposure from a
contaminated puncture
wound - 3.3% - 10%
• Most transmission is
transfusion or IV drug use
related
• About 4 million people are
infected
• Chronic infection develops in
80%
• Not vaccine preventable
HIV
• Very fragile virus and will not
survive long outside the body
• Risk of transmission through a
needlestick or cut with HIV
infected blood is 0.3%. A
splash to the eyes or nose or
mouth is 0.1%
• Risk to non-intact skin to HIV
infected blood is estimated to
be less than 0.1%
Standard
Precautions
1. Hand washing
2. Barrier protection
– Gloves
– Mask, Eye Protection ,Face Shield
– Gown
3.
4.
5.
6.
Practice Safe Clean Up In All Situations
Patient Care Equipment
Linen
Occupational Health and Blood borne
Pathogens
7. Patient Placement
Table 2-1. Standard Precautions: Key Components
Handwashing (or using an antiseptic handrub)
􀁸􀁸 After touching blood, body fluids, secretions, excretions and contaminated items
􀁸􀁸 Immediately after removing gloves
􀁸􀁸 Between patient contact
Gloves
􀁸􀁸 For contact with blood, body fluids, secretions and contaminated items
􀁸􀁸 For contact with mucous membranes and nonintact skin
Masks, goggles, face masks
􀁸􀁸 Protect mucous membranes of eyes, nose and mouth when contact with blood and
body fluids is likely
Gowns
􀁸􀁸 Protect skin from blood or body fluid contact
􀁸􀁸 Prevent soiling of clothing during procedures that may involve contact with blood
or body fluids
Linen
􀁸􀁸 Handle soiled linen to prevent touching skin or mucous membranes
􀁸􀁸 Do not pre-rinse soiled linens in patient care areas
Patient care equipment
􀁸􀁸 Handle soiled equipment in a manner to prevent contact with skin or mucous
membranes and to prevent contamination of clothing or the environment
􀁸􀁸 Clean reusable equipment prior to reuse
Environmental cleaning
􀁸􀁸 Routinely care, clean and disinfect equipment and furnishings in patient care areas
Sharps
􀁸􀁸 Avoid recapping used needles
􀁸􀁸 Avoid removing used needles from disposable syringes
􀁸􀁸 Avoid bending, breaking or manipulating used needles by hand
􀁸􀁸 Place used sharps in puncture-resistant containers
Patient resuscitation
􀁸􀁸 Use mouthpieces, resuscitation bags or other ventilation devices to avoid mouth-tomouth
resuscitation
Patient placement
􀁸􀁸 Place patients who contaminate the environment or cannot maintain appropriate
hygiene in private rooms
Standard
Precautions
WHY
To prevent the transmission of
infectious agents.
• from patient to patient.
• from patient to health worker
• Form health worker to patient
Stop
Infection
Infection
Infection
Infection
Entry
Break the
Chain
Reservoirs
Exit
Host
Trans mission
Standard
Precautions
Apply to
1) blood
2) all body fluids,
secretions, and excretions
except sweat, regardless
of whether or not they
contain visible blood;
3) non-intact skin
4) mucous membranes
Standard
Precautions
when ?
with whom?
• All the time
• with all the patients
Hand
washing
Why
By what
When
How
Hand
Washing
• Why:
• Hand washing is your first defense in
infection control.
Handwashing
what to use ?
• Handwashing with soap and water in non-health care
settings
• When health care personnel's hands are visibly soiled,
they should wash with soap and water.
• When health care personnel's hands are not visibly
soiled , use alcohol-based handrubs
• Handrubs and hand washing should be observed before
and after each patient.
Hand
Washing
When:
􀁸 After contact with blood or other
body fluids
􀁸 Before and after handling a patient
􀁸 Between glove changes
􀁸 Before and after eating/smoking
􀁸 After using the rest room
Types of hand
washing:
Social Hand washing
Hygienic hand washing or
Antiseptic hand washing
Surgical Hand washing
Alcohol hand rub
Hand
Washing
How to do It Right!
1.
First wet Wet hands under running water and apply nonabrasive soap
2.
Next Vigorously rub palms,back of hands, between fingers, and wrists for 15 –
20 seconds
Rinse well and dry your hands dry with paper towel (not cloth towel or other
fabric)
3.
4.
Avoid chapped and cracked hands if possible. Use a water-based hand lotion
frequently. Petroleum-based products and Vaseline break down latex.
Why alcohol
based hand rub?
• Alcohol-based hand rubs take less time to use than
traditional hand washing.
• Alcohol-based handrubs significantly reduce the number
of microorganisms on skin and are fast acting
• Allergic contact dermatitis due to alcohol hand rubs is
very uncommon.
Efficacy of Hand
Hygiene Preparations in
Killing Bacteria
Good
Plain Soap
Better
Antimicrobial
soap
Best
Alcohol-based
handrub
Questions
Personal
Protective
Equipment (PPE)

Is specialized clothing or
equipment worn or used by
you for protection against a
hazard.

It helps to interrupt the
transmission of microorganisms between patients
and staff.
Gloves
 Wear gloves (clean, nonsterile ) when touching
–
–
–
–
–
blood,
body fluids, secretions, excretions,
contaminated items.
just before touching mucous membranes
just before touching nonintact skin
 Change gloves
– between tasks and procedures on the same patient
– after contact with material that may contain a high concentration of
microorganisms
 Remove gloves promptly
– after use,
– before touching noncontaminated items and environmental surfaces
– before going to another patient,
Gloves
 Does not eliminate the need for hand hygiene.
 Hand hygiene does not eliminate the need for gloves.
 Gloves reduce hand contamination by 70 percent to 80 percent
 Gloves should be changed before and after each patient.
 Hands must be washed after removal because gloves may be punctured
and your hands are easily contaminated as the gloves are taken off.
 Gloves must be discarded after each procedure.
WEAR
-Mask
-Eye Protection
-Face Shield
To protect eyes, nose, and mouth during procedures and patientcare activities that are likely to generate splashes or sprays of
blood, body fluids, secretions, and excretions.
Such activities are not commonly encountered in ward
settings
•
•
•
•
•
respiratory suction
scrubbing of instruments
endoscopy,
management of women in labor
surgical procedures, particularly orthopedic and cardiac surgery.
Wear a gown
• Wear a gown to protect skin and to prevent soiling of
clothing during procedures and patient-care activities
that are likely to generate splashes or sprays of blood,
body fluids, secretions, or excretions.
• Select a gown that is appropriate for the activity.
• Remove a soiled gown as promptly as possible, and
wash hands
• Avoid actions which may splash, spray or splatter or
create droplets. Never pipette or suction infectious
materials by mouth.
Practice Safe Clean Up In All Situations:
– Do not
• recap used needles
• remove used needles from disposable syringes by hand,
• bend, break, or otherwise manipulate used needles by hand.
• pick up sharps with bare hands - use tongs/dust pan and broom
– DO
• Use gloves
• Place disposable sharp items in appropriate puncture-resistant containers for disposal,
• place reusable syringes and needles in a puncture-resistant container for transport to
the reprocessing area.
• Always handle trash as if a sharp might be present
• Use mouthpieces, resuscitation bags, or other ventilation devices as an
alternative to mouth-to-mouth resuscitation methods
– Take care when
•
•
•
•
using needles, scalpels, and other sharp instruments
handling sharp instruments after procedures;
cleaning used instruments;
disposing of used needles. Never,
Engineering Controls:
Safe needle devices
Needle less IV
connectors
Sharp Safe
containers
One hand scoop method
Retractable Needle
Safety shield
Sharp Safe Policy:
Used sharps should be handled as little as possible to
minimize the risk of injury.
Needles must not be re-sheathed. If a needle and syringe needs to
be disassembled then it should first be re-sheathed using a single
handed technique.
Sharps must be discarded immediately after use into a designated
sharps container.
Sharps must never be carried in the hand to the point of disposal,
but either carried in a tray or a sharps container brought to the point
of use.
They should not be passed by hand between staff.
Needles should not be removed from syringes but discarded as a
single unit.
The bins must never be more than ¾ filled, sharps protruding from
the aperture of a sharps bin present a major hazard to other users.
Bins must be securely closed and labeled with the date and point of
origin before being sent for disposal.
Where blood or other potentially infectious
materials are present, never
– Eat
– Drink
– Smoke
– apply cosmetics
– or handle contact lenses
Practice Safe Clean Up In All Situations:
• Use biohazard label for all infectious waste
• Use leak proof, closable, puncture resistant and
labeled Containers
• Separate Biohazard waste from regular waste
• Keep Bagged biohazard waste in the container
through out disposal
Practice Safe Clean Up In All Situations:
Patient-Care Equipment
• Handle used patient-care equipment soiled
with blood, body fluids, secretions, and
excretions in a manner that prevents skin and
mucous membrane exposures, contamination
of clothing, and transfer of microorganisms to
other patients and environments.
• Ensure that single-use items are discarded
properly.
• Reusable equipment should be decontaminated
after use.
Environmental hygiene:
Cleaning and disinfection of the environment:
Concurrent cleaning – all surfaces should
be cleaned using the approved disinfectant.
Terminal cleaning – after discharge of the
patient with infection, room should be
disinfected using approved disinfectant.
Care of Linen:
Used linen is potentially an infection risk especially if it is
contaminated with blood or body fluid substances.
Handle, transport, and process used linen soiled with blood, body
fluids, secretions, and excretions in a manner that prevents skin
and mucous membrane exposures and contamination of clothing,
and that avoids transfer of microorganisms to other patients and
environments
Render the linen “safe” by heat disinfection (usually the linen is
thermally disinfected at the highest temperature the material will
withstand 65º C for at least 10 minutes or 71 º C for at least 3
minutes).
Patient
Placement
• Place a patient who contaminates the
environment or who does not (or cannot be
expected to) assist in maintaining appropriate
hygiene or environmental control in a private
room.
• If a private room is not available, consult with
infection control professionals
Screening and Immunization:
New Employees:
All new employees are screened by Staff
Clinic for Hep B and HIV.
Chest X-ray will be done to rule out
pulmonary Tuberculosis.
New employees in high risk areas - Nasal
screening done.
In the Event of a Sharps Injury
1.
2.
3.
4.
5.
6.
Wash the area thoroughly with soap and water.
Cover with a waterproof dressing.
Inform your In Charge or Supervisor.
Document the injury on an incident form.
If known – note the details of the patient on whom the object
has been used.
Report to the Employee Health Department staff clinic) or
Emergency room.
In the Event of a conjunctiva/ Mucous Membrane splash:
1.
2.
If splashed with blood/ body fluids irrigate with copious
amounts of water;
follow steps 4 – 6 above
COLOUR CODING OF WASTE
DISPOSAL BAGS
BLACK BAG : For Disposing all types of
General Wastes :
Papers
Tissue papers
Paper Towels
Wrappers of hospital supplies
Bottles
Tin cans; Food wastes
Waste Disposal:
Pathological/Clinical Waste:
This is defined as waste which is contaminated with potentially
infectious substances e.g., blood, fecal matter, human tissue,
used dressings etc.
This waste should be disposed off in a Biohazard Bag (YELLOW
BAG).
Non pathological Waste/ Non Clinical Waste:
• This includes items such as office paper, paper towels, wrapping
for sterile packs and other health care waste which is not
contaminated with probably infectious substances.
• This waste should be disposed of in a BLACK BAG.
YELLOW BAG :
For Disposing Pathological Wastes (Any waste contaminated with
Blood & Body fluids, secretions, excretions and sharps etc.) :
Blood and Body Fluids Catheters
Wound Dressings
Syringes
IV Tubings /Sets
IV Dressings
Central Lines
Gloves
Suction Tubings
Blood Transfusion sets
Sealed Sharp Safe
Boxes
Redivac Drains
Nasogastric Tubes
Sanitary pads
Soiled Diapers
Secretions / Excretions
Laboratory specimens
SINGLE PATIENT USE DEVICES
Contd…..
Blood spill kit and Mercury spill kit:
These are available with the domestic staff
and they are trained to use these kits.
Cleaning other facilities and equipments is
done on a routine basis.
EMC (Equipment Maintenance Center):
All equipments are sent to EMC for cleaning
and disinfection .
Contd……
Items that undergo sterilization are sent to
CSSD situated outside the hospital complex.
After the sterilization process the items are
Packed and returned to the respective areas,
ready for use.
Contd……..
Screening of water supply is done on weekly
Basis through Engineering Dept.
Environmental screening is done in certain
High risk areas as per schedule.
Other Staff and environment screening will
be done if necessary, especially during
Outbreak investigation.
Work Practice Controls
• To clean up a blood spill you can carefully
cover the spill with paper towels or rags
• then gently pour the disinfectant over the
towels and leave at least ten minutes.
• Mops
TEST TIME
Now you can take the test