Pandemic Influenza Infection Control Measures

Transcription

1 NHS Greater Glasgow & Clyde Partnerships Pandemic Influenza Infection Control Measures Guidance for Community Staff April 2009

2 Introduction This presentation aims to provide you with the key information you will need to protect yourself and others from risk of contracting pandemic flu. This presentation has been adapted for community staff from the NHS Education for Scotland Influenza training module, Pandemic Flu. Infection Control Measures (May 2008).

3 What is Ordinary Flu? Thousands of Scots catch ordinary flu every year, especially in winter. Most will feel ill for a few days or a week before recovering. A small number of very young, very old and vulnerable people may become ill and die, usually due to complications involving their lungs. Annual vaccination is available for those at risk of serious illness.

4 What is Pandemic Flu? Pandemic means a disease is so widespread that many people in many countries across the world catch it. Pandemic flu is a much more serious form of flu that happens when a new, more virulent type (or strain ) of the flu virus emerges and is spread from person to person. There were three flu pandemics during the 20th century. A vaccine against pandemic flu can only be developed once the type (or strain ) emerges it can t be done beforehand.

5 How is Pandemic Flu Spread? Pandemic flu is spread from person to person through close contact. The virus that causes the flu is found in the moisture created when an infected person coughs or sneezes. The moisture called droplets - can be propelled about one meter when coughing or sneezing. The droplets land on nearby surfaces such as tables, bed linen and door handles. Flu can be passed to the next person when he or she touches these surfaces or is in close contact with an infected person who is coughing or sneezing.

6 Pandemic Flu Infection Control Measures These include:- Patient placement Hand Hygiene Personal Protective Equipment Decontamination of equipment Decontamination of the environment Disposal of waste Cough Etiquette

7 Patient Placement Where possible, patients with flu-like illness should be encouraged to phone NHS 24 or GP surgery for advice. If patient must come to the surgery provide separate entry and waiting areas. If possible place patient with flu-like symptoms into single room, preferably with hand wash sink. Home visits should be minimised to essential visits only.

8 Hand Hygiene Regular and effective hand hygiene is the single-most important thing you can do to protect yourself and others from pandemic flu. Hand hygiene is essential when you are working with patients with pandemic flu.

9 Hand Hygiene Droplets can be transferred to your hands by a number of means, including: Patients coughing or sneezing close to you. Touching surfaces, furnishings, fittings and items in the patient environment on which droplets have settled. Handling any waste products from the patient (urine, vomit, faeces or sputum, for example, or items covered with these).

10 Hand Hygiene Your hands naturally have flora on them which help to protect the skin, these don t pose a risk to yourself or other people. During the course of a day, however, your hands will acquire lots of other microorganisms that can cause harm. It is these microorganisms that hand hygiene aims to get rid of. When working with patients with pandemic flu, it s important to carry out hand hygiene at regular intervals to remove any droplets containing the virus. Hand contamination will sometimes be obvious, but not always.

11 You must carry out hand hygiene:- Before and after any direct patient contact. Before and after entering the environment of patient with confirmed or suspected flu. Before putting on personal protective equipment and after taking it off. Whenever hands are visibly dirty. Any other time you feel it is necessary. It may be necessary to carry out hand hygiene between tasks on the same patient.

12 When caring for patients, the daily routine can be summed up in what s called:

13 The correct way to wash your hands using liquid soap and water Remove any rings, watches etc Turn on taps without touching them (use elbows, wrists or paper towel) Find a comfortable temperature Wet your hands and then apply liquid soap Rub your hands vigorously for at least 15 seconds Rinse off all soap Dry with paper towels Turn off taps without touching them (use elbows, wrists or paper towel)

14 Hand Hygiene Where water is not available alcohol hand gel can be used to carry out hand decontamination providing the hands are visibly clean. Community staff should carry with them a personal dispenser of alcohol hand gel for home visits. Hand hygiene with alcohol hand gel involves using the same manoeuvres as those used during hand washing. Alcohol hand gel is not appropriate if the patient is experiencing vomiting and/or diarrhoea.

15 Hand Hygiene Technique using liquid soap and water or alcohol hand gel

16 Personal Protective Equipment (PPE) PPE is designed to protect you and others from droplets in the air and body fluids that might cause infection to be passed from one person to another. PPE will only work well if you are able to put it on, use it, remove and dispose of it in the correct manner. An error at any of these stages can cause risk of spread of flu.

17 PPE

18 Gloves Gloves should be worn for routine care of suspected/confirmed flu patients. Gloves should be worn when contact with blood and/or body fluid is anticipated. Hand hygiene must be performed after gloves are removed. Gloves must not be re-used. Gloves should be changed between different patients and may require to be changed between different tasks on the same patient. Gloves do not replace the need for hand hygiene.

19 Aprons Disposable plastic aprons should be used for routine care of suspected/confirmed flu patients. Disposable plastic apron should be worn when splashing/contact with blood and/or body fluid is anticipated.

20 Face Masks A surgical face mask should be worn for close contact (within one meter) with patients suspected of having flu. It may not be practical to change your face mask between patients if they are grouped in the same area and you are moving rapidly between them. Other PPE (such as disposable gloves and aprons) must be removed between patients and hand hygiene performed.

21 Face Masks A face mask should:- Cover your nose and mouth. Not be touched once on. Not be allowed to dangle round your neck. Be changed if it becomes moist. Be taken off and disposed of after use. It s important not to touch the area covering your nose and mouth when taking the mask off only handle it by the ties that fit round your ears or at the back of your head. Remember to perform hand hygiene after removing the mask to remove any unwanted microorganisms from your hands.

22 FFP3 Respirator Type Masks An FFP3 respirator type mask should be worn when carrying out aerosol generating procedures on confirmed flu patients. Examples of aerosol generating procedures include:- chest physiotherapy nebulisation therapy nasal and oral suction CPR

23 If you have to use a FFP3, you should be fit-tested and trained in its use. A fit-check should be carried out prior to every use to ensure a good fit and tight seal to your face. FFP3 respirators should be changed during use if: You find breathing is becoming difficult The respirator becomes damaged The respirator is obviously contaminated Proper fit cannot be maintained Respirators should be replaced after each use and disposed of as clinical waste. Remember to perform hand hygiene after removing the FFP3 respirator to remove any unwanted microorganisms from your hands.

24 Eye Protection Eye protection should be worn when there is a risk of droplets or other body fluids getting into your eyes and during aerosol generating procedures. Eye protection can be goggles/full face visor. Eye protection should be decontaminated between uses following manufacturers instructions or disposed of if single-use. Personal spectacles are not considered eye protection. Remember to perform hand hygiene after removing eye protection to remove any unwanted microorganisms from your hands.

25 Putting on PPE The type of PPE used will vary based on the type of exposure anticipated, and not all items of PPE will be required. The order for putting on PPE is apron, mask, eye protection and gloves. Perform hand hygiene before putting on PPE. Remember to perform hand hygiene before putting on PPE and following removal.

26 Kirsty fe2 Kirsty fe5 Removing PPE

27 Slide 26 Kirsty fe2 Add at top of slide - In order to minimise contamination PPE should be removed in the following order. Kirsty fe5 At the bottom of the slide change perform HH before putting on PPE to - Perform hand hygiene before putting on PPE and after removal. Kferguson1, 01/05/2009 the pictures for eye protection and mask do not correlate with the text. The text under 'aprons' advises that aprons are removed over the head (as per NES presentation) - can we remove Kferguson1, 01/05/2009

28 Decontamination of Equipment The flu virus may survive on equipment for several hours. Reduce as far as possible the amount of equipment used on patients with suspected/confirmed flu. Avoid sharing equipment where possible. Decontaminate equipment using detergent wipes, or detergent and water, followed by thorough drying unless recommended otherwise by manufacturer/infection control team. PPE must be worn when decontaminating equipment.

29 Decontamination of the environment cont The flu virus can survive in the inanimate environment for several hours. Keeping patient areas clean is referred to as environmental cleaning. As a minimum, patient areas should be cleaned daily, using a solution of freshly prepared detergent and warm water. In order to aid cleaning reduce as far as possible the amount of non-essential furniture and equipment, e.g. soft furnishings, toys, newspapers and magazines, in consultation rooms.

30 Decontamination of the environment Any area where a suspected flu case has been reviewed must be cleaned immediately following the consultation. Follow Infection Control guidance when carrying out cleaning. Disposable gloves, aprons and face masks should be worn when you are cleaning an area where a suspected/confirmed case has been reviewed. Any contamination with blood and/or body fluids must be decontaminated in accordance with local policy.

31 Kirsty fe3 Disposal of Waste No measures in adddition to those already in place are required when disposing of waste. Within the Healthcare setting items contaminated with infectious agents should be discarded as clinical waste. Patients should be encouraged to place disposable tissues into a clinical waste bag while in the healthcare setting. In the home setting items such as tissues and PPE should be discarded into the domestic waste bin.

32 Slide 30 Kirsty fe3 Add at top of slide - No special handling in addition to measures already in place are required when disposing of waste. Kferguson1, 01/05/2009

33 Cough Etiquette The precautions we take when coughing or sneezing come under the banner of cough etiquette. All patients, staff and visitors should be encouraged to carry out good cough etiquette.

34 Cough Etiquette cont Good cough etiquette means: Covering the nose and mouth with disposable tissues when sneezing, coughing, wiping and blowing nose. Disposing of used tissues promptly in the nearest waste bin or provide a bag for immediate disposal. Performing hand hygiene after coughing, sneezing, using tissues or coming into contact with secretions. Keeping hands away from the eyes, mouth and nose.

35 If you Develop Symptoms If you feel ill while at work: Report it to your Line Manager or Occupational Health Department. Do not carry on working. If you develop symptoms while off duty: Stay at home do not go to work. Phone your Line Manager. Call your GP or NHS24. Phone Occupational Health Department.

36 Infection Control Policy For the most up-to-date version of the NHS Greater Glasgow and Clyde policy please link to the infection control site at: [ Look in the Policies section to access the most recent version of all the Greater Glasgow and Clyde policies: Core Prevention Policies Disease Specific Policies Standard Operating Procedures

37 Any queries or concerns should be directed to the Infection Control Team. As any new information relating to Pandemic Influenza is received by the Infection Control Team this will be disseminated appropriately.

38 The Prevention & Control of Infection Team Sarah Freeman Alison Edwardson Lynn Pritchard Lesley Symons Kirsty Ferguson Elizabeth Marshall Stella MacPhee Gillian Farmer Dr Alison Balfour Head Infection Control Nurse Senior Infection Control Nurse Senior Infection Control Nurse Senior Infection Control Nurse Senior Infection Control Nurse Senior Infection Control Nurse Infection Control Nurse Infection Control Nurse Consultant Microbiologist Office Hours Urgent enquiries (out-of-hours) via Parkhead switchboard on: