Katie Obergfell BSN, RN CIC Karen Brody BSN, RN

Transcription

1 Katie Obergfell BSN, RN CIC Karen Brody BSN, RN

2 Purpose of Infection Prevention Chain of Infection Standard Precautions Multi-Drug Resistant Organisms Isolation Procedures Blood borne Pathogens TB Employee Health and vaccinations

3 To prevent healthcare associated infections. These infections are caused by bacteria or viruses. As of 2011 there was an estimated 722,000 HAIs in US hospitals Resulting in 75,000 deaths With more than half of all HAIs occurring in areas outside of ICUs

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6 Hand hygiene Proper cleaning and disinfection of surfaces Identifying and isolating pathogens Practicing proper PPE

7 Technique Mechanical removal of transient microorganisms using FRICTION, soap, and water. Rub well for 20 seconds over ALL surfaces of hands, wrists, and thumbs. Indications When reporting to work, hands are visibly soiled, after using the bathroom, before eating, before patient care, after contact with a potentially contaminated item, before and after glove use, when leaving work

8 Hand sanitizers may also be used in the place of hand washing in certain areas and situations. Active ingredient is alcohol (flammable). Can only be used when hands are not visibly soiled. Has moisturizers to preserve skin integrity. Must allow to dry completely. Indications for hand sanitizers are before and after glove use, before and after patient contact, and upon entering and exiting a patient care area.

9 Clean your hands upon entering a patient-care area and upon leaving

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11 No artificial/long nails of healthcare staff or food prep/servers Bacteria/fungus can grow under the artificial nail and spread to the real nail In the late 1990s, eight infant deaths in a neonatal intensive care unit at an Oklahoma City hospital were caused by infections from bacteria spread by long fingernails on the healthcare staff.

12 What is meant by contact time? The amount of time the surface must remain visibly wet for the product to disinfect.

13 Use for: surface cleaning of patient care equipment between patients. 2 minute Contact Time Wipe and allow to air dry for 2 minutes

14 Used for cleaning in: Special Procedure areas. 3 minute Contact Time Wipe and allow to air dry for 3 minutes

15 SANI CLOTH BLEACH Use for: surface cleaning of patient care equipment for patients with C.diff. 4 minute Contact Time Wipe and allow to air dry for 4 minutes

16 Standard Precautions are the actions taken with every person at all times in order to limit person to person contact with potentially infectious materials (PIMs) Blood, body fluids, secretions, excretions, tissues, specimens

17 WE ALWAYS PRACTICE Hand Hygiene Respiratory Etiquette Keep your distance Cover your cough Use tissues Sanitize your hands Proper Use of Personal Protective Equipment

18 It is important to understand the severity of these organisms because everyone is at risk. MRSA Methicillin Resistant Staph Aureus VRE Vancomycin Resistant Enterococcus ESBL+ producing organisms Extended Spectrum Beta Lactamase C. diff Clostridium difficile

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20 Wounds In the community and in hospitals. Is usually spread by direct contact with infected wounds or contaminated hands, often spread by healthcare providers Hand Hygiene before and after patient care helps prevent the spread.

21 Resistant form of Enterococcus. Found in GI tract Hand Hygiene before and after patient care helps prevent spread.

22 Gram negative bacteria K. pneumonia E. coli Difficult to treat Hand Hygiene before and after patient care helps prevent spread

23 Bacterium that causes diarrhea and serious intestinal conditions. Alcohol based sanitizers do not kill C. difficile spores. The spores can live for weeks to months on surfaces. Must wash hands with soap and water. 0 percent of the patients who were diagnosed with C. diff die. However, some officials think the infection and death rates from C. diff may be much higher, as providers currently aren't required to report the presence of the bug.

24 Other organism can become resistant to antibiotics. This supermodel died from a resistant form of Pseudomonas. She had a UTI and it spread throughout her body. Her arms and feet were amputated in an effort to save her life. Unfortunately, they were unsuccessful.

25 If a patient has a multi drug resistant organism then they are placed on isolation. This is to prevent the spread of the organism. It protects patients and staff. Contact Precaution Airborne Precaution Droplet Precaution

26 Order to put on Gown Mask Gloves Order to take off Gloves Gown Mask Throw all of the PPE away in the room Perform hand hygiene

27 To be used for diseases and/or organisms transmitted by Person to Person skin contact and/or by sharing of equipment Known or suspected infection or colonization of multi drug resistant microorganisms. Used in Addition to Standard Precautions.

28 STOP CONTACT PRECAUTIONS Private room or Cohort ALTO Visitors: Report to Nursing Station before entering Visitantes: Reportarse a la ejtacion de enfermeria antes de entrar en la habitacion Wash Hands or use Alcohol Rub Entering room Before leaving room Gloves Wear gloves entering room Remove gloves before leaving room Gowns Wear gown entering room Remove gown before leaving room Patient Care Equipment Use patient-dedicated or single-use equipment when possible Clean and disinfect all shared equipment Patient Transport Maintain precautions during transport

29 To isolate Clostridium difficile Isolate anyone that has S&S and/or a positive test Must use soap & water for hand-washing since alcohol based sanitizers do not kill the C. diff. spore Room & surface cleaning must be done with a bleach solution Used in Addition to Standard Precautions.

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31 To reduce the transmission of large droplets that travel short distances by coughing, sneezing, or talking. These droplets are to heavy to be picked up in air currents. Used in Addition to Standard Precautions.

32 To be used for diseases that are transmitted by small particles circulating in the air and in air vents systems. Specially ventilated rooms (Negative Pressure) N95 respirator mask must be worn correctly to enter this room. Used in Addition to Standard Precautions

33 Applied for immunocompromised patients Also called reverse isolation We are protecting the patient from us, other patients, and the environment Doors are kept closed; gowns, gloves, and masks are to be worn by anyone who enters the room; and a mask applied to patient when being transported No fresh fruit or flowers Anyone who is known sick should not enter room

34 Standard Precautions are so important because we do not know who is carrying a virus that could threaten your health. Human Immunodeficiency Virus (HIV) Causes AIDS Attacks the immune system/initial symptoms are flu-like According to the CDC an estimated 44,073 new cases in 2014

35 Hepatitis B Virus (HBV) Vaccine is Available Attacks the liver-causes cirrhosis, liver cancer, death Creates a carrier state without symptoms, but infectious less than 2% of the population is chronically infected, injection drug abuse and unprotected sex are the primary methods of transmission Hepatitis C Virus (HCV) No Vaccine Available Attacks the liver causing cirrhosis, liver cancer, death Symptoms may be absent or mild/creates a carrier state Contact with the blood of an infected person, primarily through sharing contaminated needles to inject drugs.

36 Liquid or semi-liquid blood or other potentially infectious materials (PIMs) Contaminated items that are dripping or saturated with PIM that would be released if compressed Sharps and items that could cut if broken Pathological and microbiological waste containing blood or PIM

37 Safe injection practices are not optional! They are a basic expectation anywhere injections are administered. It may be hard to believe, but over the last decade, syringe reuse and misuse of medication vials have resulted in dozens of outbreaks and the need to alert over 100,000 patients to seek testing for blood borne pathogens such as Hepatitis B virus, Hepatitis C virus and HIV.

38 Needles and syringes are single use devices. They should not be used for more than one patient or reused to draw up additional medication. Do not administer meds from a single dose vial or IV bag to multiple patients. Limit the use of multi-dose vials and dedicate them to a single patient whenever possible. Additional resources can be found at

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40 Notify employee health ext: 5368 Flush mucous membranes with water! Avoid bleach and other caustic agents!! Do not squeeze site Do not apply antiseptics or disinfectants Will cause an increased immune response and White Blood Cells will come rushing to the area

41 Hep B 30% risk to unvaccinated Health Care Workers Hep C 1.8% risk HIV.3% risk from needle stick.1% risk from eye, nose, or mouth exposure.1% risk from exposure to non-intact skin

42 Hep B Will get first shot in vaccination series if you are unvaccinated. Hep C There is no prophylaxis! HIV Counseled as to whether treatment should be started or not. Meet with employee health or an ID doc to speak about the risk.

43 What is TB? TB is an infectious disease which spreads through the air from person to person by droplets. These droplets are expelled from the lungs of a person with active TB disease through coughing, shouting, singing, speaking, or sneezing and are then inhaled into the lungs of another person. If the infection is not treated, it can become active and affect the liver, skin, bone, and other organs of the body. The presence of bacteria can be detected by tuberculin skin test (TST) called a Mantoux test using PPD

44 Important to recognize signs and symptoms so that we can get patients on isolation as soon as possible. Call infection prevention team!! Signs and Symptoms Bad cough that lasts longer than 2-3 weeks Pain in chest Coughing up blood Weakness or fatigue No appetite Chills Fever Night sweats

45 Latent TB No signs or symptoms Bacteria are inactive Person does not feel sick Usually will have a positive skin test reaction Can develop TB disease later in life unless preventive medication is given Not contagious Active TB Bacteria become active Will have signs and symptoms Will need to take medication Will have a positive chest X-ray if pulmonary source Will be contagious

46 Early ID of people at risk Early Isolation in a negative pressure isolation room Strict adherence to Airborne Isolation procedures Early 2 step PPD and sputum smears Early involvement of Public Health

47 Offers vaccines at no cost Open at 7:30am-3:30 pm every weekday Offers Hep B vaccine Offers flu vaccine 5-20% of population gets the flu 36,000 people die each year 200,000 people hospitalized each year for flu and flu related complications

48 Occupational Medicine/Employee Health Clinic 210 Williamson St ( Administrative Building) 1 st floor Hours 7:30 am to 3:30 pm ( no appt needed) Local pharmacy * Private physician * Local Health Dept/Clinics * * Please bring paperwork to Employee Health if you received the vaccine elsewhere. A Mandatory Declination form must be completed for employees who do not receive the flu vaccine!

49 Everyone six months and older should get the flu vaccine every year as recommended by the CDC An egg free version is available for people with severe allergic reactions

50 Questions??? You can always contact Infection Control at ext or 5150