Massage to support. Postnatal 11/11/2014. Infection Control 2013 in your Massage Practice. Monica Pasinato-Forchielli

Transcription

1 Massage to support World Pregnancy, Massage Conference Birth Presents: and Postnatal The Down for mother & Dirty and baby on World Sanitation Massage and Conference June Infection Control 2013 in your Massage Practice Monica Pasinato-Forchielli Infection Control for Regulated Health Professionals As a regulated health professional, you are accountable to providing safe and ethical care to the public in accordance with the standards of your profession. The guiding principles of Infection Control recommended by Health Canada will assist you in achieving best practices for your clinic and your clients. 1

2 Guiding Principles Know current infection control guidelines for your practice setting Advocating for best practices in infection control Assess risks and apply the appropriate infection control guidelines in your practice Adhere to current infection control programs Educating and modeling infection control practices for others Ensuring ongoing quality of infection control practices Monitoring changes to infection control practices (health alerts) and updating your practice accordingly Consider infection control in terms of the following: Your personal safety Prevention of spread of infection directly or indirectly between people Prevention of spread of infection by the tools or equipment you use Prevention of spread of infection by sources in your environment How infection spreads. SOURCE HOST 2

3 Routine Precautions Health Canada uses the term Routine Precautions to describe the system of infection prevention recommended in Canada to prevent transmission of infections in health care settings Routine Precautions Include: 1. Hand washing 2. The use of Personal Protective Equipment (PPE) 3. Appropriate handling of patient care equipment and soiled linen 4. The prevention of needle stick/sharp injuries 5. Environmental cleaning 6. Appropriate handling of waste 7. Taking care of yourself (i.e.. Immunization) Hand Washing When should you wash? What should you use to wash? How to wash your hands. 3

4 Personal Protective Equipment (PPE) Assess the need for Personal Protective Equipment Assess for additional (transmission based) Precautions Prevention Types of PPE Gloves Masks Eye protection Gowns, head covers, shoe coverings Proper Use of PPE PPE does not replace the need for proper hand washing PPE is used at all times where contact with blood and body fluids of patients may occur. This includes performing patient procedures and clean up procedures. The use of PPE is intended to reduce the transmission of microorganisms to and from health care professionals PPE reduces but does not completely eliminate the risk of acquiring an infection. 4

5 Proper Use of PPE PPE is only effective when applied, used, removed and disposed of properly. Discard used PPE in appropriate disposal bags. Do not share PPE. Change PPE completely and thoroughly. Wash hands each time you leave a patient to attend to another patient or another duty. Contact Precautions - Gloves When should gloves be used? Proper usage of gloves. Droplet Precautions When should masks be used? Proper usage of masks. 5

6 Infection Control & Your Environment Be aware of your environment Consider your clinical setting Identify furnishings, items, tools or equipment used in practice Consider food, medications, handling of money, telephones, computers Determine the levels of cleaning & disinfecting required Consider types of waste and how it is handled Disposal of sharps & needles Environmental Surfaces When should they be cleaned/disinfected? How? Cleaning, Disinfection & Sterilization Defined Cleaning Disinfection Sterilization 6

7 Cleaning Cleaning: the physical removal of foreign material, i.e.) dust, soil, organic material such as blood, secretions, excretions and microorganisms. Cleaning physically removes rather than kills microorganisms. It is accomplished with water, detergents and mechanical action. Hard Surface Disinfection The inactivation of disease-producing microorganisms. A product that has proven to kill % of gram negative and gram positive bacteria and is registered with a governing body. Disinfectants are used on inanimate objects, antiseptics are used on living tissue. Disinfection usually involves chemicals, heat or ultraviolet light. Levels of chemical disinfection vary with the type of product used. Sterilization The destruction of all forms of microbial life including bacteria, viruses, spores and fungi. Items must be cleaned thoroughly before effective sterilization can take place. 7

8 Disinfectants approved by Health Canada Alcohol Sodium Hypochlorite & Chlorine Phenol Hydrogen Peroxide Iodine Quaternary Ammonia Naturally Derived Thymol Broad spectrum of efficacy: Bactericidal Fungicidal Virucidal Tuberculocidal Ideal for health care applications Highly toxic to human health 5 minute exposure limits (NIOSH) Contact dermatitis, conjunctivitis, mutagenicity Sodium Hypochlorite & Chlorine Very fast and effective Broad spectrum of efficacy: bacteria, fungi, viruses and protozoa Readily available & inexpensive Leading cause of occupational illness in CA. Inactivated by organic matter, heavy metals and ph >8.5 Corrosive & bleaching Skin and inhalation irritant Highly toxic 8

9 Phenolics Broad Spectrum of efficacy: bacteria, fungi, viruses, Tuberculocidal Stable Compatible with detergents Can be used as a combination product Slightly bacteriostatic residual Not effective against spores Cannot tolerate low temperatures Highly toxic EPA regulatory pressures Respiratory irritant Hydrogen Peroxide Fast acting Broad spectrum of efficacy Effective at low temperatures Low foam Environmentally responsible Health Care Limited stability Destabilized by metal Corrosive to soft metals; copper, brass, galvanized steel Hazardous: Chemical burns Bleaching Alcohols Broad Spectrum efficacy: bacteria, fungi, Tuberculocidal Inexpensive Good Antiseptic properties Flammable (Pilot Lights) Unstable Volatile 9

10 Quaternary Ammonia Broad Spectrum of Efficacy Non Corrosive Odorless, colorless Low irritant Low toxicity Stable at varying temperatures Efficacy varied and selective Slow against spores, viruses, gram negative and water borne bacteria Inactivated by hard water Inactivated by anionic detergents 2 nd leading cause of occupational illness Naturally Derived Thymol Broad spectrum of efficacy Food grade ingredient Lowest toxicity class IV No potable water rinse or wipe required No warning labels, no precautionary statements Ready to use formula s no concentrates Only available as an RTU No differentiation in scent Naturally Derived Thymol No warning labels or precautionary statements Benefits: Using the safest registered product on the market No bony hand, No skull and cross bones, No flaming can Health and safety for employees and customers 10

11 Naturally Derived Thymol Disinfectants One registered disinfectant at this time: Benefect Disinfectant Toxicity Concerns 10 = High 1 = Low Relative Scale: Environmental Concern 10 Relative Scale: Environmnetal Concern Chlorine = High 8 Chlorine 8 7 Chlorine Phenol 1 = Low Quaternary AmmoniaPhenol 5 Phenol Iodine Quaternary Ammonia 5 3 Quaternary Hydrogen Ammonia Peroxide 4 2 Iodine 4 1 Iodine Thymol Hydrogen Peroxide Hydrogen Peroxide Thymol Thymol Registered Active Ingredients Chlorine Phenol Chlorine Phenol Quaternary Ammonia Quaternary Ammonia Iodine Iodine Hydrogen Peroxide Hydrogen Peroxide Thymol Registered Active Ingredients Thymol 11

12 Table 3. Selecting Disinfectants Low level Disinfectants Intermediate Level Disinfectants High Level Disinfectants Sterilization Phenolics *careful, can be toxic to infants Quaternary Ammonium Compounds 3% Hydrogen peroxide Alcohols 60-90% Hypochlorites household bleach 1:100 dilution Iodines and Iodofphors Boiling for more than Exposure to steam at 20 minutes high temperature (autoclave) Ortho-phthaladehyde 10 hours for 20 Gas sterilization minutes (ethylene oxide) Hypochlorites household bleach (1:1000 diluted solution) Hypochlorites household bleach 1:50 dilution Hydrogen peroxide 6% for 5 minutes Hydrogen peroxide, high concentration for 30 minutes Dry Heat sterilization the lower the temperature the longer the time, high temperatures for shorter times An example of an has been provided Steps for Spills of blood and body substances Protect yourself using routing precautions gloves, masks & eye protectors may be necessary Clean the area of obvious organic material using disposable towels, dispose of in a plastic lined container Follow disinfection procedure Dispose of your PPE and wash hands immediately Dispose of waste in a plastic lined container Waste Management 12

13 Management of Needles & Sharps Collect and store used needles and sharps in sharps containers. Patients returning sharps to be disposed of should not be handled directly. Thank you! ex