Infection Prevention To navigate, click the Page Up or Page Down keys on your keyboard

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1 Infection Prevention To navigate, click the Page Up or Page Down keys on your keyboard

2 Welcome to Infection Prevention This course is intended to present a brief overview of various infection control topics. In order to pass this course and receive credit, you must achieve 80% or higher on the quiz.

3 Objectives After completing this course, Stakeholders will be able to: Identify the risks involved with exposure to infectious materials. Explain the purpose and importance of appropriate hand hygiene. Identify the aspects and components of environmental controls. Explain the purpose of standard precautions. Identify the different types of transmission-based precautions. Identify the different types of additional preventative measures used.

4 Table of Contents Hand Hygiene Environmental Control Personal Protective Equipment (PPE) Infection Precautions Influenza Tuberculosis Summary

5 Introduction All hospital employees must understand the risk of exposure to infectious materials at CTCA hospitals. This course gives only a brief overview of infection prevention issues. Transmissible infections are a major concern among healthcare workers. Transmissible Infections: Infections caused by germs or microorganisms that are highly contagious and easily spread from healthcare personnel. Healthcare Workers: All persons working in a hospital. Includes people both directly and indirectly involved in patient care.

6 Proper Hand Hygiene Wash hands with soap and water Before eating After using the bathroom When hands are visibly dirty visible blood or body fluids When in contact with blood or body fluids When hands have been in contact with spores Bacillus anthracis, C. difficile

7 Proper Hand Hygiene: How to Wash hands with Soap and Water Duration of scrubbing should last 20 seconds *Images provided by the World Health Organization (

8 When to Use an Alcohol-based Rub Foam or Gel before and after: Direct contact with patients Contact with equipment or any object within the patient s environment This includes doorknobs, bedrails, trays, TV remote, etc. Glove Rising Tide, Kft.

9 Proper Hand Hygiene: How to Use an Alcohol-based Rub Duration of scrubbing should last 20 seconds *Images provided by the World Health Organization (

10 Hand Hygiene Best Practices Artificial nails & nail products can harbor bacteria and fungus. Do not wear artificial nails if you do patient care. Do not wear artificial nails if you work in food service. Any open wound, cut or scrape must be covered and gloves must be worn. Use lotion provided to prevent chapped hands. Nurses should instruct all patients and caregivers on the importance of hand hygiene and proper techniques.

11 CTCA Safety House Rules Our goal is to create a culture in which everyone is responsible for patient safety and looking for opportunities to improve clinical quality and safety. CTCA Safety House Rules are those expectations that should never be broken. -Regardless of a patient, caregiver, fellow stakeholder or physician request Proper Hand hygiene is one of our CTCA Safety House Rules.

12 Hand Hygiene Compliance CTCA leadership and hospital administration view compliance with hand hygiene as the responsibility of everyone within our organization. It is an expectation of all Stakeholders to be engaged in the improvement of hand hygiene compliance and positive patient outcomes. If a coworker is observed not doing hand hygiene, please remind them to do so. Do not be offended if a patient, caregiver or stakeholder reminds you to complete hand hygiene. Thank them for looking out for YOUR safety.

13 Environmental Control Housekeeping is very important for maintaining a clean environment at CTCA, and for the elimination of potential germs. It is an essential step in keeping our patients and Stakeholders healthy, and safe from germs. Cleaning schedules vary according to: The area of the hospital. The type of surface to be cleaned. The type of soil that is present. Length of time needed for cleaning agents to dry.

14 Environmental Control The biohazard symbol is a universal symbol placed on any container or area that may contain regulated waste. Biohazard signs are usually red or orange and have the biohazard symbol within them. These signs are meant to immediately notify healthcare workers of the presence of potentially infectious materials.

15 Minimize Risk Wear gloves and other appropriate protective equipment (PPE).

16 Minimize Risk Personal Protective Equipment (PPE): Specialized clothing and equipment that provides protection against contact with blood or other potentially infectious materials. PPE may include: Gloves Medical Gowns Medical Masks Eye Goggles PPE is meant to protect the hands, face and body and should always be checked to make sure it is not damaged or worn. In work areas where exposure is likely; do not eat, drink, or put objects into your mouth. You should also avoid putting on cosmetics, lip balm or contact lenses.

17 Minimize Respiratory Protection By law, all Stakeholders entering an airborne isolation room must wear a fitted respirator. Regular masks do not adequately protect workers from tuberculosis. A N95 respirator fit-tested for the employee, or a hood must be worn when entering the patient s room.

18 Precautions There are two levels of precautions in hospitals, Standard Precautions and Transmission Based Precautions. Standard Precautions apply to blood, all body fluids, secretions and excretions except sweat, non-intact skin and mucous membranes. They involve treating all blood and other potentially infectious material as if they are infected.

19 Precautions Standard Precautions apply to blood, all body fluids, non-intact skin, mucous membranes and secretions except sweat.

20 Transmission-Based Precautions Airborne: Precautions required for such diseases as: tuberculosis, measles, chickenpox or shingles. Gloves, gowns, N95 masks and Powered Air Purifying Respirators (PAPRs) should be worn when dealing with airborne precautions. Droplet: Precautions required for diseases such as meningitis, mumps or whooping cough. Gloves, gowns, and surgical masks should be used when dealing with droplet precautions. Contact: Precautions required for abscess or draining wounds, contact with drug resistant germs, or contact with lice. Gloves and gowns should be used when dealing with contact precautions.

21 Precautions In the event of any precautions, an isolation sign is posted at the door of the patient s room. Hospital staff must follow the instructions outlined on the sign. Staff should also assist visiting patient s family and friends in observing the required precautionary measures.

22 Vaccinations The Occupational Safety and Health Administration (OSHA) requires that a hepatitis B, tetanus and pertussis vaccine be available to all hospital employees who may be exposed to blood or other potentially infectious materials. The vaccines are: Offered at no charge Available through Occupational Health You may elect not to take these vaccines. The vaccinations will be available later should you change your mind. Additional vaccinations are available for other diseases such as measles, mumps, rubella, and varicella.

23 Influenza Signs and symptoms of seasonal influenza may include fever, chills, cough, sore throat, runny or stuffy nose, body aches, headache, dizziness, fatigue, nausea, vomiting, and diarrhea. A person is generally infectious from 1 day before symptoms occur to 7 days after symptoms begin.

24 Influenza The influenza virus usually causes minor illness; however, many patients will experience severe disease and sometimes death. Anyone with the following emergency warning signs needs urgent medical care promptly: Difficulty breathing or shortness of breath. Pain or pressure in the chest or abdomen. Sudden dizziness. Confusion. Severe or persistent vomiting. Flu-like symptoms improve but then return with fever and worsened cough.

25 Influenza Influenza viruses are transmitted by: Droplets of respiratory secretions created when an infected person coughs, sneezes, or talks. Touching the eyes, nose, or mouth after contact with an infectious patient, or surface that is contaminated with secretions. And by airborne transmission - small particle aerosols in the vicinity of the infectious individual.

26 Influenza Discourage visitors who are sick from visiting the patient, and instruct all visitors on proper hand-hygiene before they enter the patient s room. Stakeholders should stay at home while they are ill. Perform hand hygiene frequently, with soap and water or alcohol-based hand sanitizers. Avoid touching the eyes, nose, ears, and mouth. Implement respiratory hygiene and cough etiquette strategies when patients arrive with respiratory symptoms, provide them with instructions on respiratory hygiene, hand hygiene, and cough etiquette.

27 Influenza Additional influenza precautions include: Have tissues, hand sanitizer, and masks available in waiting areas. Place face masks on symptomatic patients when entering emergency rooms or when being moved from one area to another. Limit movement of patients from one area to another and move only when medically necessary. Use personal protective equipment or PPE. PPE is only effective if used throughout potential exposure periods and maintained properly, and functions properly. Vaccine experts recommend that everyone 6 months and older should get a flu vaccine each year.

28 Tuberculosis Tuberculosis (TB) continues to be a public health problem in the United States. TB is an airborne, infectious, communicable disease. The disease is spread when a person with untreated, active TB coughs, sneezes, laughs, talks, or sings and susceptible people inhale the airborne bacteria.

29 Risk factors include: Tuberculosis HIV/AIDS (human immunodeficiency virus and acquired immunodeficiency syndrome) and other immune-compromising diseases. Travel to and from areas with a high prevalence of TB such as the Middle East, Asia, Africa, the Caribbean, and Latin America. High risk areas of transmission such as nursing homes, prisons, and homeless shelters. Certain populations such as the very young, the very old, and economically suppressed. Close contact with individuals known to have infectious TB Alcoholics and IV drug users. Groups known to have a high incidence of tuberculosis include African Americans, Asians, Pacific Islanders, Native Americans, Alaska Natives, and Hispanics.

30 Tuberculosis Annual TB screening is conducted after the initial test preformed at hire. If you believe you have been exposed at work or outside of work, notify your supervisor and report to Occupational Health. Tell the healthcare provider when and where you believe you were exposed to a person with TB.

31 Tuberculosis Some symptoms of tuberculosis include: Loss of weight and appetite Feeling good in the morning but excessively tired in the evening The need to cough and clear the throat in the morning Possible elevated temperature in the evening Blood in the sputum

32 Tuberculosis As the disease progresses, the symptoms worsen and often include: Indigestion, abdominal pain, or vomiting Persistent cough lasting longer than three weeks Night sweats that are so extreme bedding is soaked Rapid weight loss and loss of strength

33 Tuberculosis Completed drug therapy is essential. Treatment may last for 6-9 months and include several drugs. People hospitalized with suspected TB should be placed in airborne isolation precautions that include a negative pressure ventilated private room with the door kept closed. All people entering the room should wear a personal respirator (N95 respirator mask) and wash their hands upon entering and leaving the room. Fit testing for selective respiratory equipment, such as the N-95 mask, is mandatory yearly and must adhere to OSHA guidelines for use and testing.

34 Tuberculosis Transporting patients with suspected or confirmed TB should be avoided unless medically necessary. However, when necessary, they should wear a surgical mask while out of the negative pressure environment, and observe respiratory hygiene and cough etiquette.

35 Remember these key elements of Infection Prevention: Wash your hands frequently. Summary Use good workplace practices and follow Standard Precautions. Wear PPE and use respiratory protection as indicated. Receive the hepatitis B vaccination and other vaccinations when they are offered. Contact your supervisor immediately if you are exposed to blood or other potentially infectious materials.

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